Pharmacology Modules 1–10 – Comprehensive Drug Review for
Medications and Therapies (Rasmussen University)
Module 2
Prototype drugs
Carbidopa/levodopa
oClass: dopaminergic
oIndications: Parkinson’s disease to decrease tremors and muscle rigidity
oMOA: increase dopamine in the CNS
oSide Effects: dyskinesias (tics), orthostatic hypotension, dark urine and sweat, N/V,
psychosis
oPT: Avoid high protein meals as they decrease the effectiveness of carbidopa/levodopa
Donepezil (Aricept)
oClass: cholinesterase inhibitors
oIndications: Alzheimer’s disease
oMOA: increase Ach (by inhibiting cholinesterase), which may improve memory and
cognition
oSide Effects: headache, diarrhea, nausea
oPT: take at bedtime. Donepezil does not cure Alzheimer’s disease
Memantine (Namenda)
oClass: NMDA receptor antagonists
oIndications: Alzheimer’s disease
oMOA: binds to NMDA receptors, preventing binding of glutamate (an excitatory
neurotransmitter), which may decrease symptoms of cognitive decline
oSide Effects: dizziness, headache, diarrhea
oPT: memantine does not cure Alzheimer’s disease
Interferon beta (Avenox)
oClass: immunomodulators
oIndications: Multiple sclerosis
oMOA: modifies the immune system by decreasing T-helper cells, slow attack on myelin
sheath, decreasing frequency of attacks
oSide Effects: flu-like symptoms, hepatotoxicity, bone marrow suppression, suicidal
ideation, irritation at injection site
oNC: at risk for developing infection, apply cold compress prior and warm compress after
Phenytoin (Dilantin)
oClass: traditional antiepileptic agents
oOther drugs: fosphenytoin, carbamazepine
oIndications: seizure disorders
oMOA: sodium channel blocker
oSide Effects: gingival hyperplasia, vision issues, dizziness, GI upset
oNC: monitor phenytoin blood levels during therapy (therapeutic range is 10-20 mcg/mL)
oPT: decrease effectiveness of oral contraceptives
Oxcarbazepine (Trileptal)
oClass: newer antiepileptic agents
, oIndications: seizure disorders
oMOA: drug binds to inactive neuron sodium channels keeping them inactive &
preventing sodium influx & neuron firing
oTherapeutic Range: 3-40 mcg/mL
oSide Effects: stevens-Johnson syndrome, birth defects, multiorgan hypersensitivity
reaction, nystagmus, dizziness, drowsiness, hyponatremia, neurological side effects
oPT: avoid driving and alcohol
Baclofen (Lioresal)
oClass: centrally acting muscle relaxer for spasticity
oIndications: spasticity related to spinal cord injury, cerebral palsy, MS
oMOA: enhances GABA in CNS to reduce muscle spasticity
oSide Effects: drowsiness, nausea, constipation
oPT: increase fiber and fluid intake
Cyclobenzaprine (Flexmid)
oClass: centrally acting muscle relaxer for localized muscle spasm
oIndications: spasticity related to spinal cord injury, cerebral palsy, MS
oMOA: works on the brainstem to reduce tonic motor activity
oSide Effects: CNS depression, anticholinergic effect, dizziness and photophobia
oPT: do not drink or drive on medication, if mixed with antidepressant an increased risk
for serotonin syndrome can occur
Amphetamine sulfate (Adderall)
oClass: amphetamines
oIndications: ADHD, narcolepsy, obstructive sleep apnea, drug induced respiratory
depression
oMOA: mimic nervous system causing CNS to speed up
oSide Effects: anemia, weight loss, dry mouth, stomach upset, dizziness, trouble sleeping,
and nervousness.
oPT: use barrier contraceptives
oContraindications: COPD, pregnancy, glaucoma, hyperthyroidism
oConsiderations: habit forming, abuse, and dependence, increased risk of suicidal
ideation, decrease effectiveness of oral contraceptives
Methylphenidate (Ritalin)
oClass: amphetamine-like drugs
oIndications: ADHD, conduct disorders, narcolepsy
oMOA: CNS stimulation, which increases mental alertness and attention
oSide Effects: insomnia, arrhythmias, decreased appetite, weight loss
oNC: monitor weight during therapy
oPT: do not take at night. For children, periodic drug holidays (withholding medication on
weekends and summer months) may be appropriate to increase growth and side effects
during those times
oConsiderations: abuse and dependence
Additional drugs to know
Pramipexole- dopamine agonist
,Entacapone- COMT inhibitor
Selegiline & Rasagiline- MAO-B inhibitor
Cholinesterase inhibitors- endophonium, tacarine, neostigmine, phyostigmine, pyridostigmine
(crosses BBB), rivastigmine, galantamine, echothiophate
Fingolimod- preserved for pt who do not tolerate injections
Mitoxantrone- only immunosuppressant approved for MS
Valproate (Depakote)
Ethosuximide (Zarontin)- treat absence seizures
Phenobarbital- decrease synthesis of vitamin K dependent clotting factors
Dantrolene- manage malignant hyperthermia caused by anesthesia
Methylxanthines- caffeine
, Module 3
Prototype drugs
Chlorpromazine
oClass: Traditional Antipsychotics (low-potency)
oOther drugs: haloperidol, droperidol
oIndications: control of positive symptoms (delusions, hallucinations) of schizophrenia
oMOA: alters the action of dopamine in the CNS
oSide Effects: Extrapyramidal symptoms (EPS), neuroleptic malignant syndrome (NMS),
agranulocytosis, anticholinergic effects, orthostatic hypotension, sedation, seizures
oNC: Monitor vital signs. Anticholinergics (benztropine) can be used to control EPS.
