Unit 6 Central Nervous System Drugs

Front 1

What are 3 groups of drugs that affect the CNS?

Back 1

1. Illicit substances: Heroin, PCP, LSD, etc.
2. Socially acceptable substances: Alcohol, tea, coffee, etc.
3. Therapeutic agents: Drugs used to treat pain, mental disorders, etc.

Front 2

What drugs are capable of passing the blood brain barrier?

Back 2

Drugs that are fat soluble.

Front 3

How do drugs affect the CNS?

Back 3

Thought to act at synapses by either:
1. Release of neurotransmitter
2. Stimulate the receptor
3. Over long term use change the number of receptors available

Front 4

What is the ratio of neurotransmitters to receptors?

Back 4

There must be one receptor for each transmitter.

Front 5

Where is NE concentrated?

Back 5

Hypothalamus and reticular activating system.

Front 6

Where is dopamine concentrated?

Back 6

Limbic structures in the cortex.

Front 7

What are signs of a stimulant?

Back 7

Sensation acuity increased, motor activity increased.

Front 8

What are the stages of a stimulant that lead to death?

Back 8

1. Euphoria
2. Anxiety, nervousness
3. Tremors, hallucinations
4. Convulsions, seizures
5. Death

Front 9

What are signs of a depressant?

Back 9

Sensation of acuity decreased, motor activity decreased.

Front 10

What are the stages of a depressant that lead to death?

Back 10

1. Sedation
2. Hypnosis
3. Loss of consciousness
4. Coma
5. Death

Front 11

What are characteristics of drug abuse?

Back 11

1. Chronic use
2. Social disapproval

Front 12

What are characteristics of drug tolerance?

Back 12

1. One must increase the dose in order to achieve/maintain the desired effect.
*Tolerance may be receptor or metabolic based.
*Tolerance always occurs in the process of becoming physically addicted to a drug.

Front 13

When is tolerance always metabolic?

Back 13

When the drug is not addicting.

Front 14

What is a physical dependance?

Back 14

When someone's body depends on the drug in order to function properly.

Front 15

What is psychological dependance?

Back 15

An emotional state that is reliant upon a drug in order to maintain a state of well being.

Front 16

What is the relationship between physical dependance and addiction?

Back 16

There is no relationship between the degree of physical dependance and degree of addiction.

Front 17

What is a general stimulant?

Back 17

A drug that excited the CNS.

Front 18

What do amphetamines do and what responses are seen?

Back 18

Stimulate all areas of the brain. They increase the release of NE in the brain and increase the dopamine release.
1. Increased alertness, wakefulness, decreased fatigue
2. Mood elevation or euphoria, increased initiative
3. Decreased appetite, little effect in reducing food intake

Front 19

What are the therapeutic uses of amphetamines?
What schedule is this drug?

Back 19

1. Narcolepsy
2. Weight control
3. ADHD
It is a schedule 2

Front 20

How do amphetamines affect ADHD?

Back 20

Increases NE which increases the attention span of a child.

Front 21

What are side/toxic effects of amphetamines?

Back 21

1. Nervousness, anxiety, sleeplessness
2. High dose: schizophrenic behavior (increased dopamine)
3. Increased HR, BP and possible arrhythmias.
4. Weight loss and malnutrition
5. Hyperkinetic child: sleeplessness, excessive crying.
6. Rare bone marrow suppression

Front 22

When are amphetamines contraindicated?

Back 22

1. With insomnia, psychological disorders
2. HTN, arrhythmias
3. Anorexia

Front 23

What precautions need to be take when administering amphetamines?

Back 23

Potential for abuse
Have interactions with:
1. Anticholinergics
2. Anticoagulants
3. Anticonvulsants
4. Tricyclic antidepressants

Front 24

What type of drug is Xanthine and where is it found?

Back 24

It is a stimulant and it is found in many plants.

Front 25

What responses are seen from Xanthines?

