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65 Cards in this Set
- Front
- Back
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CNS stimulants
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broad class of drugs that stimulate specific areas of the brain or spinal cord
- they act by stimulating the excitatory neurons in the brain |
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ADHD symptoms
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inability to maintain attention span and or the presence of hyperactivity and impulsivity
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Narcolepsy
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incurable neurologic condition in which patients unexpectedly fall asleep in the middle of adl
-1/2 experience migraine headaches as well. |
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cataplexy
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sudden acute skeletal muscle weakness, individuals fall on the floor while still awake
-often associated with strong emotions |
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overweight vs obesity
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overweight is a BMI of 25-29.9
obesity is a BMI of 30 or higher |
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obesity increases the risk of... ?
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hypertension, dyslipidemia, coronary artery disease, stroke, type 2 diabetes mellitus, gallbladder disease, gout, osteoarthritis, sleep apnea, breast and colon cancer
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migraine
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headache lasting 4-72 hours
-symptoms include nausea, vomiting, photophobia. phonophobia common migraine (the majority) have no aura |
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migraine aura
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set of altered visual or other senses
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What do CNS stimulants do and what are they also called
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elevate mood, produce a sense of increased energy and alertness, decrease appetite, enhance task performance impaired by fatigue and boredom
amphetamines |
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What is atomoxetine & its treatment and class
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atomoxetine is a nonstimulant drug that is used to treat ADHD
- norepinephrine reputake INHIBITOR -associated with low incidents of insomnia, and low abuse potential -phone in refills are allowed schedule CII drug |
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What part of the brain does amphetamines stimulate
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mental alertness
-cerebral cortex & thalamus |
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What are the respiratory effects of the CNS stimulant drugs
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relaxation of bronchial smooth muscle, increased respiration and dialation of pulmonary arteries
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What is modafinil, how does it work
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modafinil is an analeptic drug it promotes wakefulness by reducing GABA which is the inhibitory neurotransmitter
-it is being used to treat ADHD |
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what are the contraindications for ADHD drugs
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allergy, MAOI's within the last 14 days & glaucoma
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what are the adverse effects for ADHD drugs
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Common- headache, abdominal pains, vomiting, anorexia and cough
increased heart rate and blood pressure, anxiety, insomnia, headache, tremor, blurred vision, increased metabolic rate, gastrointestinal distress, dry mouth |
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All amphetamines are what drug schedule
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schedule II which means they must have a written script in order to have a refill
-NP's not permitted to write this script |
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what is ridilin
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methylphenidate
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what is an anorexiant
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any substance that supresses appetite
-used to promote weight loss in obesity |
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examples of anorexiants
(stimulant drugs) |
benzphetamines (direx), methamphetamine (desoxyn), phendimetrazine (bontril), diethylpropion (tenuate), sibutramine (meridia)
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non stimulant anorexiant
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orlistat (xenical)
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anorexiant contraindications
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cardiovascular diseases, hypertension, glaucoma, mental agitation, drug abuse history, eating disorders, monoamine oxidase within the previous 14 days
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orlistat contraindications
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chronic malabsorption, cholestasis
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adverse effects of anorexiants
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heart palp, slow heart rate, hypertension, anxiety, agitation, dizzyness, and headache
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adverse effects of orlistat
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headache upper resp infection gi distress fecal incontinence
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serotonin receceptor agonist
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these drugs stimulate the serotonin receptors in the brain
-also referred as triptans |
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example of triptans
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sumatriptan (imitrex)
almotriptan (axert) eletriptan (relpax) naratriptan (amerge) rizatriptan (maxalt) zolmitriptan (zomig) frovatriptan (frova) |
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ergot alkaloids
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mainstay of treatment of migraine headaches
-obtained by fungus and cause vasoconstriction of dialated blood vessels in brain and carotid arteries have been replaced by triptans |
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ergot alkaloid contraindications
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pt's with peripheral vascular disease, coronary artery disease, sepsis, impaired renal or hepatic function and hypertension
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abortive drug therapy
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triptans that reduce the inflammatory neuropeptides
-abortive because it works to relieve headaches that has already started |
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triptan antimigraine drugs are also referred to as... ?
