Flashcards in Neurology Drug List Deck (60)
Typical D2 Antagonists
Chlorpromazine and Haloperidol
Haloperidol and the "azines"
Chlopromazine Side Effects (SE)
Dry mouth (antimuscarinic), orthostatic hypotension (a1 antagonist), and sedation (antimuscarinic and antihistamine). Low potency, but also weight gain and increased risk for diabetes.
Halperidol Side Effects (SE)
Extrapyramidal side effects (DA blockade), can cause tardive dyskinesias. Used to tx CNS stimulant psychosis.
Atypical D2/5HT Antagonists
Clozapine, Quetiapine, Olanpazine, Risperidone, Aripipazole. All cause weight gain.
Agranulocytosis. Neuroleptic Malignancy. For pts who are refractive to other drugs.
Wt gain and Diabetes; decrease EPS
Fluoxetine, Paroxetine, Escitralopam, Setraline, and Citalopram. Wide interpatient variations; wt gain, sexual dysfunction, cognitive blunting, and withdrawal sx.
Fluoxetine and Paroxetine
blocks serotonin transporter and P450 inhibitor. Withdrawal sx.
Sedation, and potential for seizures at high doses. At high dose causes anxiety.
SNRIs. SE: HTN and anxiety, rapid withdrawal.
TCADs (Drugs and Uses)
Declining use; 2nd line agaents, antimuscarinic side effects, CV and seizures in overdose.
TCADs; 2nd line agents for depression, has antimuscarinic SE. CV problems and seizures in overdose. Also has a sedative action.
SE: postural hypotension, seizure, shock, hyperthermia in overdose, hypertensive crisis with foods high in tyramine, +SSRIs --> serotonin syndrome.
Lithium Carbonate*, Carpamazepine, Valproate, Olanzapine, Fluoxetine
Interference with PIP recycling. Enhance 5HT action/ decrease NE and DA effect. Use dependent (greatest activity in most active cells); narrow therapeutic index. Diuretics and NSAIDs will increase lithium levels. Can also cuase hypothyroidism, poluuria, and polydipsia.
BDZs, Non-BDZ BDZ Agonists, Barbiturates, Melatonin Receptor Antagonist, Other (Diphenhydramine)
"Lams and Pams"; sedative (a1) and anxiolysis (a2/a5); need much greater dosage increments to achieve CNS depression, increase margin of safety than compared to BARBs.
BDZ receptor antagonists; used in BDZ overdose to relieve CNS depression.
Non-BDZ BDZ Agonists
Zolpidem, Eszopiclone, Zalepon, "Zzz drugs", only acts on a1 GABA receptors.
"Ambien"; mild side effects and no hangover. Decrease sleep latency and nocturnal awakenings.
Longer half life than zolpedam; next day psychomotor impairment with higher doses (FDA requires lower dose for initiation); used for sleep maintenance.
Dizziness, HA, and somnolence. Decrease time for sleep onset.
Phenobarbital.Anticonvulsant effects without severe sedation or effects on mental or motor activity.
Anticonvulsant effects without severe sedation or effects on mental or motor activity.
rapid po; acute management of anxiety