Pharm Cns

Front 1

Sedative-Hypnotic-Anxiolytic

Back 1

- CNS Depressant for insomnia and anxiety

Front 2

1. Barbiturates

Back 2

Phenobarbital – treatment of seizures

Front 3

1. Barbiturates

Back 3

a. Addictive (withdrawal symptoms when stopped),develop tolerance
b. REM rebound on cessation (2-4 day of increased REM)
c. Can cause hyper-algesia (increased sensitivity to pain)
d. Pregnancy category D

Front 4

2. Benzodiazepines-

Back 4

enhance GABA action - (Lorazepam and Xanax)

Front 5

2. Benzodiazepines- enhance GABA action - (Lorazepam and Xanax)

Back 5

a. Cause ante grade amnesia (Awake but don’t remember procedure)
b. Can decrease BP and respirations (dangerous)
c. Pregnancy category D or X
d. Reversal – Flumazenil (Romazicon

Front 6

Antidepressant Medications

Back 6

Can cause increase in depression suicide

Front 7

1. Tricyclic Antidepressants (TCA)

Back 7

a. May take up to 4 weeks for therapeutic effects
b. Anticholinergic & physical s.e. may show up in 2 weeks
c. S.e. – sedation – administer at h.s.; photosensitivity
d. S.e. cardio toxicity – get baseline ECG

Front 8

2. Selective Serotonin Reuptake Inhibitors (SSRI)

Back 8

a. May take up to 2-4 weeks for full therapeutic effect
b. Highly protein bound
c. S.E. sexual dysfunction, Weight gain/loss, Akathisia, Serotonin syndrome
d. Insomnia – take in a.m.
e. Serotonin syndrome – on initiation, increase or combination

Front 9

3. NSRI

Back 9

a. S.E. similar to SSRI - S.E. sexual dysfunction, Weight gain/loss * drug holiday

Front 10

4. MonoAmine Oxidase Inhibitors (MAO-Is)

Back 10

a. Rarely used as initial therapy
b. S.e. – sedation – take at h.s., orthostatic hypotension
c. React with antidepressants, amphetamines, sympathomimetics
d. Teach client to avoid tyramine containing foods – hypertensive crisis results
i. Aged cheeses, fermented meats, red wine -
e. Discontinue 2 weeks before starting another antidepressant

Front 11

5. Atypical Antidepressants

Back 11

Bupropion (B) (Wellbutrin, Zyban)
NDRI
Appetite suppressant
No sexual side effects

Front 12

1. First Generation Antipsychotics –

Back 12

All effective the same amount, only difference is potency which is side and amount of dose to elicit response

Front 13

a. Low potency

Back 13

i. High dose(MG)
ii. Low EPS effects
iii. High Sedation/anti-cholinergic effects/orthostatic hypotension

Front 14

b. Medium potency

Back 14

i. Medium dose(MG)
ii. Moderate EPS effects
iii. moderate Sedation/
iv. low anti-cholinergic effects/ orthostatic hypotension
v. risk of neuroleptic malignant syndrome (NMS)

Front 15

c. High potency

Back 15

i. Low dose(MG)
ii. High EPS effects
iii. Low Sedation/anti-cholinergic effects/orthostatic hypotension
iv. risk of neuroleptic malignant syndrome (NMS)

Front 16

2. Second Generation Antipsychotics

Back 16

a. Also used for bipolar (anti-mania)
b. May cause metabolic effects (weight gain, dyslipidemia, diabetes)

Front 17

Anti-Mainia –
1. Lithium

Back 17

a. Water soluble salt – affected by hydration status/ sodium levels
b. Narrow therapeutic range

Front 18

Antiepileptic Drugs

Back 18

1. Phenytoin (Dilantin)
2. Carbamazepin (Tegretol
3. Gabapentin

Front 19

1. Phenytoin (Dilantin)

Back 19

a. Gingival hyperplasia risk
b. IV compatibility issues
c. Highly protein bound
d. Pregnancy Category D

Front 20

2. Carbamazepin (Tegretol

Back 20

a. Induces drug metabolizing enzymes – creating tolerance
b. Avoid grapefruit juice

Front 21

3. Gabapentin

Back 21

a. Can be used for seizures
b. More use for off label neuralgias

Front 22

Parkinson’s Medications

Back 22

1. Dopamanergic drugs – raise dopamine levels
2. Anti-cholinergic drugs – restore balance of ACH/ Dopamine - may be used for Parkinson’s disease or antipsychotic side effects

Front 23

1. Dopamanergic drugs – raise dopamine levels

Back 23

a. Levodopa – precursor to dopamine
b. Carbidopa – prevents breakdown of levodopa outside CNS
c. Clients on levodopa need to decrease vitamin B6 because it reverses the effect of levodopa

Front 24

2. Anti-cholinergic drugs

Back 24

– restore balance of ACH/ Dopamine - may be used for Parkinson’s disease or antipsychotic side effects
a. S.e….