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selective serotonin receptor agonist (SSRAs)
-abortive migraine therapy -not indicated for preventative migraine therapy |
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can the elderly take triptans and why
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NO
because of vasoconstriction. -postural hypotension |
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Trips contraindications
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uncontrolled hypertension, glaucoma
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adverse effects of trips
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nausea, vomiting, cold or clammy hands and feet, muscle pain, dizziness, numbness, a vague feeling of anxiety, bitter or foul taste in mouth or throat, irritation of nose (with nasal spray)
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how are the trips available
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oral tabs, sub ling tabs, sub q inj, and nasal sprays
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analeptics
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used to treat neonatal and postop respiratory depression, respiratory depression secondary to drug of abuse
-neonatal use is more common |
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examples of an analeptic
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doxapram (dopram)
methylxanthines aminophylline theophylline and caffeine |
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how do analeptics work
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they stimulate areas of the CNS that control respiration mainly the medulla and spinal cord
-also inhibits the enzyme phosphodiesterase (this enzyme breaks down cAMP) resulting in a relaxation of smooth muscles in the respiratory tract, dialation of pulmonary arterioles, and stimulation of the CNS |
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theophylline is metabolized to ... what?
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caffeine
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contraindications to analeptics
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cardiovascular disease, peptic ulcer disease, epilepsy, head injury, hypertension, stroke, viagra
-doxampram is contraindicated in newborns because of the bezyl alcohol contained in the injectable formulation of the drug. |
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adverse effects of the analeptics
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stimulation of gastric secretions, diarrhea, reflex tachycardia
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seizure
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abnormal electical activity in the nerve cells of the brain may or may not lead to convulsion
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convulsion
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more severe seizure characterized by involuntary spasmodic contractions of any or all voluntary muscles throughout the body
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epilepsy
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chronic recurrent pattern of seizures
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electroencephalogram EEG
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a recording of the electrical activity that arises from spontaneous currents in the nerve cells in the brain derived from electrodes placed on the outer skull
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idiopathic epilepsy
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also known as primary epilepsy
-epilepsy that occurs with no known cause |
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secondary or symptomatic epilepsy
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known cause, eg. trauma, infection, cerebrovascular disorder or other illness
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antipyretic drugs
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acetaminophen
-treat seizures |
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febrile seizures
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6 months - 5 years
seizure brought on by fever |
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generalized onset seizures
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formerly called grand mal seizures
-characterized by neuronal activity that originates simultaneously in the gray matter of both hemispheres |
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tonic-clonic seizures
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being with muscular contractions throughout the body (tonic phase) and progress to alternating contraction and relaxation (clonic phase)
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tonic seizures
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spasms of the upper trunk and flexion of the arms
STIFFENING |
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clonic seizures
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contracting and relaxing
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atonic seizures
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drop attacks
-sudden muscle weakness and syncope |
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myoclonic seizures
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brief muscular jerks but not as extreme in other subtypes
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absence seizures
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characterized by brief loss of awareness that commonly occurs with repetitive spasmodic eye blinking for up to 30 seconds
-rarely occurs after the age of 14 |
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partial onset seizures
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originate in a localized region of the brain
-typically one lobe |
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status epilepticus
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multiple seizures occur with no breaks in between them
-brain damage and death can occur if not taken care of immediately |
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antiepileptic drugs vs anticonvulsants
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antiepileptic drugs are indicated for all types of epilepsy
-anticonvulsants are indicated to prevent the convulsive seizures typically associated with epilepsy |
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what can happen with abrupt discontinuation of anticonvulsants
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withdrawal seizures
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therapeutic drug monitoring
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of serum concentrations provides a useful guideline in assessing te effectiveness of therapy
-maintaining serum drug levels withing therapeutic ranges helps not only to control seizures but also to reduce adverse effects -antiepileptic drugs have a low therapeutic index |
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what are the three classes of antiepileptic drugs
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barbiturates
hydantoins and iminostilbenes |
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pharmacologic effects of antiepileptics
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-increase the threshold of activity in the motor cortex (ability to tolerate the annoying mom mom mom is increased)
-limit the spread of the seizure by suppressing the transmission of impulses from one nerve to the other -decrease the speed of the nerve impulse |
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carbamazepine
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worsens myoclonic or absence seizures
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what drugs are good for partial onset seizures
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phenobarbital
phenytoin primidone carbamazepine valproic acid |
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what adjunctive therapy is good for partial onset seizures
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lamotrigine
toiramate gabapentin oxcarbamazepine zonisamide levetiracetam tiagabine |