Muscle relaxants (dantrolene) can be used to treat NMS.
oConsiderations: increased risk of mortality in elderly with dementia-related psychosis.
Haloperidol
oClass: Traditional Antipsychotics (high-potency)
oOther drugs: chlorpromazine, droperidol
oIndications: control of positive symptoms (delusions, hallucinations) of schizophrenia
oMOA: alters the action of dopamine in the CNS
oSide Effects: Extrapyramidal symptoms (EPS), neuroleptic malignant syndrome (NMS),
agranulocytosis, anticholinergic effects, orthostatic hypotension, sedation, seizures
oNC: Monitor vital signs. Anticholinergics (benztropine) can be used to control EPS.
Muscle relaxants (dantrolene) can be used to treat NMS.
oConsiderations: increased risk of mortality in elderly with dementia-related psychosis.
Clozapine (Clozaril)
oClass: Atypical Antipsychotics
oOther drugs: olanzapine, risperidone
oIndications: control of positive and negative symptoms (anergia, anhedonia, social
withdrawal) of schizophrenia
oMOA: serotonin and dopamine antagonist
oSide Effects: type 2 diabetes, weight gain, hypercholesterolemia, sedation,
anticholinergic effects, decreased libido, agranulocytosis
oNC: monitor blood glucose and for signs of infection
oConsiderations: suicidal thoughts/behaviors, increase mortality in elderly with
dementia-related psychosis, severe neutropenia, seizures
Fluoxetine (Prozac)
oClass: Selective Serotonin Reuptake Inhibitors
oOther drugs: paroxetine, sertraline
oIndications: anxiety, depression, OCD, PTSD
oMOA: inhibits serotonin reuptake
oInteractions: St. John’s wort (increased risk for serotonin syndrome)
oSide Effects: sexual dysfunction, weight gain, insomnia.
oNC: Assess for symptoms of serotonin syndrome (agitation, fever, diaphoresis, tremors)
oConsiderations: suicidal thoughts and behaviors
oPT: full effects not felt for 2 or more weeks
Medications and Therapies (Rasmussen University)
Module 2
Prototype drugs
Carbidopa/levodopa
oClass: dopaminergic
oIndications: Parkinson’s disease to decrease tremors and muscle rigidity
oMOA: increase dopamine in the CNS
oSide Effects: dyskinesias (tics), orthostatic hypotension, dark urine and sweat, N/V,
psychosis
oPT: Avoid high protein meals as they decrease the effectiveness of carbidopa/levodopa
Donepezil (Aricept)
oClass: cholinesterase inhibitors
oIndications: Alzheimer’s disease
oMOA: increase Ach (by inhibiting cholinesterase), which may improve memory and
cognition
oSide Effects: headache, diarrhea, nausea
oPT: take at bedtime. Donepezil does not cure Alzheimer’s disease
Memantine (Namenda)
oClass: NMDA receptor antagonists
oIndications: Alzheimer’s disease
oMOA: binds to NMDA receptors, preventing binding of glutamate (an excitatory
neurotransmitter), which may decrease symptoms of cognitive decline
oSide Effects: dizziness, headache, diarrhea
oPT: memantine does not cure Alzheimer’s disease
Interferon beta (Avenox)
oClass: immunomodulators
oIndications: Multiple sclerosis
oMOA: modifies the immune system by decreasing T-helper cells, slow attack on myelin
sheath, decreasing frequency of attacks
oSide Effects: flu-like symptoms, hepatotoxicity, bone marrow suppression, suicidal
ideation, irritation at injection site
oNC: at risk for developing infection, apply cold compress prior and warm compress after
Phenytoin (Dilantin)
oClass: traditional antiepileptic agents
oOther drugs: fosphenytoin, carbamazepine
oIndications: seizure disorders
oMOA: sodium channel blocker
oSide Effects: gingival hyperplasia, vision issues, dizziness, GI upset
oNC: monitor phenytoin blood levels during therapy (therapeutic range is 10-20 mcg/mL)
oPT: decrease effectiveness of oral contraceptives
Oxcarbazepine (Trileptal)
oClass: newer antiepileptic agents
, oIndications: seizure disorders
oMOA: drug binds to inactive neuron sodium channels keeping them inactive &
preventing sodium influx & neuron firing
oTherapeutic Range: 3-40 mcg/mL
oSide Effects: stevens-Johnson syndrome, birth defects, multiorgan hypersensitivity
reaction, nystagmus, dizziness, drowsiness, hyponatremia, neurological side effects
oPT: avoid driving and alcohol
Baclofen (Lioresal)
oClass: centrally acting muscle relaxer for spasticity
oIndications: spasticity related to spinal cord injury, cerebral palsy, MS
oMOA: enhances GABA in CNS to reduce muscle spasticity
oSide Effects: drowsiness, nausea, constipation
oPT: increase fiber and fluid intake
Cyclobenzaprine (Flexmid)
oClass: centrally acting muscle relaxer for localized muscle spasm
oIndications: spasticity related to spinal cord injury, cerebral palsy, MS
oMOA: works on the brainstem to reduce tonic motor activity
oSide Effects: CNS depression, anticholinergic effect, dizziness and photophobia
oPT: do not drink or drive on medication, if mixed with antidepressant an increased risk
for serotonin syndrome can occur
Amphetamine sulfate (Adderall)
oClass: amphetamines
oIndications: ADHD, narcolepsy, obstructive sleep apnea, drug induced respiratory
depression
oMOA: mimic nervous system causing CNS to speed up
oSide Effects: anemia, weight loss, dry mouth, stomach upset, dizziness, trouble sleeping,
and nervousness.