Back 25

1. CNS Stimulation: Increased alertness, decreased fatigue
2. Cardiac Stimulation: Rate and force
3. Constricts blood vessels in the brain
4. Diuresis
5. Bronchorelaxation with high doses

Front 26

How do Xanthines work?

Back 26

1. Inhibits the breakdown of cyclic AMP
2. Increases CNS activity
3. Dilates bronchioles
4. Dilates pulmonary blood vessels
5. Constricts cerebral blood vessels
6. Affects metabolism of many other drugs

Front 27

How are Xanthines used therapeutically?

Back 27

1. Headaches
2. Asthma, bronchitis, emphysema
3. Counters drowsiness

Front 28

What are side effects of Xanthines?

Back 28

1. Increased HR, cardiac arrhythmias
2. Increased gastric secretion
3. Diuresis
4. Excess CNS stimulation (convulsions, insomnia)
5. Withdrawal may include headache and irritability

Front 29

Xanthines precautions:

Back 29

1. Arrhythmias
2. Ulcers
3. Possible birth defects

Front 30

What is Cocaine and what schedule is it?

Back 30

A very powerful CNS stimulant, it is approved by the FDA for local anesthetic use only in a hospital/clinic.
It is a schedule 2

Front 31

What responses are observed with Cocaine?

Back 31

Stimulate all areas of the brain. They increase the release of NE in the brain and increase the dopamine release.
1. Increased alertness, wakefulness, decreased fatigue
2. Mood elevation or euphoria, increased initiative
3. Decreased appetite, little effect in reducing food intake

Front 32

When is Cocaine contraindicated?

Back 32

1. With insomnia, psychological disorders
2. HTN, arrhythmias
3. Anorexia

Front 33

What precautions need to be take when administering cocaine?

Back 33

Potential for abuse, very intense.
Have interactions with:
1. Anticholinergics
2. Anticoagulants
3. Anticonvulsants
4. Tricyclic antidepressants

Front 34

Side effects to cocaine use?

Back 34

1. CNS Stimulation:
Early signs: Anxiety, restlessness, confusion, dizziness, tremors, convulsions
Later signs: Depression, unconsciousness, death
2. Cardiovascular:
Early signs: Increased HR, BP and possible arrhythmias.
Later signs: Bradycardia, hypotension, cardiac arrest

Front 35

What is a CNS depressant?

Back 35

An agent which decreases excitability of tissues in the CNS. Produces sedation, hypnosis, general anesthesia, coma, death. All of these drugs can act as sedatives, hypnotics or generals. It depends on the dose that is given.

Front 36

What is a sedative?

Back 36

Drugs administered at a dose level to cause mild drowsiness or sedation or to reduce restlessness or anxiety. They should ideally now interfere with a person's ability to function normally.

Front 37

What are hypnotics?

Back 37

Drugs administered at a dose level to induce sleep or allow an individual to stay asleep. The dose is usually 3-4 times that of a sedative. A person can be aroused after being given a hypnotic.

Front 38

What are general anesthetics?

Back 38

Drugs administered at a dose level to depress the CNS to a degree that causes unconsciousness and analgesia. The person cannot be aroused and it abolishes perception of and reaction to pain.

Front 39

What are barbituates?

Back 39

A type of sedative-hypnotic. They may be taken orally or given IV.

Front 40

What are non barbiturates?

Back 40

A CNS depressant/sedative-hypnotic, also called minor tranquilizers.

Front 41

What are uses therapeutic responses to sedative-hypnotics, barbiturates and non-barbiturates?

Back 41

1. Reduced anxiety
2. Sedation
3. Hypnosis
4. General anesthesia

Front 42

How do barbiturates work?

Back 42

Mechanism unclear. Depresses all areas of brain, seem to inhibit reticular activating system. They probably enhance GABA receptor complex and enhance Cl entrance to neurons and hyper-polarize cells. GABA independent.

Front 43

How do Benzodiazepines work?

