Central Nervous System Drugs PDF

ANTIPSYCHOTIC DRUGS ~ notes by Kemi Peterside  ANTIPSYCHOTIC DRUGS ~ notes by Kemi Peterside CNS DEPRESSANTS BENZODIAZEPINES MOA —> calm brain down to help with anxiety DRUG —>diazepam, lorazepam, temazepam, alprazolam INDICATIONS —> p...

ANTIPSYCHOTIC DRUGS ~ notes by Kemi Peterside  ANTIPSYCHOTIC DRUGS ~ notes by Kemi Peterside CNS DEPRESSANTS BENZODIAZEPINES MOA —> calm brain down to help with anxiety DRUG —>diazepam, lorazepam, temazepam, alprazolam INDICATIONS —> panic level anxiety, status epilepticus seizures (lasts more than 5 minutes or multiple seizures), depression, sedation, chronic pain. CONSIDERATIONS —> never stop abruptly, do not take with alcohol, slow position changes, not safe in pregnancy. ADVERSE EFFECTS —> sedation, hypotension, drowsiness, dizziness, hangover effect (daytime sleepiness) ANTIDOTE —> flumazenil NON BENZODIAZEPINES HYPNOTICS DRUG —> zolpidem INDICATION —> insomnia ADVERSE EFFECT —> daytime sleepiness, drowsiness MUSCLE RELAXANTS MOA —> work on CNS to help with muscle spasms DRUG —> baclofen, cyclobenzaprine INDICATION —> muscle spasms ADVERSE EFFECT —> hypotension, dizziness, drowsiness, nausea, GI distress, constipation INTERACTIONS —> alcohol, CNS depressants, diphenhydramine  ~ notes by Kemi Peterside ANTIDEPRESSANTS DRUG —> old generation: tricyclics & MAOI | new generation: SSRI’s & SNRI’s | miscellaneous: bupropion CONSIDERATIONS —> risk of suicide, slow onset and slow taper, never mix, common side effects are hypotension and weight gain. TRICYCLICS MOA —> correcting imbalance of seratonin and norepinephrine. DRUG —> amitriptyline, nortriptyline, imipramine INDICATIONS —> depression, OCD, migraine ADVERSE EFFECTS —> dry mouth, urinary retention, blurry vision, drowsiness, constipation, hypotension, dysrhythmias, suicidal ideation, weight gain, seizures can cause death due to overdose. MONO AMINE OXIDASE INHIBITORS (MAOIs) MOA —> increases the level of hormones in brain DRUG —> phenelzine, isocarboxazid INDICATIONS —> anxiety, depression, bipolar disorder INTERACTIONS -> food with tyramine e.g red wine, aged cheese, pickles, soy sauce, beer, pepperoni, hot dogs, chocolate they can cause hypertensive crisis, should not be taken within 2 weeks of other antidepressants ADVERSE EFFECTS —> tachycardia, palpitations, seizures OVERDOSE TREATMENT —> hemodialysis SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIs) DRUG —>citalopram, sertraline, fluoxetine, paroxetine  ~ notes by Kemi Peterside INDICATION —> OCD, bipolar & eating disorder, depression, anxiety ADVERSE EFFECTS —> loss of sexual interest, insomnia, weight gain, serotonin syndrome (fever, diaphoresis, tachycardia, tremors, hyperreflexia, agitation) INTERACTION —> St. John’s wort, MAOI’s SEROTONIN NOREPINEPHRINE REUPTAKE INHIBITOR (SNRI’s) DRUG —> venlafaxine, duloxetine INDICATIONS —> bipolar disorder, depression, anxiety, peripheral neuropathy MISCELLANEOUS ANTIDEPRESSANTS MOA —> increases seratonin levels DRUG —> bupropion INDICATION —> depression, anxiety, smoking cessation CONTRAINDICATION —> risk for seizures ADVERSE EFFECTS —> dizziness, confusion, tachycardia MOOD STABILIZING DRUGS MOA —> it is a natural sodium that decreases dopamine & norepinephrine levels but increase serotonin DRUG —> lithium INDICATION —> bipolar