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35 Cards in this Set
- Front
- Back
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what is the major inhibitory neurotransmitter in the CNS?
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GABA
gamma-aminobutyric acid |
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diazepam is the DOC in what 2 situations?
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1. status epilepticus
2. alcohol withdrawal |
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name the benzodiazepine antagonist. how does it work?
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flumazenil
competitive inhibitor of benzo's at the GABA(A) receptor |
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how do benzo's work?
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bind to receptors ADJACENT to GABA receptors; enhance GABA action of Cl- ion conductance
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what drug is indicated for generalized anxiety? what type of drug is it?
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buspirone
serotonin receptor agonist |
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how does buspirone work? how are its effects different from benzo's?
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partial agonist at serotonin (5-HT(1A)) receptors;
not a muscle relaxant and not an anti-convulsant |
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name 2 indications for barbiturate use, and the 2 specific barbiturates used.
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induction of anesthesia - thiopental
anticonvulsant - phenobarbital |
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how do barbiturates work?
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enhance action of GABA on Cl- entry into the cell; uses different receptor than benzo's
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when are barbiturates contra-indicated?
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pts with acute intermittent porphyria; barbiturates increased porphyrin synthesis
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what is the principal mxn of action for anti-psychotics?
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blocking of dopamine receptors in the CNS, especially the D2 receptors in the mesocortical and mesolimbal systems of the brain
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is haloperidol traditional or atypical antipsychotic?
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traditional
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name 4 indications for haloperidol.
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Tourette's syndrome
Huntington's disease PCP (phencyclidine) overdose infantile autism |
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what side effect is pronounced with haloperidol?
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extrapyramidal side effects
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what is akathisia?
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a movement disorder in which a person feels the need to move constantly
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what is dystonia?
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abnormal muscle tone - too rigid or insufficient tone
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what are extrapyramidal side effects?
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physical symptoms that include slurred speech, dystonia, akathisia, bradyphrenia, tremor
BAD TremorS Bradyphrenia Akathisia Dystonia Tremor Slurred speech |
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what are general side effects in traditional neuroleptics?
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1. extrapyramidal side effects
2. sedation 3. anticholinergic effects 4. alpha-adrenergic effects (hypotension) |
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name 2 high potency traditional antipsychotics.
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1. haloperidol
2. fluphenazine |
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what traditional anti-psychotic is a DOC for intractable hiccups?
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chlorpromazine
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what traditional anti-psychotic is a DOC for anti-pruritic therapy?
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promethazine
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what class of traditional antipsychotics are used for anti-emetic therapy?
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phenothiazines
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what type of schizophrenia sx are treated with traditional anti-psychotics?
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the positive sx: delusions, thought d/o, hallucinations
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neuroleptic malignant syndrome and tardive dyskinesia are also extrapyramidal side effects. how do they present? does TD occur at the onset of treatment?
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NMS: rigidity, altered mental status, cardiac arrhythmias, HTN, hyperpyrexia
TD: occurs 4mos to 1yr into therapy; rhythmic involuntary movements of tongue, lips, or jaw |
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what is the therapy for neuroleptic malignant syndrome?
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dantrolene, a muscle relaxant
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is there a treatment for tardive dyskinesia? what type of drug makes TD worse?
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no. it can improve after withdrawing the neuroleptic; anticholinergics make TD worse
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what is an acute dystonic reaction?
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prolonged muscle spasms of tongue, neck or face
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name 6 atypical antipsychotic drugs, both generic and brand name
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CROAQZ
Clozapine - Clozaril Risperidone - Risperdal Olanzapine - Zyprexa Aripiprazole - Abilify Quetiapine - Seroquel Ziprasidone - Geodon |
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how are atypicals different from 'typical' neuroleptics?
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in addition to blocking dopamine receptors, they also block serotonin (5-HT(2)) receptors
rarely associated with extrapyramidal side effects |
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what is clozapine (Clozaril) used for?
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treating schizophrenia that has been refractory to other neuroleptics; especially effective for NEGATIVE schizophrenia sx (blunted emotion, withdrawal, reduced ability to form relationships)
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what are some particular side effects when using clozapine (Clozaril)?
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- fewer extrapyramidal side effects than typicals
- seizures - agranulocytosis in 1% to 2% of pts (need lots of blood monitoring) - weight gain |
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which of the atypicals is a first-line agent in schizophrenia?
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risperidone (Risperdal) is effective for BOTH positive and negative sx of schizophrenia
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what is a particular cardiac side effect that may appear on the EKG when using risperidone?
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QT interval prolongation
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which of the atypicals can be used to treat depression and OCD?
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olanzapine (Zyprexa)
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which of the atypicals is the only one that is also a partial agonist of the D2 receptors?
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aripiprazole (Abilify)
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what drug is used to treat both infantile autism and Huntington's chorea?
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haloperidol
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