Drugs
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Disulfiram
Naltrexone (used for opioids and cigarettes)
Acamprostate
Buproprioin (Used for cigarettes and meth)
Varenicline
Clonidine
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methadone, buprenorphine, naltrexone
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Modafinil
FOR PARKINSONS
Dopamine Replacement
Levodopa
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Highly effective for treating PD but effect wears off by end of 5 years
AE
o Nausea, vomiting
o CV: Postural hypotension
o Dysrhythmias
o Dyskinesia
 Ballismus: Rapid involuntary jerking or flinging
 Choreoathetosis: Slow writing movement
o Psychosis
o CNS stimulation
Vitamin B6 (pyridoxine) decreases levodopa effectiveness
Non Ergot derivatives
Pramipexol
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AE
o
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Nausea, dizziness, somnolence, insomnia, constipation
Rare: Sleep attacks
Ropinirole (Requip)
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AE: Same as pramipexol
Rotigotin
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Transdermal patch
Apomorphine
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Used for “off” episodes in advanced PD
AE
o
Hallucinations, yawning, dyskinesia
ERGOT Derivatives
Bromocriptine
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Similar to pramipexol and ropinirole
COMT Inhibitors
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Only indicated for use with levodopa, no direct therapeutic effects
Prevents the metabolism of levodopa
Improves motor function
Entacapone
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AE
o
Constipation, yellow orang urine
Tolcapone
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AE in addition to entacapone AE
o Hematuria and liver failure
MAO – B inhibitor
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Prevents metabolism of levodopa
Selegiline
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Don’t mix with antidepressants
Intensify AE of levodopa
AE
o Insomnia, orthostatic hypotension, GI effects
Rasagiline
Amantidine
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Can cause levedo reticularis
Centrally acting anticholinergics
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Benztropine
FOR ALZHEIMERS
Cholinesterase inhibitors
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Donepezil
Rivastigmine
o Irreversible inhibition of cholinesterase
Galantine
o Reversible inhibition of cholinesterase
NMDA inhibitors
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Memantine
o MOA: Antagonizes NMDA receptors when glutamate levels are low
 Bc there is a constant leakage of glutamate in AD pts, so its always active
 Prevents calcium influx
EPILEPSY
Phenytoin therapeutic levels: 10-20mcg
Types of seizures
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Simple partial: 20-60s with no loss of consciousness
Complex partial: 45-60s with impaired consciousness
Secondarily generalized: 1-2min with loss of consciousness
Tonic-clonic: 90s or less with impaired consciousness
Absence: Primarily in children. 10-30s with loss of consciousness
Atonic: loss of muscle tone
Myoclonic: Sudden muscle contraction for 1s
Status epilepticus: Persists for 15-30 mins with no consciousness
Febrile: due to infection at a young age
Lennox-Gastaut: mixed
Drug abuse
DRUG SCHEDULES
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Schedule I: No current accepted medical use, high potential for abuse
o LSD, maryjane, ecstasy
Schedule II: High potential for abuse and dependence
o Hydrocodone, Vicodin, cocaine
Schedules III: abuse potential, moderate to low potential for dependence
o Ketamine
Schedule IV: Low potential for abuse and dependence
Schedule V: lower potential than IV
Alcohol
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Facilitate withdrawal:
o Benzodiazepines: Decreases withdrawal intensity
Maintain abstinence
o Disulfiram: unpleasant effects if alcohol in consumed
 Avoid all sources of alcohol
o Naltrexone: Decrease cravings for alcohol and blocks pleasurable effects
o Acamprosate: Reduces unpleasant feelings brought on by abstinence
Nicotine
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Bupropion
o Atypical antidepressant
o Reduce urge to smoke
Varenicline
o Most effective aide for smoking cessation
Opioids
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Triad of symptoms
o Respiratory depression
o Coma
o Pinpoint pupils
Detox
o Clonidine assisted
Methadone
o Suppressive therapy
o Large doses create high tolerance and decreases desirable affects via cross tolerance
Naltrexone
o Blocks euphoria