gold pharm cns
TRANSCRIPT
Gold Pharm
CNS
•Short -acting BDZs:
•“TOM” –Triazolam– Onazelam– Midazolam
•Butyrophenone
•Haloperidol & Droperidol
•Atypical D4
•Clozapine - Thioridazine - Olanzepine -
Risperidone = Do not cause EPS
•Flumazenil
–BDZ antidote for OD
•Phenytoin
•Causes aplastic anemia/ gingival
hyperplasia/ cleft lip & palate
•Thiopental
•Short acting Barb
•Carbamazepine
–DOC trigeminal neuralgia. Txt lennox
gestaut seizures in kids
•Atypical D4-r
•Thioridazine; Olamzapine;
Clozapine
•Pimozide
–Txt Tourette’s
•Risperidone
•Good for negative symptoms
•Thioridazine
•Most anti cholinergic neuroleptic
•Haloperidol
•Neuroleptic malignant hyperthermia due to
chronic D2 block. give Dantrolene and Bromocriptine
•Imirpamine
–Enurisis
•Clomirpramine
•Txt OCD See aggressive behavior w/
use
•Trazadone
•Priapism
•Bupropion
–Helps to quit smoking
•SSRIs
–Primarily used for OCD
•Fluoxetine
–Good for negative symptoms
•Phenelzine
–Irreversible MAOI
•Lithium
– Txt manic phase of Bipolar Disorder– Causes goiter by (-) conversion of
T4 to T3– Nephrogenic diabetes insipidus– Low salt diet will lead to Li toxicity
•Alprazolam
–DOC stage fright
•Propranolol
–Social phobia
•-r
–Spinal analgesia. Euphoria. ++euphoria. ++sedation.
Constipation.
•-r
–Supraspinal analgesia. Dysphoria.
+respiratory depression. +sedation.
•Morphine & O2
– Admin. is contraindicated to pts on
morphine sedation= decrease CO2 sensitivity and O2 admin. can stop
breathing.
•Morphine
•Increase ICP = do not give to pt. with head
trauma
•Morphine OD
•1.pinpoint pupils 2. decrease respiraiton
3.coma
•Meperidine
–Anesthetic used during labor
•Hydromorphone
– (+) used in renal failure
•Tramadol
•Ambulatory txt for mod. to severe pain
•Part (+) & part (-)
•Pentazocine•Butorphenol • Nalbuphene
•decrease GABA
–decrease seizure focus= Barbs &
BDZs
•decrease Fast Na Ch.
–decrease electrical activity spread =
Phenytoin & Carbamazepine
•Methoxyflurane
•Can be nephrotoxic. Needs low MAC for anesthetic induction.
•Enflurane
•Can cause tonic/clonic muscle spasms
•Isoflurane
–Can cause bronchospasm
•Halothane
–Can cause ventricular extrasystoles &
Malignant hyperthermia &
Hepatitis
•Nitric Oxide
–No effect on HR. Needs high MAC for anesthetic induction.
•Thiopental
–Short acting Barb.
•Droperidol
–Can be used in combo w/ Fentanyl for
neuroleptoanalgesic effect– Neuroleptic tranquilizer.
Has mild alpha block
•Fentanyl
–Can be used on combo w/ Droperidol for
neuroleptoanalgesic effect
– Used transdermally for chronic pain
•Midazolam
•Pre anesthetic. Induces amnesia
•Primidone
–Biotransformed to Phenobarb.
•First fibers to be blocked w/ anesthesia
•C & A delta Fibers
•Esters
–Procaine, Tetracaine, Benzocaine
– Broken down and make PABA (allergen)
•Amides
–Lidocaine, Mepivaciane, Bupivaciane, Etidocaine= “i” before “caine” always
an amide– Metabolized in the liver
•Amphetamine
–DA reuptake (-)’r. MAOI. Parkinson’s
txt
•Bromocriptine
–D2(+). Used w/ L-Dopa for “on-off” phenomenon of
Parkinson’s
•Benztropine
–Ant M w/ some DA reuptake (-).
Parkinson’s txt
•Amantidine
–decrease DA reuptake. Can cause livido reticularis=
skin mottling.
•Diphenhydramine
–Txt early Parkinson’s stages
•Pergolide
–> Effective & longer acting than
Bromocriptine
•Tranylcypromine
–MAOI = antidepressant
•SSRI & MAOI
•Fatal combo, especially seen with the use of
Paroxetine or Fluoxetine (SSRIs) and
Tranylcypromine (MAOI)
•Labor opioids
•Meperidine & Nalbuphine
•Desipramine causes
•Sudden cardaic death in children