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Pharmacology > Drugs acting on the nervous system > Flashcards

Drugs acting on the nervous system Flashcards

1
Q

Sedative hypnotic anxiolytics - benzos
Name 2
MOA
something useful

A

alprazolam (Xanax) (-pams)
diazepam (Valium)
enhances effects of GABA
antidote is flumazenil

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2
Q

Atypical anxiolytics (nonbarbituate)
Name 1
MOA
something useful

A

buspirone (BuSpar)
binds to serotonin and domamine receptors
dependency is unlikely, no sedation

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3
Q

Selective Serotonin Reuptake Inhibitors (SSRI)
Name 3
MOA
something useful

A 
paroxetine (Paxil)
fluoxetine (Prozac)
sertraline (Zoloft)
inhibits serotonin reuptake
may take up to 4 weeks for effects, use for depression and anxiety, SE of sexual disfunction
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4
Q

Atypical antidepressants
Name 3
MOA
something useful

A 
bupropion (Wellbutrin)
venlaflaxine (Effexor)
duloxetine (Cymbalta)
likely inhibits dopamine uptake
for depression, no sexual dysfunction and aid to quit smoking (bupropion)
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5
Q

tricyclic antidepressants
Name 2
MOA
something useful

A

amitriptyline (Elavil)
imipramine (Tofranil)
block reuptake of NE and serotonin
anticholinergic effects

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6
Q

anticholinergic effects:

A

can’t see, can’t spit, can’t pee, can’t sh*t

(blurred vision, dry mouth, urinary retention, constipation

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7
Q

Monoamine oxydase inhibitors (MAOIs)
Name 4
MOA
something useful

A

phenelzine (Nardil)
isocarboxazid (Marplan)
tranylcypromine (Parnate)
selegiline (Emsam) patch
block MAO, thereby increasing NE, serotonin, DA
for depression
avoid tyramine (hypertensive crisis), and most other drugs

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8
Q

major meds for anxiety disorders (3 categories)

A

benzos such as diazepam
atypical anxiolytics such as buspirone
some antidepressants such as paroxetine, sertraline (SSRIs), venlafaxine (SNRI)

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9
Q

meds used less often for anxiety (4 categories)

A

TCAs such as amitriptyline, clomipramine
antihistamines such as hydroxyzine
beta blockers such as propranolol
anticonvulsants such as gabapentin

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10
Q

4 classes of antidepressant meds

A

SSRIs, atypical antidepressants, TCAs, MAOIs

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11
Q

main bipolar med

A

mood stabilizer - lithium

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12
Q

additional classes used to treat bipolar disorder (4 categories)

A

AEDs such as valproate, carbamazapine, lamotrigine
atypical antipsychotics
anxiolytics such as clonazepam, lorazepam
antidepressants such as bupropion, sertraline

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13
Q

mood stabilizer
Name 1
MOA
something useful

A

lithium
produces neurochemical changes in the brain, including serotonin receptor blockade
therapeutic level 0.6-1.4 mEq/L

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14
Q

mood stabilizing anti epileptic drugs (AEDs)
Name 3
MOA
something useful

A

carbamazapine (Tegretol)
valproic acid (Depakote)
lamotrigine (Lamictal)
slow entrance of Na and Ca back into neuron, enhances GABA, inhibits glutamate (suppressing CNS excitation)
rash (Steven Johnson syndrome) in carba and lamo

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15
Q

Positive symptoms related to schizophrenia

A

related to thought, behavior, and speech (agitation, delusions, hallucinations, tangential speech patterns)

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16
Q

Negative symptoms related to schizophrenia

A

social withdrawal, lack of emotion, lack of energy, flattened affect, decreased motivation, decreased pleasure in activities

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17
Q

first generation (conventional) antipsychotic meds control

A

mainly positive symptoms such as bizarre behavior

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18
Q

second generation (atypical) antipsychotic meds are for (5)

A 
clients receiving initial treatment and for treating breakthrough episodes
both positive and negative symptoms
less EPS including TD
less anticholinergic effects
less relapse
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19
Q

antipsychotics - first generation (conventional)
Name 2
MOA
something useful

A

chlorpromazine (Thorazine)
haloperidol (Haldol)
block D2, Ach, histamine, and NE receptors in brain and periphery
AEs of EPS:
dystonia, parkinsonism, akathisia, TD
also neuroleptic malignant syndrome: high fever, BP fluctuations, muscle rigidity, change in LOC
and anticholinergic effects