oPT: use barrier contraceptives
oContraindications: COPD, pregnancy, glaucoma, hyperthyroidism
oConsiderations: habit forming, abuse, and dependence, increased risk of suicidal
ideation, decrease effectiveness of oral contraceptives
Methylphenidate (Ritalin)
oClass: amphetamine-like drugs
oIndications: ADHD, conduct disorders, narcolepsy
oMOA: CNS stimulation, which increases mental alertness and attention
oSide Effects: insomnia, arrhythmias, decreased appetite, weight loss
oNC: monitor weight during therapy
oPT: do not take at night. For children, periodic drug holidays (withholding medication on
weekends and summer months) may be appropriate to increase growth and side effects
during those times
oConsiderations: abuse and dependence
Additional drugs to know
Pramipexole- dopamine agonist
,Entacapone- COMT inhibitor
Selegiline & Rasagiline- MAO-B inhibitor
Cholinesterase inhibitors- endophonium, tacarine, neostigmine, phyostigmine, pyridostigmine
(crosses BBB), rivastigmine, galantamine, echothiophate
Fingolimod- preserved for pt who do not tolerate injections
Mitoxantrone- only immunosuppressant approved for MS
Valproate (Depakote)
Ethosuximide (Zarontin)- treat absence seizures
Phenobarbital- decrease synthesis of vitamin K dependent clotting factors
Dantrolene- manage malignant hyperthermia caused by anesthesia
Methylxanthines- caffeine
, Module 3
Prototype drugs
Chlorpromazine
oClass: Traditional Antipsychotics (low-potency)
oOther drugs: haloperidol, droperidol
oIndications: control of positive symptoms (delusions, hallucinations) of schizophrenia
oMOA: alters the action of dopamine in the CNS
oSide Effects: Extrapyramidal symptoms (EPS), neuroleptic malignant syndrome (NMS),
agranulocytosis, anticholinergic effects, orthostatic hypotension, sedation, seizures
oNC: Monitor vital signs. Anticholinergics (benztropine) can be used to control EPS.
Muscle relaxants (dantrolene) can be used to treat NMS.
oConsiderations: increased risk of mortality in elderly with dementia-related psychosis.
Haloperidol
oClass: Traditional Antipsychotics (high-potency)
oOther drugs: chlorpromazine, droperidol
oIndications: control of positive symptoms (delusions, hallucinations) of schizophrenia
oMOA: alters the action of dopamine in the CNS
oSide Effects: Extrapyramidal symptoms (EPS), neuroleptic malignant syndrome (NMS),
agranulocytosis, anticholinergic effects, orthostatic hypotension, sedation, seizures
oNC: Monitor vital signs. Anticholinergics (benztropine) can be used to control EPS.
Muscle relaxants (dantrolene) can be used to treat NMS.
oConsiderations: increased risk of mortality in elderly with dementia-related psychosis.
Clozapine (Clozaril)
oClass: Atypical Antipsychotics
oOther drugs: olanzapine, risperidone
oIndications: control of positive and negative symptoms (anergia, anhedonia, social
withdrawal) of schizophrenia
oMOA: serotonin and dopamine antagonist
oSide Effects: type 2 diabetes, weight gain, hypercholesterolemia, sedation,
anticholinergic effects, decreased libido, agranulocytosis
oNC: monitor blood glucose and for signs of infection
oConsiderations: suicidal thoughts/behaviors, increase mortality in elderly with
dementia-related psychosis, severe neutropenia, seizures
Fluoxetine (Prozac)
oClass: Selective Serotonin Reuptake Inhibitors
oOther drugs: paroxetine, sertraline
oIndications: anxiety, depression, OCD, PTSD
oMOA: inhibits serotonin reuptake
oInteractions: St. John’s wort (increased risk for serotonin syndrome)
oSide Effects: sexual dysfunction, weight gain, insomnia.
oNC: Assess for symptoms of serotonin syndrome (agitation, fever, diaphoresis, tremors)
oConsiderations: suicidal thoughts and behaviors
oPT: full effects not felt for 2 or more weeks