disorder, acute mania THERAPEUTIC LEVELS —> acute mania (1-1.5), bipolar disorder (0.6-1.2) ADVERSE EFFECTS —> dry hair & mouth TOXICITY S/S —> tremors, confusion, nausea, vomiting, diarrhea, seizures, blurry vision, lethargy, dysrhythmias, hypotension, ataxia (imbalanced gait) INTERACTIONS —> hyponatremia increases risk of lithium toxicity E.G diuretics  ~ notes by Kemi Peterside CONSIDERATIONS —> take with meals, monitor liver & kidney function ANTIEPILEPTIC DRUGS DRUG —> phenytoin, carbamazepine, valproate acids (cannot be stopped) PHENYTOIN MOA —> depress excess neuron activity in brain INDICATION —> seizures (PO or IV) THERAPEUTIC RANGE —> 10-20 ADVERSE EFFECTS —> gingival hyperplasia, acne, hirsutism (excess hair), suicidal ideation TOXICITY S/S —> ataxia, slurred speech, encephalopathy (swelling in brain), nystagmus (involuntary eye movement) CONSIDERATIONS —> IV slow infused with normal saline at 50mg/min CARBAMAZEPINE MOA —> same as phenytoin INDICATION —> seizures, bipolar disorder ADVERSE EFFECTS —>anemia, leukopenia, thrombocytopenia, Steven Johnson syndrome, photosensitivity, suicidal ideation CONSIDERATIONS —> take larger dose at night *Auto induction —> enhances own metabolism leading to a need for an increased dosage VALPROIC ACID MOA —> same as phenytoin & carbamazepine INDICATION —> seizures, bipolar disorder  ~ notes by Kemi Peterside ADVERSE EFFECTS —> liver toxicity, thrombocytopenia, pancreatitis NEWER ANTIEPILEPTIC MOA —> unclear DRUG —> gabapentin INDICATION —> neuropathic pain, seizures ADVERSE EFFECTS —> somnolence (sleepiness), dizziness, drowsiness, ataxia, fatigue BARBITURATES MOA —> depresses central nervous system DRUG —> phenobarbital INDICATION —> seizures, sedation ADVERSE EFFECTS —> drowsiness, hypotension, dizziness TOXICITY —> respiratory depression, nystagmus, ataxia, hypotension, pin point pupils, coma, death CONSIDERATIONS —> narrow index ANTI PARKINSON DRUGS DRUG —> Carbidopa - levodopa MOA —> increases dopamine levels in brain INDICATION —> Parkinson’s disease ADVERSE EFFECT —> confusion, involuntary movements, hypotension, hallucinations, cardiac dysrhythmias, paranoia, discolored urine. CONSIDERATIONS —> does not cure disease, slows it  ~ notes by Kemi Peterside ANTICHOLINERGIC MOA —> stimulate sympathetic nervous system DRUG —> benztropine INDICATION —> parkinson’s disease, (Tremors, Rigidity, Akinesia, Postural instability) ADVERSE EFFECT —> constipation, dry mouth, urinary retention, hypotension CNS STIMULANTS MOA —> Cause CNS stimulation by releasing norepinephrine INDICATION —> ADHD, narcolepsy, migraines, weight loss THERAPEUTIC EFFECT —> euphoria, decreased fatigue, increased mental alertness DRUG —> ADHD: dextroamphetamine, methamphetamine, methylphenidate DRUG —> NARCOLEPSY: dextroamphetamine, methamphetamine, methylphenidate, modafinil CONSIDERATION —> take in the morning, monitor height & weight, limit caffeine intake ADVERSE EFFECT —> insomnia, anorexia, growth suppression, dry mouth DRUG —> MIGRAINES: almotriptan, sumatriptan, ergot-amine tartrate with caffeine (only for acute migraines, as needed) ADVERSE EFFECT —> hyperthermia, tachycardia, hypertension, seizures, agitation, hallucination, risk of overdose DRUG —> WEIGHT LOSS: phentermine ADVERSE EFFECTS —> palpitations, tachycardia, hypertension, dysrhythmias