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20
Q

antipsychotics - second generation (atypical)
Name 3
MOA
something useful

A

risperidone (Risperdal)
clozapine (Clozaril)
aripiprazole (Abilify)
mainly block serotonin and to lesser degree, DA
also block NE, histamine, ACh
less EPS side effects and treats negative and positive symptoms

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21
Q

meds used to treat behavioral disorders in children (5 categories)

A

TCAs, antipsychotics, nonbarbituate anxiolytics, CNS stimulants, NSRIs

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22
Q

CNS stimulants used in children/adolescents
Name 2
MOA
something useful

A

methylphenidate (Ritalin)
amphetamine mixture (Adderall)
raise levels of NE, serotonin, and DA in the CNS
used for ADHD and narcolepsy, have substance abuse potential

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23
Q

Norepinephrine selective reuptake inhibitor used for ADHD
Name 1
MOA
something useful

A

atomoxetine (Strattera)
block reuptake of NE
not a stimulant, minimal SE

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24
Q

alpha2 adrenergic agonists (2) used for ADHD in children and possible MOA

A

guanfacine (Intuniv)
clonidine (Kapvay)
may active presynaptic alpha2 receptors in the brain

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25
Q

meds to detox from alcohol

A

benzos such as chlordiazepoxide, diazepam, lorazepam

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26
Q

used to decrease seizures in alcohol detox

A

carbamazapine

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27
Q

decreases alcohol cravings during detox

A

propranolol

28
Q

maintenance drugs after alcohol detox

A

disulfiram (Antabuse- can’t abuse [makes you sick if you drink])
naltrexone - reduces cravings
acamprosate - reduces anxiety

29
Q

meds to support opioid withdrawal

A

methadone substitution
clonidine - diarrhea, nausea and vomiting
buprenorphine - decreases cravings, helps maintenance

30
Q

meds to support nicotine withdrawal

A

bupropion - reduces craving

verenicline - promotes release of dopamine for pleasurable effects

31
Q

cholinesterase inhibitors
Name 2
MOA
something useful

A

neostigmine (Prostigmin)
pyridostigmine (Mestinon)
prevent cholinesterase from inactivating ACh
antidote is atropine
neostigmine reverses neuromuscular blocking agents and treats myasthenia gravis

32
Q 
anti parkinson's meds:
dopamine synthesis and DA agonist
Name 2
MOA
something useful
A

levodopa/carbidopa (Sinemet-combo)
levodopa - crosses BBB synthesizes DA
carbidopa - augments levodopa by decreasing amount of DA in intestine and periphery (more in CNS)
relieve dyskinesias and improve ADLs

33
Q

anti parkinson’s meds:
DA agonists
Name 2
MOA

A

pramipexole (Mirapex)
bromocriptine (Parlodel)
activate DA receptors

34
Q

anti parkinson’s meds:
dopamine releaser
Name 1
MOA

A

amantadine (Symmetrel)

prevents DA reuptake

35
Q

anti parkinson’s meds:
Catecholamine-O-methyltransferase (COMT) inhibitors
Name 2
MOA

A

entacapone (Comtan)
tolcapone (Tasmar)
enhance the effect of levodopa by blocking its breakdown

36
Q

Traditional anti epileptic drugs

Name 4

A

barbituate: phenobarbital (Luminal)
hydantoin: phenytoin (Dilantin)
carbamazapine (Tegretol)
valproic acid (Depakote)

37
Q

Newer AEDs

Name 4

A

lamotrigine (Lamictal)
topiramate (Topamax)
gabapentin (Neurontin)
pregabalin (Lyrica)

38
Q

benzos used as AEDs

Name 2

A

diazepam (Valium)

lorazepam (Ativan)

39
Q

beta adrenergic blockers for eye disorders
Name 1
MOA
something useful

A

timolol (Timoptic)
decrease IOP by reducing aqueous humor
systemic affects of beta block could occur

40
Q

alpha adrenergic blockers for eye disorders
Name 2
MOA

A

brimonidine (Alphagan)
apraclonidine (Iopidine)
decreases production of aqueous humor

