1 - Pharmacology.pdf - CONCEPT: PHARMACOLOGY NERVOUS SYSTEM...

“Everything comes to you in the right moment. BE PATIENT.”
CONCEPT: PHARMACOLOGY
NERVOUS SYSTEM
The
Nervous System
CNS PNS
TYPE MECHANISM OF
ACTION
PHYSIOLOGIC EFFECTS
Dopamine Inhibitory Affects behavior (attention,
emotions)
Fine movement
Acetylcholine Excitatory Parasympathetic effects sometimes
inhibitory
Serotonin Inhibitory Control mood and sleep
Inhibits pain pathways
Norepinephrine Excitatory Mood and overall activity
Gamma-Amino
Butyric Acid
(GABA)
Inhibitory Regulates other neurotransmitters

“Everything comes to you in the right moment. BE PATIENT.”
DEPRESSION MANIA
ANXIETY SEIZURE
MYASTHENIA GRAVIS PSYCHOSIS
PARKINSON’S DISEASE SCHIZOPHRENIA
ALZHEIMER’S DISEASE
DEPRESSION
CAUSE: THERAPEUTIC GOAL:
ASSOCIATED DISORDERS: EATING DISORDERS
ANOREXIA NERVOSA
BULIMIA
ANTIDEPRESSANTS
1. TCAs 2. SSRIs
Prototype Drugs:
Amitrip
TYLINE
HCl (Elavil)
Nortrip
TYLINE
HCl
(Pamelor, Aventyl)
Protrip
TYLINE
(Vivactyl)
Clomi
PRAMINE
HCl
(Anafranil)
Imi
PRAMINE
HCl
(Tofranil)
Nor
PRAMINE
Amoxapine (Asendin)
Doxepin HCl (Sinequan)
Prototype Drugs:
Citalo
PRAM
(Celexa)
Fluoxet
INE
(Prozac)
Sertral
INE
HCl (Zoloft)
Paroxetine (Paxil)
Atypical Reuptake Inhibitors:
Mertazapine (Remeron)
Bupropion (Wellbutrin)
Trazodone (Desyrel)
Therapeutic Effect:
Side Effect:
WOF:
1.
2.
3.
*Avoid Alcohol and Antihistamines
*can be taken in the AM
“TOO LITTLE”
Neurotransmission
“TOO MUCH”
Neurotransmission

“Everything comes to you in the right moment. BE PATIENT.”
3. MAOIs
Nursing Considerations
Prototype Drugs:
Tranylcypromine sulfate (
PA
rnate)
Phenelzine sulfate (
NA
rdil)
Isocarboxazid (
MA
rplan)
Moclobemide (
MA
nerix)
Therapeutic Effect:
Common Side Effects:
* interacts with food and drugs with
TYRAMINE (potent vasoconstrictor)
Wash out period: the time allowed for the medication to be eliminated from the body
MAOI-SSRI
SSRI-MAOI
4. Herbal Medication
St. John’s Wort Specific for St. John’s Wort:
s-adenosyl methionine (sAME)
For both: Do not use in conjunction with other prescribed anti-depressants
PARKINSON’S DISEASE
CAUSE: THERAPEUTIC GOAL:
ANTI-PARKINSON DRUGS
1. Dopaminergics 2. Anticholinergics Nursing Considerations:
Levodopa (Larodopa, Dopar)
Carbidopa-Levodopa (Sinemet)
Amantadine (Symmetrel)
Bromocriptine (Parlodel)
Pergolide mesylate (Permax)
Pramipexole (Mirapex)
Benztropin mesylate (Cogentin)
Trihexyphenidyl HCl (Artane)
Diphenhydramine HCl (Benadryl)
Biperiden HCl (Akineton)
Common Side Effect:
ANTICHOLINERGIC SIDE EFFECT
ALZHEIMER’S DISEASE
CAUSE: THERAPEUTIC GOAL: MECHANISM OF ACTION:
Block Acetylcholinesterase
Block Cholinesterase

“Everything comes to you in the right moment. BE PATIENT.”
ANTI- ALZHEIMER’S DRUGS
Cholinesterase Inhibitors
Mechanism of Action: Elevate acetylcholine concentration in cerebral cortex by slowing degradation of acetylcholine released in
cholinergic neurons
Drugs:
Donepezil HCl (Aricept)
Tacrine (Cognex)
Nursing Considerations:
CHOLINERGIC SIDE EFFECT:
S
L
U
D
MANIA
CAUSE: THERAPEUTIC GOAL:
MOOD STABILIZERS
1. Lithium Preparations
Mechanism of Action: Correct an ion exchange abnormality
Lithium carbonate (Eskalith, Lithane, Lithobid)