Neuro Drugs!!

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tonic clonic seizure first choice

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phenytoin (Na channel inactivation) (also first line prophylaxis for generalized status epilipticus)

cabamazepine. same mechanism, also firstline for trigeminal neuralgia

valproic acid. increase Na channel inactivation, increase GABA concentration (also used for absence seizures and myoclonic seizures)

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first line for prophylaxis of status elipticus?

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phenytoin (Na channel inactivation) (also first line prophylaxis for generalized status epilipticus)

Front 3

first line for trigeminal neuralgia

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cabamazepine.inactivates Na channels, also firstline for tonic clonic seizure along with phenytoin

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first line for absence seizures

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ethosuximide, only use. blocks thalamic T type Ca channels.

can also use valproic acid, not first line, but also does tonic clonic seizures (first line along with carbamazepine, phenytoin). Na channel inactivation and increase GABA activity

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Na channel inactivation and increase GABA activity

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valproic acid. thus used for first line tonic clonic seizures AND absence seizures, and myoclonic seizures

Front 6

first line in pregnant women/children

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phenobarbital (the drug of choice for abuse for housewives). increase GABA-A action by increasing duration of Cl channel opening)

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potentiate GABA-A via increase duration of Cl channel opening? via increase frequency of Cl channel opening

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barbs. benzo's.

Front 8

used for seizures of eclampsia

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benzos. first line prophylaxis for this is MgSO4

Front 9

used only for partial seizures

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Tiagabine, vigabatrin.
Tigabine: inhibs GABA reuptake.
vigabatrin: inhibs GABA transaminase, thus increasing GABA

Front 10

inhibs GABA transaminase, thus increasing GABA

Back 10

vigabatrin. partial seizures only

Front 11

inhibs GABA reuptake.

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tiagabine. partial seizures only.

Front 12

blocks T type Ca channels

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ethosuximide. first line for absence seizures, no other use

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first line for acute status epilipticus

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benzo. potentiate GABA action by increasing frequency of Cl channel opening. also for seizures of eclampsia (MgSO4 is prophylaxis). these are its only seizures uses.

Front 14

used for peripheral neuropathy and also seizures

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Gabapentin. designed as GABA analog but primarily inhibs HVA Ca channels. also used for bipolar disorder

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epilipsy drug that can be used for bipolar disorder

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Gabapentin. designed as GABA analog but mostly inhibs HVA Ca channels. also used for:
peripheral neuropathy.
tonic clonic and partial seizures.
bipolar disorder

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block Na channels and increase GABA action

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topiramate. for partial seizures and tonic clonic.

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myoclonic seizures

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valproic acid

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blocks voltage gated Na channels

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Lamotrigine, used for partial and tonic clonic seizures.

Front 19

venlafaxine

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SNRI.
use: depression, and GAD
tox: increase BP so monitor!!.
stimulant effects
sedation
nausea

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Duloxetine

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SNRI
use: depression, and diabetic periph neuropaty.
tox: increase BP so monitor!!.
stimulant effects
sedation
nausea

has greater effect on NE than venlaxafine

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phenelzine

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MAOI
nonselective. increase levels of dopa, NE, serotonin
use: atypical depression, anxiety, hypochondriasis
tox: HTN crisis if eat with tyramine (cheese, wine, etc) and beta-agonists

contraind w/ SSRI or meperidine (fast acting opiod analgesic) to prevent serotonin syndrome

Front 22

tranylcypromine

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MAOI
nonselective. increase levels of dopa, NE, serotonin
use: atypical depression, anxiety, hypochondriasis
tox: HTN crisis if eat with tyramine (cheese, wine, etc) and beta-agonists

contraind w/ SSRI or meperidine (fast acting opiod analgesic) to prevent serotonin syndrome

Front 23

isocarboxazid

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MAOI
nonselective. increase levels of dopa, NE, serotonin
use: atypical depression, anxiety, hypochondriasis
tox: HTN crisis if eat with tyramine (cheese, wine, etc) and beta-agonists

contraind w/ SSRI or meperidine (fast acting opiod analgesic) to prevent serotonin syndrome