41
Q

neuromuscular blocking agents
Name 2
MOA
something useful

A

depolarizing: succinylcholine (Anectine)
nondep: pancuronium (antdote - neostigmine)
block ACh at neuromuscular junction, resulting in relaxation, paralysis w/out loss of consciousness
could cause malignant hyperthermia- use dantrolene

42
Q

muscle relaxants and antispasmodics- centrally acting
Name 2
MOA
something useful

A

diazepam (Valium)
baclofen (Lioresal)
enhances GABA depressing spasticity
AE- CNS depression

43
Q

muscle relaxants and antispasmodics- peripherally acting
Name 1
MOA
something useful

A

dantrolene (Dantrium)
acts directly on muscles by preventing release of Ca (inhibits muscle contraction)
AE- CNS depression

44
Q

muscarinic agonists related to bladder
Name 1
MOA
something useful

A

bethanechol (Urecholine)
relaxes trigone and sphincter muscles and contraction of detrusor muscle
go pee

45
Q

muscarinic antagonists related to bladder
Name 2
MOA
something useful

A

oxybutynin (Ditropan)
darifenacin (Enablex)
inhibits receptors of detrusor muscle, prevents contraction and urge to void
for overactive bladder, anticholinergic effects

46
Q

sedatives and CNS depressants are used

A

to induce a sense of calm and decrease anxiety

47
Q

hypnotics are

A

CNS depressants that induce sleep

48
Q

3 types of sedative-hypnotics

A

benzos, barbs, and benzo-like meds

49
Q

benzodiazepines
Name 3
MOA
something useful

A 
triazolam (Hacion)
alprazolam (Xanax)
midazolam (Versed)
enhance action of GABA in the CNS
for anxiety, seizures, insomnia, induction of anesthesia, and more, risk of tolerance
50
Q

nonbenzodiazepines
Name 3
MOA
something useful

A 
zolpidem (Ambien)
zaleplon (Sonata)
eszopiclone (Lunesta)
enhance GABA, increasing sleep duration and decreased awakenings
low risk of tolerance
51
Q

melatonin agonist used for sleep
Name 1
MOA
something useful

A

ramelteon (Rozerem)
activates melatonin receptors
for insomnia

52
Q

IV anesthetics
nonopiod agents
barbituate

A

pentobarbitol (Nembutal)

53
Q

Use for IV anesthetics

A

produce loss of consciousness and eliminate response to painful stimuli

54
Q

IV anesthetics
nonopioid agents
benzodiazepines 2

A

midazolam, diazepam

55
Q

IV anesthetics
nonopioid agents
others 2

A

propofol, ketamine

56
Q

IV anesthetics

opioid agents 2

A

fentanyl (Sublimaze)

alfentanil (Alfenta)

57
Q

opioid (narcotic agonists)
Name 6
MOA
something useful

A 
morphine (Roxanol)
hydromorphone (Dilaudid)
codeine
meperidine (Demerol)
oxycodone (OxyContin)
tramadol (Ultram)
react w/ opioid receptors throughout the body to cause analgesia, sedation, or euphoria
commonly used drugs, are controlled substances
58
Q

narcotic (opioid) antagonist
Name 2
MOA
something useful

A

naloxone (Narcan)
naltrexone (ReVia)
bind to opioid receptors but do not activate them
naloxone - antidote for opioid overdose
naltrexone - adjunct treatment for alcohol or opioid dependence

59
Q

antimigraine ergot derivative

A

ergotamine

60
Q

antimigraine triptans

A

sumatriptan (Imitrex) all end in triptan

61
Q

barbiturates
Name 2
MOA
something useful

A

phenobarbital (Luminal)
secobarbital (Seconal)
inhibit conduction in RAS, depress cerebral cortex, depress motor output
higher SE and addictive

62
Q

anticholinergic adjuncts for parkinsonism
Name 2
MOA

A

benztropine (Cogentin)
diphenhydramine (Benadryl)
treatment of drug induced Parkinsonism

63
Q

cholinesterase inhibitors that are used for dementia 3

A

donepezil (Aricept)
rivastigmine (Exelon)
galantamine (Razadyne)

64
Q

drug that antagonizes the receptors that are thought to be overactive in dementia (NMDA receptor antagonist)

A

menantine (Namenda)

65
Q

can be used to treat drug induced dystonias

A

antihistamines such as diphenhydramine

Pharmacology (3 decks)

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