Barbiturates
Difference between sedative, hypnotics, and sedative-hypnotics
sedative = reduce nervousness, excitability, and irritability without causing sleep
hypnotics = cause sleeps more potent affect on CNS than sedatives
s/h = both
primary inhibitory neurotransmitter
gamma-aminobutyric acid GABA has the ability to inhibit stimulation of the brain
used to treat ADHD in children older than 6 to adults, not a controlled substance but can cause SI, ED is a common side effect
atomoxetine Strattera
first-line drug for epilepsy indicated for tonic clinic seizures, long term can cause gingival hyperplasia, low serum levels can cause can cause inflated medication levels because it is HIGHLY protein bound, can be mixed with antifreeze to stabilize the drug in parenteral use
phenytoin Dilantin or fosphenytoin
difference between dopamine and acetylcholine
dopa= inhibitory
acteyl= excitatory
pts w/Parkinson's have no dopamine so their bodies are off the wall excited
short acting used for pre Op to relieve anxiety and provide sedation can be used to control status epilepticus can also treat withdrawal of barbits
pentobarbital Nembutal
herbs that interact with benzos and their action
Kava used for sleep and stress, can cause yellowing skin, contraindicated in Parkinson's and liver disease
Valerian used for anxiety and sleep disorders can cause CNS depression, insomnia, hepatoxicity contraindicated in MAOIs, and phenytoin
first prescription indicated for ADHD and can be used for narcolepsy
methylphenidate Ritalin
second most common antiepileptic drug, can worsen myoclonic and absent seizures, can cause autoinduction
carbamazepine Tegretol
only 50% of pts see good results, selective MAO-B inhibitors (two drugs)
rasagiline and selegiline
long acting used for generalized tonic clonic and fever induced convulsions and hyperbilirubinemia
phenobarbital
can be used for moderate sedation, anxiety, procedural sedation, and anesthesia adjunct, first clinically available benzo, long acting
diazepam or Valium
improvement of wakefulness in patients with excessive daytime sleepiness associated with narcolepsy and shift work, has to potential for abuse
modafinil Provigil
chemical analogue of GABA, can be used as an adjunct drug for partial seizures, most commonly used for neuropathic pain
gabapentin Neurontin
antiviral used for influenza, used early on but only good for 6-12 months
amantadine Symmetrel
name medications that act to relax skeletal muscles used to reduce inflammation, and relieve pain
baclofen Lioresal can be used in a pump can be used for chronic spasms
cyclobenzaprine Flexiril extended form is called Amrix can be used for muscle spams secondary to musculoskeletal injuries
dantrolene!!!
most commonly used pre Op and for moderate sedation, can cause amnesia and reduce anxiety, usually injection in adults and oral for children, short acting
midazolam or Versed
binds to gastric enzymes and pancreatic enzymes called lipase, must restrict dietary fat intake, can cause fecal incontinence
orlistat Xenical OTC Alli
unique related to fructose, can cause angle closure glaucoma, increased risk for cleft palate if used during pregnancy
topiramate Topamax
COMT inhibitor, adjunct treatment for parkinson, can help reduce the wearing off effect and the on-off effect when taken with Levodopa
entacapone Comtan
name the antidote for benzos, barbiturates, and muscle relaxants
benzo = Flumazenil
barbital = NOTHING!
muscle = Nothing!
long term hypnotics and name a fact about each
eszopiclone Lunesta allot 8 hours of sleep considered short to intermediate avoid taking if needing to be awake within 6-8 hours
zolpidem Ambien short acting possibility of somnambulating
stimulate receptors in the cerebral arteries causing vasoconstriction, reduce the production of inflammatory neuropeptides, abortive drug therapy
sumatriptan Imitrex
used to treat generalized seizures, also for bipolar, contraindicated in urea cycle disorders, highly protein bound and competes with other protein bound drugs, can be made into sprinkles for food
valproic acid Depakote sprinkles
stimulates D2 receptors and antagonizes D1, cannot be taken by a patient with severe ischemic disease
bromocriptine