NR565 Week 4 Midterm Exam Study Guide
Chapter 15: Drugs Affecting the Central Nervous System
Anorexiants (p. 226): Short-term adjuncts to calorie limiting, cognitive-
behavioral, weight-loss programs for severely obese individuals.
Nonamphetamine appetite suppressants are commonly used today but are
chemically and pharmacologically related to amphetamines.
(Phendimetrazine, Benzphetamine, Diethylpropion HCl, Phentermine,
Lorcaserin)
Precautions and Contraindications: High risk of tolerance and
dependence. Should be used in caution with patients who have a history of
alcohol or drug dependence. Use should be limited to 6 months and
discontinued at any sign of tolerance.
Substance Abuse: Patients who abuse substances such as cocaine,
phencyclidine, and methamphetamine should not be prescribed
anorexiants because of the potential for excessive adrenergic
stimulation.
Alcoholics: Actively drinking alcoholics taking anorexiants have
experienced depression, paranoia, and psychosis.
Diabetes: Patients with diabetes may experiences altered insulin or
oral hypoglycemic dosage requirements.
Lorcaserin: Serotonergic drug. Patients may develop serotonin
syndrome or Neuroleptic Malignant Syndrome like reactions if
coadministered with serotonergic drugs. Pregnancy Category X and is
not approved in children under 18.
Anticonvulsants (p. 227):
Hydantoins: First line treatment of choice for tonic-clonic and partial
complex seizures and the lease sedating drugs used to treat seizure disorders
of any type. (phenytoin-Dilantin, ethotoin-Peganone, fosphenytoin-
, Cerebyx).
Pharmacodynamics: Inhibit and stabilize electrical discharges in the
motor cortex of the brain by affecting the influx of sodium ions into
the neuron during depolarization and repolarization, slowing the
propagation and spread of abnormal discharges.
Metabolism and Excretion: Metabolism takes place in the liver
and excretion via the kidneys. Plasma half-lives range from 6-
24 hours.
Precautions and Contraindications: Contraindicated under conditions
of hypersensitivity. Phenytoin induced hepatitis is a common
hypersensitivity reaction. Other hypersensitivity reactions include
fever, rash, arthralgias, and lymphadenopathy.
Phenytoin: May cause severe cardiovascular events and death
has resulted from too-rapid IV administration. Phenytoin has a
Black-Box Warning that IV administration should not exceed
50mg/minute in adults and 1-3 mg/kg/minute in pediatric
patients owing to risk of cardiovascular reactions associated
with a too rapid rate of administration. Contraindicated in sinus
bradycardia, sinoatrial block, second-and third-degree AV
block, and Stokes-Adams syndrome. Should be used cautiously
in patients with hepatic or renal disease.
Ethotoin: Contraindicated in the presence of hepatic or
hematological disorders.
Fetal Defects: Pregnancy Category D. About 10% of babies
have defects in Mother’s who take phenytoin during pregnancy.
Newborns exposed to phenytoin is utero may experience
decreased levels of Vitamin K-dependent clotting factors and
the mother should receive Vitamin K before delivery and the
newborn at birth.
Adverse Drug Reactions: CNS effects (agitation, ataxia, confusion,
dizziness, drowsiness, headache, and nystagmus), Cardiovascular
Chapter 15: Drugs Affecting the Central Nervous System
Anorexiants (p. 226): Short-term adjuncts to calorie limiting, cognitive-
behavioral, weight-loss programs for severely obese individuals.
Nonamphetamine appetite suppressants are commonly used today but are
chemically and pharmacologically related to amphetamines.
(Phendimetrazine, Benzphetamine, Diethylpropion HCl, Phentermine,
Lorcaserin)
Precautions and Contraindications: High risk of tolerance and
dependence. Should be used in caution with patients who have a history of
alcohol or drug dependence. Use should be limited to 6 months and
discontinued at any sign of tolerance.
Substance Abuse: Patients who abuse substances such as cocaine,
phencyclidine, and methamphetamine should not be prescribed
anorexiants because of the potential for excessive adrenergic
stimulation.
Alcoholics: Actively drinking alcoholics taking anorexiants have
experienced depression, paranoia, and psychosis.
Diabetes: Patients with diabetes may experiences altered insulin or
oral hypoglycemic dosage requirements.
Lorcaserin: Serotonergic drug. Patients may develop serotonin
syndrome or Neuroleptic Malignant Syndrome like reactions if
coadministered with serotonergic drugs. Pregnancy Category X and is
not approved in children under 18.
Anticonvulsants (p. 227):
Hydantoins: First line treatment of choice for tonic-clonic and partial
complex seizures and the lease sedating drugs used to treat seizure disorders
of any type. (phenytoin-Dilantin, ethotoin-Peganone, fosphenytoin-
, Cerebyx).
Pharmacodynamics: Inhibit and stabilize electrical discharges in the
motor cortex of the brain by affecting the influx of sodium ions into
the neuron during depolarization and repolarization, slowing the
propagation and spread of abnormal discharges.
Metabolism and Excretion: Metabolism takes place in the liver
and excretion via the kidneys. Plasma half-lives range from 6-
24 hours.
Precautions and Contraindications: Contraindicated under conditions
of hypersensitivity. Phenytoin induced hepatitis is a common
hypersensitivity reaction. Other hypersensitivity reactions include
fever, rash, arthralgias, and lymphadenopathy.
Phenytoin: May cause severe cardiovascular events and death
has resulted from too-rapid IV administration. Phenytoin has a
Black-Box Warning that IV administration should not exceed
50mg/minute in adults and 1-3 mg/kg/minute in pediatric
patients owing to risk of cardiovascular reactions associated
with a too rapid rate of administration. Contraindicated in sinus
bradycardia, sinoatrial block, second-and third-degree AV
block, and Stokes-Adams syndrome. Should be used cautiously
in patients with hepatic or renal disease.
Ethotoin: Contraindicated in the presence of hepatic or
hematological disorders.
Fetal Defects: Pregnancy Category D. About 10% of babies
have defects in Mother’s who take phenytoin during pregnancy.
Newborns exposed to phenytoin is utero may experience
decreased levels of Vitamin K-dependent clotting factors and
the mother should receive Vitamin K before delivery and the
newborn at birth.
Adverse Drug Reactions: CNS effects (agitation, ataxia, confusion,
dizziness, drowsiness, headache, and nystagmus), Cardiovascular