Front 24

isocarboxazid

Back 24

MAOI
nonselective. increase levels of dopa, NE, serotonin
use: atypical depression, anxiety, hypochondriasis
tox: HTN crisis if eat with tyramine (cheese, wine, etc) and beta-agonists

contraind w/ SSRI or meperidine (fast acting opiod analgesic) to prevent serotonin syndrome

Front 25

selegiline

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MAOI
selective for MAO-B. metabolizes dopa normally.
use: atypical depression, anxiety, hypochondriasis
tox: HTN crisis if eat with tyramine (cheese, wine, etc) and beta-agonists

contraind w/ SSRI or meperidine (fast acting opiod analgesic) to prevent serotonin syndrome

Front 26

which MAOI is selective for MAO B

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selegiline

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which SNRI has greater effect on NE

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vduloxetine

Front 28

treatment of atypical depression?

Back 28

MAOI

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Bupropion

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atypical antidepressant
also smoking cessation.
increase NE and dopa via ? mech
tox:
1.stimulant effects (tachy, insomnia),
2. headache
3. seizure in bulimic pts
NO SEXUAL SIDE EFFECTS YAY

Front 30

which antidep has no sexual side effects

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Bupropion (atypical antidep)

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which antidep not for bulimic patients

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Bupropion, seizures in bulemics (atypical antidep)

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Mirtazapine

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Atypical antidep.

alpha-2 antag (increases release of NE and serotonin), and potent 5HT2 and 5HT3 receptor antag

tox: sedation, hunger, weight gain, dry mouth

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Maprotiline

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atypical anti dep

blocks NE reuptake.
tox: sedation, orthostatic hypotension

Front 34

trazodone

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atypical antidep

inhibs serotonin reuptake
use: insomnia, high dose for antidep
tox:
1. sedation
2. nausea
3. pripism
4. postural hypotension

Trazadone = TrazaBONE

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priapism and antidep

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Trazadone

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fluoxetine

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SSRI

use: depression, OCD, bulimia, social phobias

tox:
1. GI distress
2. sexual dysfunction (anorgasmia)
3. "serotonin syndrome" w/ MAOI etc (hyperthermia, muscle rigidity, CARDIOVASCULAR COLLAPSE, flushing, diarrhea, SEIZURES)

tx: cyproheptadine (5HT-2 receptor antagonist

Front 37

Paroxetine

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SSRI

use: depression, OCD, bulimia, social phobias

tox:
1. GI distress
2. sexual dysfunction (anorgasmia)
3. "serotonin syndrome" w/ MAOI etc (hyperthermia, muscle rigidity, CARDIOVASCULAR COLLAPSE, flushing, diarrhea, SEIZURES)

tx: cyproheptadine (5HT-2 receptor antagonist

Front 38

sertraline

Back 38

SSRI

use: depression, OCD, bulimia, social phobias

tox:
1. GI distress
2. sexual dysfunction (anorgasmia)
3. "serotonin syndrome" w/ MAOI etc (hyperthermia, muscle rigidity, CARDIOVASCULAR COLLAPSE, flushing, diarrhea, SEIZURES)

tx: cyproheptadine (5HT-2 receptor antagonist

Front 39

citalopram

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SSRI

use: depression, OCD, bulimia, social phobias

tox:
1. GI distress
2. sexual dysfunction (anorgasmia)
3. "serotonin syndrome" w/ MAOI etc (hyperthermia, muscle rigidity, CARDIOVASCULAR COLLAPSE, flushing, diarrhea, SEIZURES)

tx: cyproheptadine (5HT-2 receptor antagonist

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imipramine

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TCA

block reuptake of NE and serotonin

use: major depression
bedwetting (imipramine only)
fibromyalgia

sides:
1. sedation
2. alpha-blocking
3. atropine like anticholinergic (tachy, urinary retention)

