Module IV: Central Nervous - Dextroamphetamine Indication: obesity

System Medications (Dexedrine)

Ex. Dextroamphetamine (Dexadrine)
- Methylphenidate (concerta,
Ritalin)
A. CNS Stimulants
Narcolepsy Side Effects/adverse effects:
- Drugs that enhances the activities of
- Modafinil (Provigil) - Tachycardia, palpitatios,
neurotransmitters: dopamine,
- Pemoline (Cylert) dizziness, hypertension
norepinephrine, serotonin
- Sleeplessness, restlessness,
II. Analeptics
1. Amphetamines nervousness, tremors,
Action: stimulates CNS by either irritability
2. Analeptics
increasing neuronal discharge or - Increases hyperactivity
3. Anorexiants inhibiting neurotransmitters (INCOMPLETE)
Indication:
 Contraindications/Precautions
I. Amphetamines - Reversal of anesthesia-induced - C:Glaucoma, severe CV
Action: acts on cerebral cortex, respiratory depression disease
reticular activity system - Stimulate respiration in (INCOMPLETE)
newborns
Indication :
Methylxanthines B. CNS Depressants
- Increases in narcolepsy
- Increases attention span, - Aminophylline Action: Drugs that have an CNS
cognition - Theophylline inhibitory effect
- Decreases hyperactivity, - Caffeine
Sedatives
impulsiveness, restlessness of NoDoz
ADHD - Reduces nervousness,
Doxapram (Dopram) excitability, and irritability
ADHD without causing sleep
III. Anorexiants
- Methamphetamine (Desoxyn) Sedativ-hypnotics
Action: suppress the appetite control
- Amphetamine (Adderall)
center in the brain
 - Low doses: calm the CNS
without inducing sleep
- High doses: calm the CNS and
causes sleep; also causes
respiratory depression
I. Barbiturates
II. benzodiazepines
III. Non-benzodiazepines
I. Baribiturates
- Action: inhibits GABA, which
inhibits nerve impulses in the cerebral
cortex; suppresses REM sleep
Indication: Hypnotics, sedatives,
anticonvulsants, anesthesia
 Habit forming; low therapeutic
index
Ultrashort-acting
- Used as a general anethetic
Ex. Thipental sodium (pentothal)
Short-acting
- Induce sleep, controls
convulsion, and no residual
drowsiness
Ex. Pentobarbital
(INCOMPLETE)
Intermediate-acting
- Induce and sustain sleep, for
convulsion, but causes residual
drowsiness (hangover effect)
Ex. (INCOMPLETE)
NOTE! Barbiturates are notorious
enzyme inducers; it stimulates liver
enzymes, which speeds up drug
metabolism resulting to shortened
duration of drug action
II. Benzodiazepines
Action: Interacts with GABA to
reduce neuron excitability; do not
suppresses REM sleep
Indication: agitation, anxiety, alcohol
withdrawal, pre-operative sedation,
insomnia, seizure, skeletal muscle
relaxation
Long-acting
- Estazolam (Prosom),
- Flurazepam (Dalmane)
-
INCOMPLETE
NOTE! Benzodiazepines are the most
frequently prescribes sedative-
hypnotics because of its favourable
drug effects
III. Non-benzodiazepines
Action: neurotransmitter inhibition
Indication: treat short-term (<10 days)
insomnia
Ex. Zolpidem (ambien), eszopiclone
(Lunesta)
Drug Interactions;l
- Alcohol, ethanol,
antihistamines,
benzodiazepines, MAOIs=
increases effect, decreases
respirations with
- MAOIs will prolong effects of
barbiturates
- Decreases anticoagulant
response, leading to possible
clot formation
Side Effects/adverse effects
- Residual drowsiness (Hangover
Effect)
- Headache, vertigo
- Fall hazard for frail elderly
persons
 - Drug dependence and tolerance Suppress Na influx - Primary treatment for acute
- Respiratory depression seizures: diazepam
- Phenytoin (Dilantin)
- Withdrawal symptoms - Short term effect; not for
Suppress Ca influx maintenance
Contraindication:
- Valproic acid - For petit mal seizures:
- Pregnancy, uncontrolled pain, clonazepam
INCOMPLETE
acute intermittent porphyria - High degree of tolerance
Types of Antinconvulsants - Adjunctive therapy for
C. Anticonvulsants
1. Hydantoin treatment of partial seizures:
Seizure Disorders clorazepate
2. Barbiturates
Seizure- abnormal electric discharges Succinimides
from neurons characterized by loss of 3. Benzodiazepines
consciousness. - Used to treat absence or petit
4. Succinimides mal seizures
Convulsion- sudden, violent, irregular INCOMPLETE
movement of a lim or of the body,
caused by involuntary contraction of Hydantoin D. Neuromuscular Medications
muscles and associated especially - Most commonly-used drug for Myasthenia Gravis
with brain disorders seizure control - Autoimmune disease caused by
Epilepsy- chronic, recurrent INCOMPLETE lack of nerve impulses and
occurrence of 2 or more unprovoked Barbiturates muscle responses at myoneural
seizure episodes junction due to lack of
- For grand mal acute episodes of acetylcholine reaching
Tonic- body’s defense status epilepticus cholinergic receptors
Action: Suppress abnormal neuron - Use long-acting barbiturate:
firing, inhibiting seizure activites phenobarbital Cholinesterase Inhibitors
- Lesser teratogenic effects than Action: transmission of
Indications: tonic-clonic seizure, phenytoin
status epilepticus, complete partial neuromuscular impulses by
seizures, arrhythmias, trigeminal Benzodiazepines preventing destruction of Ach- allows
neuralgia cholinergic response
INCOMPLETE
3 Medications
Neostigmine (Prostigmin)
- Short-acting
Edrophonium (Tensilon)
- Ultrashort-acting for
diagnosing MG
Pyridostigmine (Mestinon)
INCOMPLETE
Myasthenia Crisis
- Underdosed
- Severe muscle weakness
- Improves after edrophonium
Cholinergic crisis
- Overdosed
- Severe muscle cramping
Cholinesterase Inhibitors
Side Effects
- Pupil constriction
- GI distress, abdominal cramps
- Excess saliva, sweating
- Headache, dizziness, seizures
- Hypotension, bradycardia,
dysarrthmias
- INCOMPLETE
Multiple Sclerosis (MS)
- Autoimmune disorder that
attacks myelin sheath of nerve
fibers
- Characteristics: INCOMPLETE
Muscle relaxants
- Provides relief of painful
musculoskeletal condition:
 Muscle spasms
 Management of spasticity of
severe chornic disorders
INCOMPLETE
Central Acting: CNS
- Baclofen (Lioresal)
- Diazepam
- Clarisoprodol (Soma)
- Cyclobenzaprine (Flexeril)
INCOMPLETE
E. Parkinson’s Diseases (PD) and
Alzheimer’s Diseases (AD)
Parkinson’s Disease
- Chronic, progressive,
degenerative disorder due to
neurotransmitter imbalance:
dopamine<acetylcholine (ACh)
Anti-Parkinsonism Drugs
1. Anticholinergic
- benztropine, biperiden
- Block the effects of Ach by blocking
cholinergic receptors
Indication: muscle tremors and
muscle rigidity associated
INCOMPLETE
Alzheimers’s Disease
- Progressive, degenerative
disease due to neuritic plaques
formation and neurofibrillary
tangels in neurons
INCOMPLETE
Anomia- inability to remember names
of things
Apraxia- misuse of object o
INCOMPLETE