Anticonvulsants
Has a short half life
Given TID
Monitor Guarding/Grimacing
Gabapentin/Pregabalin
A cholinergic
Increases acetylcholine in the brain increasing ADL
Should be taken at bed time
Take at bedtime
May cause GI bleed, bronchoconstriction, bradycardia
Donepezil
Galantmine
Anticholenergic
Blocks the effects of acetylcholine
Allows dopamine to exert
May cause hallucinations, paralytic illness and cardiovascular collapse
Benztropine
Inhibit upper motor neuron activity
May cause drowsiness, constipation
C/I in pts over 65 (confusion, hallucinations)
Short term therapy (2-3 weeks)
Cyclobenzaprine
Binds to acetylcholine causing paralysis
For intubation
Leave the system fast (5 mins)
May cause malignant hyperthermia (give dantrolene)
Succinylcholine
May cause respiratory depression & cardiovascular collapse
Should be on cardiac monitor
Benzos
Lams/Pams
NMDA receptor blockers
Reduce glutamate ; too much glutamate = brain cell death
Moderate to Severe
Memantine
Restores dopamine in areas of the brain Increases gait, reduced tremors and bradykinesia
May cause confusion, cramps and headache
C/I in glaucoma and hx of melanoma
(dopa) Levodopa/carbidopa
Wide safety margin
Baclofen
Competes with acetylcholine
May cause paralysis of diaphragm \ Should be in ventilator
Does not cause pain relief or sedation
May cause bradycardia and respiratory depression
ium
Rocuronium
May cause dependence
Monitor for rash (SJS) RD, CNS depression
Phenobarbital
Promotes vasodilation
Interacts with meds for seizures (antihistamine, antipsychotic)
May interact with coagulation
Gingko Biloba
Slows progression
May cause dizziness, confusion and flu like symptoms
Given QOD (every other day)
MS DRUG
Interferon Beta 1B
Skeletal muscle relaxant
Treats malignant hyperthermia
Interferes with calcium ions in the muscle
May cause photosensitivity, weakness
No alcohol, or other drugs
Dantrolene
Desensitize sodium channels
May cause acne, hirsutism & flu-like symptoms & gingiva hyperplasia / agranulocytosis
Has a narrow therapeutic index
can only be mixed with saline
Phenytoin (hydantoin)
Blocks acetylcholine
May cause weakness, dysphagia and anaphylaxis
Botox
Desensitize sodium channel in CNS
May cause bone marrow depression and suicidal behavior, diplopia and headache
Carbamazepine
Valproic acid
Levetiracetam