Substance Use Disorders
Bupropion (Wellbutrin), an antidepressant is also used for what substance use d/o
Smoking, weight loss
Haloperidol and chlorpromazine are examples of first generation antipsychotics. Name as many adverse effects as you can
Anticholinergic; inc. risk of seizures, sedation, sexual dysfunction, orthostatic hypotension, agranulocytosis, photosensitivity, liver impairment
Acronym for cholinergic crisis
SLUDGE (salivation, lacrimation, urination, defecation, GI upset, emesis)
Name a nondepolarizing neuromuscular blocking agent. They block ACh with binding to cholinergic receptors causing muscle paralysis
vecuronium, rocuronium, pancuronium and atracurium.
Neostigmine=reversal agent
What is carbidopa-levadopa used for?
Parkinson's disease
What medication is used for alcohol withdrawal
benzodiazapine - lorazepam, chlordiazepoxide
Antihistamines and OTC sleep aids should be avoided. with antipsychotics. Why?
Increased anticholinergic effects
Donepezil is frequently used for what disease?
Alzheimer's
Name the only depolarizing neuromuscular blocking agent (NMBA). Agent fills the cholinergic receptors preventing ACh from binding. Short acting
succinylcholine
phenobarbital and primidone are examples of what class of medications used for seizures?
Barbituates
varencycline
(Chantix) smoking
Alcohol causes what to happen to the CNS?
Depression of CNS
How does cholinesterase inhibitors work? What is allowed to remain in the synapses?
NMBAs are used as adjuncts to general anesthesia to promote muscle relaxation. Name another use
Endotracheal intubation, endoscopy, and for seizure control during electroconvulsive therapy
Name a med used to relieve spasticity related to cerebral palsy,, spinal cord injury, or multiple sclerosis
diazepam, baclofen, dantrolene
cyclobenzaprine (Flexeril) and tizanidine (Zanaflex) are also muscle relaxants
Naltrexone
Opioids and alcohol
Olanzapine, quetiapine and ziprasidone are atypical/second generation antipsychotics.
What is quetiapine ALSO frequently used for?
Sleep aid in elderly
Name common side effects of these meds
Excessive sweating, nausea, diarrhea, urinary retention, salivation
Why should succinylcholine not be used for patients with renal failure, massive trauma or burns (think electrolytes)
Hyperkalemia
Muscarinic agonists: bethanochol and pilocarpine cause what type of effects?
Cholinergic
Bethanochol for bladder relaxation
pilocarpine - glaucoma or to relieve dry mouth
Disulfuram
alcohol (Antabuse)
Ariprazole (Abilify) is a third generation antipsychotic used in bipolar I, schizophreia and an add on tx for major depressive disorder. What else is it used for?
Restless leg syndrome in low doses. Note at higher doses it can cause akasthesia.
Tensilon test to diagnose mysthenia gravis. This medication is also a reversal agent for nondepolarizing neuromuscular blocking agents.
Edrophonium (Tensilon)
Note: neostigmine also used to reverse NMBA
Manifestations include muscle rigidity, accompanied by elevated temperature as high as 109.4F (43C)
Malignant hyperthermia. Administer dantrolene
Oxybutynin is a muscarinic antagonist used for what?
Overactive bladder. Causes anticholinergic effects