Module 2 Neurological System (Part 1)

MODULE 2: NEUROLOGICAL SYSTEM (PART 1) CENTRAL NERVOUS SYSTEM DEPRESSANTS DRUG THERAPY FOR SLEEP DISORDERS Benzodiazepine – temazepam (Restoril) Non-benzodiazepine – zolpidem (Ambien) DRUG THERAPY FOR MUSCLE SPASMS Centrally acting muscle relaxants – baclofen (Lioresal) Peripherally acting muscle relaxants – dantrolene (Dantrium) Photosentivity DRUG THERAPY FOR SEIZURE DISORDERS Hydantoins – phenytoin (Dilantin)-> skin rash (Steven Johnson syndrome). If oral Hydroxyzine spension-> u should sake well Iminostilbenes – carbamazepine (Tegretol) Valproic acid – valproic acid (Depakote, Depacon, Depakene) DRUG THERAPY THAT SUPPORTS ANESTHESIA Local anesthesia – lidocaine (Xylocaine) General anesthesia/barbiturates – sodium thiopental (Pentothal) General anesthesia/benzodiazepine – midazolam (Versed) General anesthesia/opioid – fentanyl (Sublimaze) Nabulphine: miosis, constipation, urinary urgency DRUG THERAPY FOR ADHD AND NARCOLEPSY Amphetamines – amphetamine and dextroamphetamine sulfate (Adderall) Methylphenidate – methylphenidate (Ritalin, Concerta) Non-amphetamine – modafinil (Provigil) DRUG THERAPY FOR PARKINSON’S DISEASE Dopamine-replacement drugs – levodopa/carbidopa (Sinemet) Direct-acting dopamine receptor agonists – pramipexole (Mirapex) Indirect-acting dopamine receptor agonists/MAOs – selegiline (Eldepryl, Zelapar ODT) DRUG THERAPY FOR ALZHEIMER’S DISEASE Cholinesterase inhibitors – donepezil (Aricept, Aricept ODT) NMDA receptor antagonist – memantine (Namenda) DRUG THAT TREAT MULTIPLE SCLEROSIS Immunomodulators – Interferon beta-1a (Avonex, Rebif), Interferon beta 1b (Betaseron) DRUG THAT TREAT MIGRAINE HEADACHES Serotonin agonists – sumatriptan (Imitrex) Transdermal: take as needed,, activate 15 min PSYCHOTHERAPEUTIC DRUGS DRUG THERAPY FOR ANXIETY DISORDERS Benzodiazepines – diazepam (Valium), alprazolam (Xanax)-> monitor paradoxical effect: insomnia and excitation, hypotension, inability to reacall events (amnesia) Non-benzodiazepines – buspirone DRUG THERAPY FOR DEPRESSION Tricyclic antidepressants – amitriptyline- block reutake of nore and serotonin-> risk for orthostatic hypotension, avoid alcohol, should take at bedtime due to drowsiness and sedation SSRIs – fluoxetine (Prozac) SNRIs – venlafaxine MAOIs – phenelzine (Nardil) Atypical antidepressants – bupropion HCL (Wellbutrin) DRUG THERAPY FOR BIPOLAR DISORDER Lithium (0.8-1.4) – lithium carbonate (Lithobid)-> engage in strenuous exercise, take 7-10 day to achieve, therapeutic dose 300 SA: muscle weakness Toxic: hypokalemia: dehydration, diarrhea, sweating, excessive exercise in hot weather, diuretic use, low sodium diet) Antiepileptic drugs (AED) – valproic acid (Depakote) Paroxetine (antidepressant)- SSRI Valproate, Carbamazepine (anticonvulsants), smooth stabilizer DRUG THERAPY FOR SCHIZOPHRENIA Conventional antipsychotics – chlorpromazine, fluphenazine sleepiness should subside within a week Anticholinergic effects Haloperidol EPS Tardive dyspnea: tongue thrusting and lip smacking, facial grimacing and eye blinking Dystonia: repetitive muscular contraction cause twisting of the body Clozapine Agranulocytosis Atypical antipsychotics – risperidone (Risperdal) AUTONOMIC NERVOUS SYSTEM DRUGS Drug therapy for glaucoma Beta adrenergic blocker – betaxolol (Betoptic), timolol (Timoptic) Cholinergic agonists – pilocarpine (Isopto Carpine) regular schedule for rest of life Cholinesterase inhibitors – echothiophate (Phospholine Iodide) Prostaglandin, latanoprost DRUG FOR RETINAL DETACHMENT: Phenylephrine (mydriatic meds) dilate pupil after surgeries