Transcript of Agents for the Central Nervous System Many CNS medications are used to treat multiple disorders ...
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- Agents for the Central Nervous System
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- Many CNS medications are used to treat multiple disorders
Neurontin (gabapentin) Topamax (topiramate)
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- Brand nameGeneric name Abilifyaripiprazole Invegapaliperidone
Risperdal*risperidone Seroquelquetiapine Zyprexaolanzapine
*available generically
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- Extreme, inappropriate behavior Hallucinations, delusions,
violent outbursts Common side effects: Sleepiness Weight gain
Change in blood sugar levels
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- Aka manic depression Broad spectrum of symptoms & severity
Highs are high Lows are low Antidepressants Antipsychotics
Anticonvulsants Anti-anxiety medications
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- Brand nameGeneric name Depakote*divalproex Dilantin*phenytoin
Keppra*levetiracetam Neurontin*gabapentin Lamictal*lamotrigine
Tegretol*carbamazepine Topamax*topiramate *available
generically
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- Abnormal electrical activity in the brain dazed and confused
Violent convulsions (physical expression of seizure) Periodic blood
tests (Dilantin, Depakote) Error Alert Depakote available as DR
(delayed release) and ER (extended release)
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- Brand nameGeneric name Adderall*,Adderall XR *(CII)
dextroamphetamine/amphetamine Concerta (CII) methylphenidate, ext.
rel. Focalin* (CII)dexmethylphenidate Ritalin* (CII)methylphenidate
Vyvanse (CII)lisdexamfetamine *available generically
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- Attention Deficit-Hyperactivity Disorder Chronic affecting 50%
of those diagnosed into adulthood Boys >>> girls Symptoms
for at least 6 months AND interfere w/ normal living (classroom,
home, play) Hyperactive-impulsive Predominantly inattentive
Combination hyperactive-impulsive & inattentive
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- Causes genetic, social, diet, environmental (?) Dopamine,
glucose metabolism (?) Hyperactive-impulsive Excessive talking,
fidgeting, squirming in seat, blurts out inappropriate comments,
act w/o regard for consequences Inattentive Inability to focus or
complete tasks, easily distracted, doesnt listen when spoken to
directly, often loses things
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- Controversial Higher rates of schizophrenia & bipolar
disorder in those treated with stimulants during childhood
Stimulants increase the dopamine and norepinephrine levels black
box warnings heart attack, stroke, sudden death Strattera only non
stimulant approved for ADHD treatment Off label clonidine,
guanfacine, certain antidepressants
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- Brand nameGeneric name Ariceptdonepezil Namendamemantine
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- Alzheimers versus aging Symptoms Confusion, lack of judgement,
personality changes, inability to perform basic tasks Aricept early
stage to late stage Namenda late stage
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- Brand nameGeneric name Cogentin*benztropine Sinemet*, Sinemet
CR*carbidopa/levodopa & Parcopa *available generically
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- Progressive disease Low levels of dopamine; high levels of
acetylcholine Resting tremor, rigid movements, difficulty chewing
& swallowing, emotionless facial expression Gold standard =
carbidopa/levodopa
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- Brand nameGeneric name Amergenaratriptan Imitrex*sumatriptan
Maxalt, Maxalt MLTrizatriptan Treximetsumatriptan/naproxen Zomig,
Zomig ZMTzolmitriptan *available generically
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- Brand nameGeneric name Fioricet, Esgic
Plusbutalbital/APAP/caffeine Fiorinal (CIII)butalbital/ASA/caffeine
*all available generically
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- Fluctuations in serotonin levels Pain, sensitivity to
light/sound/odor, nausea & vomiting Women >> men aura
flashing lights, burning sensation, numbness, tingling
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- Prevention Beta blockers Tricyclic antidepressants
anticonvulsants Treatment Triptans - taken at first sign of
migraine Can cause Serotonin Syndrome Combination products
caffeine