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anticonvulsant drug classes (5+misc.)
- hydantoins
- barbituates
- succinimides
- diones
- benzodiazepines
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anticonvulsant drug FX on memory formation
slower
drugs work by slowing down nerve conduction --> this slows down memory formation and leads to poorer school performance in kids
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higher or lower doses of anticonvulsants needed in elderly?
lower bc metabolized more slowly. low doses prevent accumulation of drug in circulation.
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phenytoin [Dilantin]
hydantoin
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a pt shouldn't change generic brands of this drug bc bioavailability varies
Dilantin
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hydantoin SFX
- lethargy
- ABN mvmt
- cognitive changes - confusion
- gingival hyperplasia
- acne
- periph polyneuropathy
- bone marrow suppression
- skin rash - benign
- hirsutism
- osteoporosis
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pt population esp susceptible to skin rash and hyperplasia
peds
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pt population esp susceptible to skin rash, confusion, and slow drug metabolism
geri
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hydantoin action
inhibit spread of seizure by desensitizing Na channels
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ETOH interaction with hydantoins
speeds up drug metabolism --> drug less effective
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"...barbitol"
barbituates - anticonvulsant
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"...suximide"
succinimides - used only to tx absence seizures
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"...zepam / zepate"
benzodiazepines
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valproic acid [Depakene] & valproate [Depakote]
anticonvulsant - used alone to tx absence seizures or as adjunct for other types
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carbamazepine [Tegretol]
anticonvulsant
pt at risk for heart block, bone marrow suppression, renal damage
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felbamate [Felbatol]
anticonvulsant - dangerous (aplastic anemia, liver failure)
used only to tx pts refractory to all other drugs
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lamotrigine [Lamictal]
anticonvulsant
- used in conjunction with other seizure meds.
- not teratogenic
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topiramate [Topamax]
anticonvulsant
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tiagabine [Gabitril]
anticonvulsant
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oxcarbazepine [Trileptal]
anticonvulsant
similar to carbamazepine, but better tolerated
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levitiracetam [Keppra]
anticonvulsant
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magnesium sulfate uses and action
- OB (stop premature labor, tx uterine ateny)
- prevent ecclampsia
action: suppress mm activity by making it unresponsive to neural signal to contract (blocks periph neurotransmission by reducing acetylcholine release at the myoneural junction)
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Mag SO4 (aka magnesium sulfate) therapeutic blood serum level
4-6. >25 = cardiac arrest
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major risk to monitor for in pt receiving Mag SO4
resp suppression - drug suppresses all mm activity, incl resp mm (will see decreased DTR even at therapeutic level)
if DTRs are gone, need to reduce dose
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anticholinergics used to tx what disease?
Parkinson's
anticholinergics aka parasympatholytics
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cholinergic effects in body
rest and digest, everything gets wetter
- Salivation
- Lacrimation
- Urination
- Diarrhea
- GI motility
- Emesis
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levodopa [L-dopa]
dopamine increaser, used to tx Parkinsons
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amantadine [Symmetrel]
dopamine releasing drug
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bromocriptine [Parlodel]
dopamine agonist - stims production of more dopamine
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pegolide [Permax]
stim receptors to used dopamine better
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levodopa-carbidopa [Sinemet]
dopamine increaser
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entacapone [Comtan]
COMT inhibitor - increases amt of available dopamine
doesn't cause liver damage like tolcapone [Tasmar}
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tolcapone [Tasmar]
COMT inhibitor - increases amt of available dopamine
causes liver damage
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"...capone"
COMT inhibitors
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physostigmine [Antilirium]
cholinergic
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pyridiostigmine [Mestinon]
cholinergic
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"...stigmine" and others
cholinergic
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bethanechol [Urecholine]
cholinergic
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tacrine [Cognex]
cholinsterase inhibitor --> cholingeric drug
used to tx Alzheimer's
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donepezil [Aricept]
Alzheimer drug
inhibits acetylcholinesterase (inhibits breakdown of acetylcholine)
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memantine [Namenda]
tx Alzheimers
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interferon beta-1b [Betaseron] and interferon beta-1a [Avonex]
main drugs for MS
self-administered IM
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glatrimer acetate [Copaxone]
drug for MS
synthetic copy of myelin basic protein, so acts as a decoy to the immune sys. Abs attack this decoy instead of myelin itself.
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riluzole [Rilutek]
drug for ALS (aka Lou Gehrig's disease)
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methylphenidate [Ritalin]
amphetamine (CNS stimulant)
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amphetamine mixture [Adderall]
amphetamine (CNS stimulant)
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doxapram [Dopram]
analeptic (CNS stim)
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modafinil [Provigil]
analeptic (CNS stim)
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