Neuropharm

• Derived from tyrosine, tryptophan, phenylalanine, and thyroid.
• Histamine
• Catecholamines: Dopamine, EPI, NEP
• Tryptamines: Serotonin, melatonin
• Trace amines

• Stimulant for ADHD
• MOA: inc DA & NE

Contra: Drug abuser, hyperthyroid, HTN

• Stimulant for ADHD
• MOA: inc DA & NE

Contra: drug abuser, hyperthyroid, HTN

• Stimulant for ADHD
• MOA: inc DA & NE

• Contra: Drug abuser, hyperthyroid, HTN

• Stimulant for ADHD (SR-12hrs)
• MOA: inc DA & NE

• A/E: insomnia (narcolepsy)

• Stimulant for ADHD (9 hour wear ~to cocaine)
• MOA: Inc DA & NE

Contra: Not in adults

• Nonstimulant for resistant ADHD (1/day)
• MOA: NE uptake inhibitor/ CYP450 metabolism

CONTRA: tramadol, MAOI, drugs that inhibit CYP450

• Nonstimulant for resistant ADHD (also antidepressant)
• MOA: inc NE & DA/ inhibits CYP 450

A/E: peripheral NE & DA effects

• Nonstimulant for resistant ADHD
• MOA: A-2 receptor agonist in prefrontal cortex --> inc noradrenergic system (for tics and emotional bursts)

CONTRA: sedative drugs, phenobarbital and phenytoin (may dec plasma level)

FOR: All the partial seizures

MOA: Na channel inactivation

Enzyme inducer

best risk/benefit ratio

FOR: All partial seizures

• MOA: slows Na channel recovery
• 5-10X enhances GABA

Enzyme inducer

Inhibits Warfarin metabolism

FOR: status epilepticus, Generalized t-c, partial seizures

MOA: Inc GABA


Enzyme inducer

Teratogen

FOR: Partial Seizures

MOA: Prodrug

Enzyme inducer

No Warfarin interference

FOR: Partial & generalized seizures

MOA: Inc GABA via Ca2+ channel

No enzyme induction

A/E: ataxia & fatigue

FOR: Partial and generalized seizures

MOA: Inc GABA via Ca2+ channel


ataxia & fatigue

FOR: Resistant partial seizures

MOA: K channels

FOR: Partial, absence, and myoclonic seizures

• MOA: Na inactivation
• Inc GABA
• Reduces T-type Ca2+ current

Inhibits liver enzymes

Teratogen

FOR: Absence, Lennox-Gastaut syndrome w/ myoclonic seizures

MOA: Inc GABA A opening frequency

A/E: Lethargy Cognitive effects

FOR: All partial, Lennoz-Gastut syndrome, general T-C, absence

• MOA: Na channel inactivation
• inhibit glutamate release

(used with Valproic in drug resistant epilepsy)

Aggravates myoclonie seizures

FOR: Partial, generalized, myoclonic seizures

MOA: Unkonwn

No enzyme induction

asthenia

FOR: All partial & Lennox-Gastut Syndrome

• MOA: Red Na current
• activate K hyperpolarization
• enhance GABA
• Limits glutamate receptor
• Inhibit Brain Carbonic anhydrase

Enzyme inducer

FOR: Partial and generalized & Lennox-Gastut syndrome

• MOA: inhibits NMDA response
• Potentiate GABA response

w/ other anticonvulsants --> rash & toxicities

FOR: Partial, generalized T-C(except myoclonic)

• MOA: Inhibits Ca channel
• Prolongs Na channel inactivation
• inhibits Carbonic anhydrase

• IV lorazepam
• Diazepam followed by phenytoin
• phenobarbital & phenytoin

Tricyclic for Depression

MOA: inhibits 5-HT and NEP reuptake sites

Tricyclic for Depression

MOA: inhibits 5-HT and NEP reuptake sites

Tricyclic for Depression

MOA: inhibits 5-HT and NEP reuptake sites

MAOI for depression

MOA: inhibits breakdown of the 3 monoamines

Irreversible nonselesctive MAOI

MAOI for depression

MOA: inhibits breakdown of the 3 monoamines

Irreversible MAO-B inhibitor

SSRI for depression

MOA: block reuptake sites --> downregulate auto-receptors

inhibits P450 enzymes

can be used in kids

SSRI for depression

MOA: Block 5HT reuptake site --> autoreceptor downregulate

inhibits P450 enzyme

Used in kids

SSRI for depression

MOA: block reuptake sites-> downregulate auto-receptors

• Strong efficacy
• tolerability
• OK for kids

SSRI for depression

MOA: block reuptake site -> downregulate autoreceptor

• tolerability
• OK for kids

SSRI for depression

MOA: block reuptake site -> downregulate autoreceptor

• Great efficacy
• tolerable
• Ok for kids

TERATOGEN

Hyperkinetic, tremor, clonus, hyper-reflexia, agitation, tachycardia

SNRI for depression

Ok For kids

Liver concerns

SNRI for depression

• good efficacy
• ok for kids

No P450 interaction

SNRI for depression

• ok for kids
• No P450 interaction

Atypical for depression

• MOA: presynaptic alpha2 receptor blocker
• block 5-HT2A and 2c autoreceptor

Atypical for depression

MOA: NE & Da uptake inhibitor

• tolerable
• Ok with kids
• Safe in cardiac patients

Atypical for depression

MOA: H1 antagonism

Blocks 5-HT3 sites -> anti-nausea

• good efficacy
• ok with kids

Atypical for depression

MOA: 5-HT2C antagonist & MT1/MT2 agonist

Restores circadian rhythms and improves sleep quality

• SSRI
• SNRI
• Buproprion
• CBT
• interpersonal therapy

1st generation sedative hypnotic (for anxiety)

Inc time channel is open

• Teratogen
• Abuse risk

Barbituate Anxiety (long acting)

MOA: inc time channel is open

• Increased pain perception
• Respiratory depression

Barbituates (intermediate)

MOA: inc time GABA channel is open

For: surgery, anesthesia, & sleep induction

Barbituate (short acting)

MOA: Inc time GABA channel is open

Supports anesthesia

2nd generation

MOA: Inc frequency of GABA channel opening

• Teratogen
• No coma or death
• active metabolite accumulation

Benzodiazepine (long acting)

MOA: inc opening frequency of GABA channels

Hypnotic

Benzodiazepine (long acting)

MOA: inc open frequency of GABA channel

dec sleep latency, inc total sleep time, but dec REM