tox: Tri C's: Convulsion, Coma, Cardiotox (arrythmias)
resp depression
hyperpyrexia
confusion and hallucinations in ELDERLY via anticholinergic (use nortriptyline instead, less anticholinergic b/c 2nd gen)

tx: NaHCO3 for cardiovasc tox

Front 41

amitriptyline

Back 41

TCA

block reuptake of NE and serotonin

use: major depression
fibromyalgia

sides:
1. sedation
2. alpha-blocking
3. atropine like anticholinergic (tachy, urinary retention)

tox: Tri C's: Convulsion, Coma, Cardiotox (arrythmias)
resp depression
hyperpyrexia
confusion and hallucinations in ELDERLY via anticholinergic (use nortriptyline instead, less anticholinergic b/c 2nd gen, amitriptyline 3rd gen)

tx: NaHCO3 for cardiovasc tox

Front 42

desipramine

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TCA

block reuptake of NE and serotonin

use: major depression
fibromyalgia

LEAST SEDATING TCA but also LOWER SEIZURE THRESHOLD

sides:
1. sedation
2. alpha-blocking
3. atropine like anticholinergic (tachy, urinary retention)

tox: Tri C's: Convulsion, Coma, Cardiotox (arrythmias)
resp depression
hyperpyrexia
confusion and hallucinations in ELDERLY via anticholinergic (use nortriptyline instead, less anticholinergic b/c 2nd gen)

tx: NaHCO3 for cardiovasc tox

Front 43

nortriptyline

Back 43

TCA

block reuptake of NE and serotonin

use: major depression
fibromyalgia

sides:
1. sedation
2. alpha-blocking
3. atropine like anticholinergic (tachy, urinary retention)

tox: Tri C's: Convulsion, Coma, Cardiotox (arrythmias)
resp depression
hyperpyrexia
confusion and hallucinations in ELDERLY via anticholinergic (USE THIS TCA, less anticholinergic b/c 2nd gen)

tx: NaHCO3 for cardiovasc tox

Front 44

clomipramine

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TCA

block reuptake of NE and serotonin

use: major depression
fibromyalgia
OCD (clomipramine ONLY)

sides:
1. sedation
2. alpha-blocking
3. atropine like anticholinergic (tachy, urinary retention)

tox: Tri C's: Convulsion, Coma, Cardiotox (arrythmias)
resp depression
hyperpyrexia
confusion and hallucinations in ELDERLY via anticholinergic (use nortriptyline instead, less anticholinergic b/c 2nd gen)

tx: NaHCO3 for cardiovasc tox

Front 45

doxepin

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TCA

block reuptake of NE and serotonin

use: major depression
fibromyalgia

sides:
1. sedation
2. alpha-blocking
3. atropine like anticholinergic (tachy, urinary retention)

tox: Tri C's: Convulsion, Coma, Cardiotox (arrythmias)
resp depression
hyperpyrexia
confusion and hallucinations in ELDERLY via anticholinergic (use nortriptyline instead, less anticholinergic b/c 2nd gen)

tx: NaHCO3 for cardiovasc tox

Front 46

amoxapine

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TCA

block reuptake of NE and serotonin

use: major depression
fibromyalgia

sides:
1. sedation
2. alpha-blocking
3. atropine like anticholinergic (tachy, urinary retention)

tox: Tri C's: Convulsion, Coma, Cardiotox (arrythmias)
resp depression
hyperpyrexia
confusion and hallucinations in ELDERLY via anticholinergic (use nortriptyline instead, less anticholinergic b/c 2nd gen)

tx: NaHCO3 for cardiovasc tox

Front 47

Tx for bedwetting

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imipramine (TCA)

Front 48

Tx for OCD

Back 48

clomipramine (TCA)
SSRI's (fluoxetine, paroxetine, sertraline, citalopram)

Front 49

Buspirone

Back 49

stimulates 5Ht1A receptors
use: GAD
DOESN'T CAUSE SEDATION, ADDICTION OR TOLERANCE, NO INTERACTION WITH ALCOHOL (like benzo's and barbs)

