Neurology Drugs (Steffensen)
Terms
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- Lithium
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-Used for bipolar
-Side effects: GI, alopecia, weight gain, ataxia, acne, polyuria, polydipsia, Ebstein's anomoly.
-Most drugs elevate lithium levels (except caffeine)
-Elevates TSH *
-"Water faucet to water closet" - Thioridazine (Melaril)
- -Side effects: Arrhythmias, retrograde ejaculation, pigmentary retinopathy
- Clozapine (Clozaril)
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-Atypical antipsychotic
-Side effects: sialorrhea, agranulocytosis*, seizures, cardiomyopathy
-"biggest gun" for hallucinations - Trazodone (Desyrel)
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-inhibits 5HT reuptake, inhibits alpha-1 receptor on vessels causing dilation
-Side effects: priapism, orthostatic hypotension - Uremic polyneuropathy
- axonal mixed sensorimotor polyneuropathy
- Lead
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Encephalopathy in children
Demyelinating polyneuropathy (motor) with preference for radial nerve - Arsenic
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Demyelinating polyneuropathy (motor)
Abdominal pain, anemia, jaundice
Encephalopathy - Thalium
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Demyelinating polyneuropathy (sensory)
Optic atrophy and ophthalmoplegia
*Alopecia - Mercury
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Bilateral basal ganglia dysfunction
Movement disorder associated with biliary excretion problems - Pilocarpine
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-Muscarinic agonist (Ach)
-Parasympathomimetic
-pupillary constriction - Nucleus basalis
- Nucleus where Ach is made
- Nucleus Accumbens
- Nucleus associated with addiction and Dopamine
- Raphe nucleus and Serotonin
- Mediates NREM sleep
- Nefazodone
- Increases REM
- Locus Ceruleus and sleep stage
- Location that initiates REM
- Vigabatrin
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-Inhibits GABA transaminase therefore increasing GABA.
-bi-Nasal VF abnormalities - Mitazapine (Remeron)
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-Atypical antipsychotic
-5HT2A and Histamine H1 blocker
-Same as Olanzapine/Clozapine - Baclofen and PAN
- Improves PAN (Periodic Alternating Nystagmus)
- Capsaicin
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VA1 receptor
Causes release of substance P
-involved in pain modulation -
Ropinirole (Requip)
Pramipexole (Mirapex) -
-Dopamine agonists used in PD
-Can cause sudden attacks of sleep while driving. - Midodrine
-
-Used to treat orthostatic hypotension
-alpha-1 adrenergic agonist (NE) causing vasoconstriction - Sumatriptan (Imitrex)
- Agonist of 5HT1D causing vasoconstriction
- Odansetron (Zofran)
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Ligand of 5HT3 receptor (antagonist)
-treat nausea - Phenytoin (Dilantin)
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1/2 life=22 hours
-Reduces post-tetanic potentiation
-Causes lymphadenopathy, ataxia, rash, gingival hyperplasia, hirsuitism, vermian atrophy
-Na channel blocker - Valproate (Depakote)
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1/2 life=14 hours
Side effects: allopecia, wt gain
-Na channel blocker - Carbamazepine (Tegretol)
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1/2 life=12 hours
Side effects: diplopia, ataxia, hyponatremia, rash, liver dysfunction, dyscrasias
-Na channel blocker - Ethosuximide (Zarontin)
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1/2 life=40 hours
Side effects: Nausea, lethargy, headache, rash
-Ca channel blocker (T-type)
-Treat absence seizures - Lamotrigine (Lamictal)
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1/2 life=24 hours
-side effects: rash, Stevens Johnson, elevated epoxide, ataxia
-Voltage-gated Na channel blocker - Topiramate (Topamax)
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1/2 life=22 hours
-side effects: somnolence, confusion, word-finding difficulty, paresthesias, angle closure glaucoma, kidney stones, myopia
-Na channel blocker - Felbamate (Felbatol)
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1/2 life=20 hours
Side effects: bone marrow failure (1/3000), liver failure, wt loss, GI complaints
-Glutamate-receptor glycine blocker - Clonazepam (Klonopin)
- 1/2 life=30 hours
- Cisplatinum
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Encephalopathy
Ototoxicity
Cerebellar findings
Renal problems
Autonomic & peripheral neuropathy - 5-FU
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acute cerebellar syndrome
cranial neuropathy
disorientation/confusion
seizures - Cytarabine (Ara-C)
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cerebellar dysfunction
somnolence/confusion
personality change
peripheral neuropathy
rhabdomyolysis *
myelopathy * - Methotrexate
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Leukoencephalopathy *
myelopathy
chemical arachnoiditis if intrathecal - Tamoxifen
- decreased visual acuity
- Vinblastine
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autonomic neuropathy
cranial neuropathy (same as 5-FU)
muscle pain