Week 4 Study Guide
Chapter 15: Drugs Affecting the Central Nervous System
Know the drug names, pharmacodynamics, pharmacotherapeutics clinical use, drug
interactions, and adverse drug reactions for:
Anorexiants
Related to amphetamines
Phentermine, benzphetamine, diethylpropion HCL, phendimetrazine, lorcaserin
Pharmacodynamics
o Stimulate satiety centers in hypothalamus and limbic region
o Contraindicated in pts w substance abuse/ dependence
Pharmacotherapeutics
o Clinical Use
Morbid obesity with calorie restricted diet
No longer than 6 months
o Drug Interactions
Hypertn crisis with MAOs, serotonergic agents, ETOH, insulin,
sulfonylureas, phenothiazines
o ADR
CNS overstimulation and agitation, confusion, insomnia, dizziness, HTN,
palpitations, arrythmias, dry mouth, dysuria, constipation, V/M, impotence
Anticonvulsants
Hydantoins
Dilantin, ethotoin, fosphenytoin 1st linie treatment for tonic-clonic and partial complex
seizures. least sedating, dilantin is most common
Pharmacodynamics
o Inhibit and stabilize electrical discharges in brain affecting influx of sodium ions
into neuron. Also affect brainstems contribution to grand mal seizures and have
antiarrhythmic properties
Pharmacotherapeutics
o Clinical Use
Seizures, epilepsy, status epilepticus
o Drug Interactions
Benzos, cimetidine, TCA, Depakote, ETOH, antacids, steroids, birth
control- decreases effect
o ADR
Agitation, ataxia, confusion, dizziness, drowsy, headache, nystagmus, CV
effects, GI effects, urinary retention/discoloration
SJS, toxic epidermal necrolysis
, o Prec/Cont.
C/I in hypersensitivity- phenytoin-induced hepatitis, fever, rash,
bradycardia, AV block
CV death in too rapid IV admin- black box warning
o Monitoring- assess for hypersensitivity (week 308), baseline CBC, UA, LFT,
plasma levels, suicide, depression
Iminostilbenes
Carbamazepine (Tegretol) and oxycarbazepine (Trileptal)
Pharmacodynamics
o Affect Na channels, slowing influx of Na and slowing spread of abnormal activity
Pharmacotherapeutics
o Prec/C/I
Hypersensitivity to Tegretol or TCAs
Hx of bone marrow suppression
Admin w MAOIs
Tegretol black bock warning for dermatological rxn especially in Asians-
need to be screened for HLA-B-1502 variant, blood dyscrasias
o Clinical Use
Epilepsy, Bipolar do, aggressive behavior, neuralgias
o Drug Interactions
Propoxyphene, hydantoins, cimetidine, erythromycin and clarithromycin,
verapamil, beta blockers, valproic acid, coumadin, Haldol, doxy,
grapefruit juice
Trileptal can decrease effectiveness of hormonal contraceptives
o Monitoring
Baseline CBC, LFT, CMP, TSH
o ADR
Leukopenia, thrombocytopenia, agranulocytosis, hepatic damage, thyroid
damage, dizziness, diplopia, somnolence, fatigue, N/V
Succinimides
Ethosuximide and methsuximide
Pharmacodynamics
o Decreasing nurse impulses and transmission in motor cortex
Pharmacotherapeutics
o Prec/ C/I
Safe for pregnancy but not during lactation
CBC and LFT before starting
o Clinical Use
Absence seizures
o Drug Interactions
Chapter 15: Drugs Affecting the Central Nervous System
Know the drug names, pharmacodynamics, pharmacotherapeutics clinical use, drug
interactions, and adverse drug reactions for:
Anorexiants
Related to amphetamines
Phentermine, benzphetamine, diethylpropion HCL, phendimetrazine, lorcaserin
Pharmacodynamics
o Stimulate satiety centers in hypothalamus and limbic region
o Contraindicated in pts w substance abuse/ dependence
Pharmacotherapeutics
o Clinical Use
Morbid obesity with calorie restricted diet
No longer than 6 months
o Drug Interactions
Hypertn crisis with MAOs, serotonergic agents, ETOH, insulin,
sulfonylureas, phenothiazines
o ADR
CNS overstimulation and agitation, confusion, insomnia, dizziness, HTN,
palpitations, arrythmias, dry mouth, dysuria, constipation, V/M, impotence
Anticonvulsants
Hydantoins
Dilantin, ethotoin, fosphenytoin 1st linie treatment for tonic-clonic and partial complex
seizures. least sedating, dilantin is most common
Pharmacodynamics
o Inhibit and stabilize electrical discharges in brain affecting influx of sodium ions
into neuron. Also affect brainstems contribution to grand mal seizures and have
antiarrhythmic properties
Pharmacotherapeutics
o Clinical Use
Seizures, epilepsy, status epilepticus
o Drug Interactions
Benzos, cimetidine, TCA, Depakote, ETOH, antacids, steroids, birth
control- decreases effect
o ADR
Agitation, ataxia, confusion, dizziness, drowsy, headache, nystagmus, CV
effects, GI effects, urinary retention/discoloration
SJS, toxic epidermal necrolysis
, o Prec/Cont.
C/I in hypersensitivity- phenytoin-induced hepatitis, fever, rash,
bradycardia, AV block
CV death in too rapid IV admin- black box warning
o Monitoring- assess for hypersensitivity (week 308), baseline CBC, UA, LFT,
plasma levels, suicide, depression
Iminostilbenes
Carbamazepine (Tegretol) and oxycarbazepine (Trileptal)
Pharmacodynamics
o Affect Na channels, slowing influx of Na and slowing spread of abnormal activity
Pharmacotherapeutics
o Prec/C/I
Hypersensitivity to Tegretol or TCAs
Hx of bone marrow suppression
Admin w MAOIs
Tegretol black bock warning for dermatological rxn especially in Asians-
need to be screened for HLA-B-1502 variant, blood dyscrasias
o Clinical Use
Epilepsy, Bipolar do, aggressive behavior, neuralgias
o Drug Interactions
Propoxyphene, hydantoins, cimetidine, erythromycin and clarithromycin,
verapamil, beta blockers, valproic acid, coumadin, Haldol, doxy,
grapefruit juice
Trileptal can decrease effectiveness of hormonal contraceptives
o Monitoring
Baseline CBC, LFT, CMP, TSH
o ADR
Leukopenia, thrombocytopenia, agranulocytosis, hepatic damage, thyroid
damage, dizziness, diplopia, somnolence, fatigue, N/V
Succinimides
Ethosuximide and methsuximide
Pharmacodynamics
o Decreasing nurse impulses and transmission in motor cortex
Pharmacotherapeutics
o Prec/ C/I
Safe for pregnancy but not during lactation
CBC and LFT before starting
o Clinical Use
Absence seizures
o Drug Interactions
