CAM
Herbal therapy used for mild-moderate depression, also used to treat menopausal symptoms; may increase sedation in CNS depressants and opioids; may decrease anticoagulant effects
St. John's wort
alpha and beta adrenergic receptors are associated with which division of the autonomic nervous system?
sympathetic division
"flight or flight"
selective serotonin reuptake inhibitor (SSRI); indicated to treat MDD, PTSD, OCD, social anxiety disorder and premenstrual dysphoric disorder; Black box: increased risk of suicidal ideation for pediatric and young adult patients; Abrupt d/c may cause n/v, agitation, tremors, insomnia and seizures
sertraline (Zoloft)
Potent benzodiazepine; treats anxiety, but also used as preanesthetic med for sedation; used off label for insomnia, treatment for chemotherapy induced n/v and management of alcohol withdrawal symptoms
lorazepam (Ativan)
antipsychotic; dopamine receptor antagonist; used to treat symptoms of schizophrenia; extrapyramidal side effects (EPS) are common, particularly in older adults
haloperidol (Haldol)
Reduces mild nausea and vomiting; increases bleed risk when taken with anticoagulants as well with aspirin and other NSAIDs
ginger
Which of the following is associated with muscarinic receptor activation? SATA.
A. stimulates digestion
B. dilates bronchioles
C. Accelerates heart rate
D. stimulates salivation
E. constricts pupils (miosis)
A. stimulates digestion
D. stimulates salivation
E. constricts pupils (miosis)
monoamine oxidase inhibitor (MAOI); used to manage symptoms of depression; use when taken w/ foods w/ high tyramine may cause severe HTN; OD s/s: seizures, resp. depression, circulatory collapse, coma
phenelzine (Nardil)
nonbenzodiazepine GABAA receptor agonist; only indication is short-term insomnia management; Schedule IV controlled substance
zolpidem (Ambien)
Antiseizure drug; drug enhances GABA action; stands out for successful management of neuropathic pain and postherpetic neuralgia
gabapentin (Neurontin)
effective in reducing high blood lipid levels; shown to be effective against HTN; Increases bleeding risk when taken with aspirin, other NSAIDs, warfarin and isoniazid
garlic
direct acting muscarinic receptor drug; primarily used to treat urinary retention; Extreme caution for pts w/ suspected bowel obstruction, active GI ulcer or inflammatory disease; Overdose Tx: atropine
bethanechol (Urecholine)
CNS stimulants; used to treat ADHD; Schedule II drug, high abuse potential; Periodic drug-free "holidays" are often recommended
methylphenidate (Ritalin)
benzodiazepine receptor antagonist; overdose treatment of benzodiazepines; can reverse CNS depressant effects
flumazenil (Romazicon)
hydantoin; acts by desensitizing sodium channels in CNS; effective against most seizures (not absence seizures); Black box: pediatric patients at risk for severe hypotension and cardiac dysrhythmias
phenytoin (Dilantin)
Shown to be effective against insomnia; reduces the effectiveness of oral contraceptives; increases sedation when taken with barbiturates, benzodiazepines and other CNS depressants
Valerian
acetylcholinesterase inhibitor; antidote for anticholinergic toxicity; Drug may cause cholinergic crisis (hypersalivation, muscle weakness, difficulty breathing), treat w/ atropine
physostigmine
traditional med for bipolar disorder; very narrow therapeutic index (0.6-1.5 mEq/L), serum levels must be monitored regularly; excessive sweating or dehydration may cause drug toxicity, sodium levels must be monitored
lithium
Selective serotonin reuptake inhibitor (SSRI); indicated for GAD, MDD; used off label for insomnia and OCD; Black Box: increased risk for suicidal ideation for children, adolescents and young adults w/ MDD and other psych. disorders; St John's wort may cause serotonin syndrome
escitalopram (Lexapro)
succinimide; drug of choice for absence seizures; psychosis, extreme mood swings, suicidal ideation may occur; abrupt d/c of this drug may induce tonic-clonic seizures
Ethosuximide (Zarontin)
used to reduce stress and improve sleep quality; increases hypoglycemic risk in antidiabetic meds; increases hypotension risk under antihypertensives; increases sedation of CNS depressants
ashwagandha
adrenergic drug; for intranasal route, blood vessels in nasal mucosa are constricted; contraindicated in pts w/ acute pancreatitis, heart disease, hepatitis, and narrow angle glaucoma
phenylephrine (Neo-Synephrine)
group of signs and symptoms r/t overmedication of meds that affect the metabolism, synthesis or reuptake of serotonin; confusion, anxiety, restlessness, HTN, tremors, sweating, hyperpyrexia, ataxia, death
serotonin syndrome (SES)
Herbal product; shown to be effective in promoting relaxation; high doses associated w/ liver damage, should not be used unless recommended by a provider
kava
The type of seizure characterized by brief, sudden contractions of a group of muscles.
myoclonic seizures