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GAD

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buspirone (stimulates 5Ht1A receptors)
venlafaxine (SNRI)

Front 51

hypochondriasis tx

Back 51

MAOI

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Haloperidol

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typical antipsych

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trifluoperazine

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typical antipsych p 451

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fluphenazine

Back 54

typical antipsych p 451

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thioridazine

Back 55

typical antipsych p 451

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chlorpromazine

Back 56

typical antipsych p 451

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neurleptic malignant syndrome:

Back 57

typical antipsychs

haloperidol + azine's (trifluoperazine, flluphenazine, thioridazine, chlorpromazine)

rigidity, myoglobinuria, autonimic instability, hyperpyrexia

Tx dantrolene, or agonists (bromocriptine)

Front 58

dantrolene

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tx for neurleptic malignant syndrome from typical antipsychs (haloperidol + azine's: trifluoperazine, fluphenazine, thioridazine, chlorpromazine)

Front 59

tardive dyskinesia

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stereotypical oral-facial movemetnts due to long term typical antipsych use. often irreversible

part of extrapyramidal side effects:
4 h acute dystonia
4 d akinesia (parkinsonian)
4 wk akathisia (restless)
4 mo tardive dyskinesia

MUST STOP USE B/F HERE B/C OFTEN IRREVERSIBLE

Front 60

schizo imbalance

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increased dopa

Front 61

olanzapine

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atypical antipsych

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clozapine

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atypical antipsych

Front 63

atypical antipsych for OCD:

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olanzapine

also for depression, mania tourette's

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quetiapine

Back 64

atypical antipsych

Front 65

resperidone

Back 65

atypical antipsych

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aripiprazole

Back 66

atypical antipych

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ziprasidone

Back 67

atypical antipsych

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tourette's

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olanzapine (atypical antipsych) but 1st is typical antipsych (haloperidol)

Front 69

SIADH

Back 69

can use lithium! one of it's side effects is nephrogenic diabetes

Front 70

methylphenidate

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ritalin (inreases presynaptic NE vesicle release)

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PTSD

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SSRI

Front 72

social phobias

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SSRIs

Front 73

depression w/ insomnia

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mirtazapine

Front 74

OCD

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SSRI
Clomipramine (TCA)

Front 75

alcohol withdrawal

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benzo

Front 76

anorexia/bulemia

Back 76

SSRI

Front 77

anxiety

Back 77

benzo
buspirone
SSRI

Front 78

atypical depression

Back 78

MAOI
SSRI

Front 79

bipolar disorder

Back 79

mood stabilizers:
lithium, valproic acid
carbamazepine

Front 80

depression

Back 80

atypical antipsychs
ssri
snri
TCA

Front 81

panic disorder

Back 81

SSRI
TCA
Benzo

Front 82

cluster headaches

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sumatriptan p 433

Front 83

donepezil
galantamine
rivastigmine

Back 83

alzheimer's (ACH esterase inhibs)

Front 84

pergolide

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parkinson's (ergot alkaloid and partial dopa agonist)

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pramipexole

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parkinson's (non ergot)

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ropinirole

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parkinson's (non egot)

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benzos: short, medium, long acting

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short: TAO (Triazolam, alprazolam, oxazepam)

medium: LET (Lorazepam, Estazolem, Temazepam)

Long: F CDC (Flurazepam, Chlordiazepoxide, Diazepam, Clorazepate)

long acting have less abuse potential, but cause more severe ataxia/drowsiness symptoms (risky for parkinson's pts)

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intention tremor

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beta blocker

Front 89

BP DISORDER SUSPECTED DON'T GIVE ANTIDEP!!!

Back 89

WILL SWITCH TO MANIC!!!

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post operative ileus

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bethanecol or another cholinimimetic!

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flumenazil

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benzo receptor antagonist tx for overdose

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phenoxybenzamine

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long acting alpha blocker

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insulin regulation

Back 93

parasymp secretes
symp beta secretes, alpha inhibs
via ACh mediation on nicotinic receptors for parasymp.