Back 43

Bind to special receptrs that decreases activity of the brain. Also increase activity of GABA but GABA dependent. Degree os depression decreases as GABA concentration decreases.

Front 44

How does alcohol work?

Back 44

Mechanism unclear. Seems to increase GABA activity with short term use. Long term use decreases GABA and therefore decreases anti-anxiety effects of alcohol. May explain why alcoholics drink more to relieve anxiety.

Front 45

Therapeutic uses for sedative-hypnotics:

Back 45

1. Usually used to relieve situational anxiety and neurotic anxiety.
2. Sleep disorders but should only be used temporarily because they have a high risk for abuse.
3. Anticonvulsant
*Epilepsy is a major reason to use barbiturates over benzodiazepines.

Front 46

Side/toxic effects of sedative-hypnotics:

Back 46

1. Drowsiness
2. Impaired performance, decreases perception/judgement
3. Hangover effect
4. Hyperalgesia
5. Overdose

Front 47

Sedative-hypnotic precautions:

Back 47

1. Administering with other sedative-hypnotics
2. Drug abuse and habituation
3. Withdrawal state
4. Birth defects

Front 48

What are goals of anesthetics?

Back 48

1. Analgesia
2. Loss of consciousness
3. Muscle relaxation
*No one drug meets all three goals

Front 49

Inhalation anesthetics:
1. Response
2. Toxic
3. Caution

Back 49

1. Loss of consciousness, amnesia
2. Respiratory depression, lower BP/HR, arrhythmias, N/V
3. Malignant hyperthermia

Front 50

IV anesthetics Thiopental:
1. Response
2. Toxic

Back 50

1. Loss of consciousness, quick onset
2. Respiratory depression, lower BP/HR, N/V, increased sensitivity to pain

Front 51

IV anesthetics ketamine:
1. Response
2. Toxic

Back 51

1. Acts as a stimulant, may increase HR/respiration. Causes analgesia w/o loss of consciousness. Loss of consciousness at high dose, no skeletal muscle relaxation
2. After awakening, nightmares, hallucinations

Front 52

Non-psychotropic conditions:

Back 52

1. Epilepsy
2. Parkinsonism
3. Pain and arthritis

Front 53

Psychotropic conditions:

Back 53

1. Depression
2. Anxiety
3. Schizophrenia
4. Bipolarity

Front 54

Antiepileptic Agents / Anticonvulsant Drugs:
1. How do they work
2. What are adverse effects?

Back 54

1. Drug of choice depends on the type of seizure. They act by intensifying the action of GABA in the brain which suppresses the ability of neurons to fire. They are often used to treat bipolarity and alcoholism.
2. Sedation, kidney/liver damage, blood diseases

Front 55

What are the 2 ways Parkinson's is treated?

Back 55

1. Increase dopamine
2. Decrease ACH w/ anticholinergic drugs
*Withdrawal of Parkinson's medications must be done gradually

Front 56

Narcotics:
1. Therapeutic uses
2. Side/toxic effects
3. Precautions
4. Withdrawals

Back 56

1. Pain relief, antitussive, chronic diarrhea
2. N/V, respiratory depression, constipation, behavioral changes, physical dependence
3. Head injuries, respiratory problems
4. Chills, hot flashes, tearing, runny nose, sneezing, drowsiness, yawning, anxiety, twitching, cramps, N/V, diarrhea, dilated pupils, elevated temperature, increased pulse/BP.

Front 57

Salicylates:
1. Therapeutic uses
2. Side/toxic effects

Back 57

1. Relief of pain, antipyretic, anti-inflammatory, anticoagulant
2. Short term: GI Irritation, CNS stimulation
Long term: hearing problems, GFR decrease
*Advised against using these with children

Front 58

Anilines:
1. Therapeutic uses
2. Side/toxic uses

Back 58

1. Relief of pain
2. Long term: Kidney/liver damage, blood diseases, bladder cancer