PHARM SI

"Hangover" poor judgement, amnesia, coordination loss and headache

Kava kava and Valerian

An herbal supplement made of dried rhizomes from Piper methysticum. Can cause discoloration of hair skin and nails with long term use. It has CNS depressing effects and is used to treat anxiety, insomnia and sometimes ADHD.

The root of contains acids that are used to treat anxiety, restlessness or sleep disorders. It is used as a CNS depressant. It interacts with most CNS depressants, MAOIs and Phenytoin.

Primarily women, 10-20% suffer from in the US, increases with age.

Specific sleep schedule/ritual

insomnia, muscle spasms, anxiety, anesthesia, seizures, and status epilepticus

Depress CNS- thought to stimulate GABA

narrow angle glaucoma, allergy or pregnancy

hangover- drowsy, lethargic confused dizzy amnesic and impaired cognitively

They end in -pam and -lam

More likely when used with other CNS depressants including alcohol, valerian or kava kava

Flumazenil is antidote for overdose/ or do bring patient out of anesthesia. Not often used for general toxicity as it can cause seizures.

Benzodiazepine

Benzodiazepine

Benzodiazepine

Benzodiazepine

Benzodiazepine

Benzodiazepine

Benzodiazepines

1.Alcohol and other CNS depressants.

Zolpidem (Ambien)

Non−benzodiazepine hypnotic, acts via inhibition of the BDZ1 (omega1) neurotransmitter receptor subtype and is reversed by flumazenil; less amnesia and muscle relaxation; lower dependence liability

Indicated for use in insomniacs

"hangover" (especially amnesic), tolerance, dependence and binge eating.

Facilitate GABA(a) action by inc duration of Cl- channel opening --> dec neuron firing

insomniacs, seizure disorders, anesthetic

Most life threatening: respiratory depression, hypotension

supportive: Ventilation (mainstay airway assisted ventilation due to respiratory depression), oxygen, fluid replacement and vasopressors (counteract hypotension)

No longer used to regularly used to treat insomniacs because of dependency and rapid development of tolerance. Not prescribed more than 2 weeks for sleep.

Drug history, including supplement use (kava/valerian)

-give at night

-Drug history: Previous use, drugs that may interact

Use bed alarm for elderly or first time users

don't drive, do not use or supplement other drugs with CNS depressing effects, do not stop treatment abruptly and will not take longer than 2 weeks for barbits or 3-4 weeks benzos

1 Identify cause of insomnia

relaxes skeletal muscle via CNS stimulus; indicated for muscle spasms; contraindicated in those with severe renal impairment and na glaucoma; has anticholinergic effects, hallucinations, ED, hypotension and fatigue; Interacts with CNS depressants

Emergency drug! act directly on skeletal muscle, Closely resemble GABA; indicated for malignant hyperthermia or neuroleptic malignant syndrome.

CNS acting Muscle Relaxant

direct acting muscle relaxant

drugs that stimulate norepinephrine and dopamine release, causing speeded-up body functions and associated energy and mood changes

ADHD and Narcolepsy

glaucome, hyperthyroidism, structural cardiac abnormalities, parkinson's and anxiety

Tachycardia, palpitations and hypertension

failure to gain weight with age/weight loss that can be symptomatic of growth deficiency

MAOIs- hypertensive crisis that can lead to stroke or MI

Ritalin

Amphetamine-like drug used to treat adhd

1. Report tachycardia or palpitations

Migraine tx; constricts cranial arteries, but can have systemic effects; therefore should not be used in patients with cardiovascular disease or uncontrolled hypertension, previous MI or stroke.

numbness, tingling and warm sensation

tingling, numbness, warm sensation N/V/D, muscle cramps dysrhythmia, thromboembolism MI and Stroke

Paroxysmal, uncontrolled electrical discharge of neurons in the brain that interrupts normal function.

The final phase of a generalized seizure, during which the patient becomes extremely fatigued and is recovering.

Seizure is a one time occurrence or one time collection of seizures due to trauma.

a seizure that affects only one part or one side of the brain

a partial seizure, starting from a focus and remaining localized, that produces loss of consciousness

the patient maintains consciousness, is aware and remembers

seizures that involve the entire brain

peculiar sensations that precede a seizure, may take the form of a taste, smell, sight, or sound; dizziness; or funny feeling

Increased risk of having a seizure while pregnant, hypoxia occurs during these episodes putting mom and fetus at risk, many drugs are teratogens and can inhibit optimum pregnancy folate and potassium levels

Most commonly prescribed antiepileptic and are indicated for use in tonic-clonic and complex/partial seizures

Hydantoin Anticonvulsant

can cause gingival hyperplasia and is a teratogen

Anti coagulants- warfarin

Very small therapeutic range 10-20mcg/mL

a barbiturate used as a sedative and as an anticonvulsant

brain stem depressant

Narrow therapeutic range 15-40 mcg/mL

sedation and tolerance

anticonvulsant class of drugs including carbamazepine

Anticonvulsant

bone marrow suppression

Narrow therapeutic range (4-12 mcg/mL)

Anticonvulsant

pregnancy, caution in young pts and elderly, pts with hepatic impairment

Liver failure/ jaundice

Narrow therapeutic range (50-125 mcg/mL)

Seizures that result from sudden high fevers; most often seen in children and lead to increased risk of developing epilepsy.

Assess location, duration, and characteristics or seizure activity

IV phenytoin can only be mixed with normal saline

Maintain proper oral hygeine and biannual dentist visits

Peak:1-3 days

Peak:1-3 days

Short acting

Mild alcohol withdrawal: symptoms similar to other depressants.

Nicotinic receptors all over body, reduced stimulation=w/drawl S/S

the division of the autonomic nervous system that calms the body, conserving its energy. Rest and Digest

the division of the autonomic nervous system that arouses the body, mobilizing its energy in stressful situations.

relaxation techniques, group therapy, solo therapy.

Lorazepam (Ativan) and diazepam (Valium)

Psych

grapefuit juice

Emotional disorders that are characterized by changes in mood.

a person experiences elation, extreme confusion, distractibility, feelings of grandeur and racing thoughts

lack of energy, concentration, low self esteem, loss of interest, and helplessness

Indicated for SEIZURES and BIPOLAR disorder

Last resort bipolar treatment as it has lts of adverse effect, narrow therapeutic range and lots of interactions

Alters Na transport in neurons

At toxic levels, Li can cause ataxia, dysarthria, coarse tremors, and delirium, potentially culminating in seizures, coma, and death.