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Neuro/Psych Disorders & Tx (Infectious (Encephalitis & Myelitis…
Neuro/Psych Disorders & Tx
Neurodegenerative
MS
Immunomodulators
Immunosuppressants
Sx management
Pain
Tricyclic Antidepressants
Amitriptyline
Nortriptyline
Antispasticity meds
Baclofen
Clonazepam
#
antiepileptic meds
Gabapentin
Carbamazepine
#
Phenytoin
Gait/Spasticity
Diazepam
Nerve Blocks
Baclofen
Botox
Fatigue
CNS stimulants
Amantadine
Modafinil
Antidepressants
Fluoxetine
Parkinson's Disease
Exercise (esp. Tai Chi)
Medication
Early PD Sx
Rasagiline (MAO-B inhib) or Sinemet (Carbidopa/Levodopa
Tremor ONLY
Zonisamide (SE: nephrolithiasis, keep hydrated)
Anticholinergics
Trihexyphenidyl (SE: Antichol., avoid use in cog. impaired)
Diphenhydramine (Benadryl)
Benzotropine
Motor Fluctuations
Dopaminergic Therapy
COMT inhibitors
entacapone
tolcapone
DA precursor
Levodopa
Decarboxylase inhibitors
Carbidopa
Rytary
Duodopa
Sinemet CR
MAO type B inhibitors
Selegiline
Rasagiline
DA agonists
Pramipexole
Ropinirole
Apomorphine
DA synthesizer
Zonisamide
DA releaseer
Amantadine (antiviral flu med)
Alzheimers
Cholinesterase inhibitors
Donepezil (Aricept)
Rivastigmine (Exelon)
Tacrine
Razadyne
Galantamine (Reminyl)
NMDA antagonist
Memantine (Namenda)
Huntington's Disease, ALS, Prions (CJD)
No tx
Infectious
Acute Pyogenic Meningitis
Bactericidal agents
Child (2 mo. - 6 yr)
Ceftriaxone + Vanco
Adult
+
Neonates (<2 mo)
Amp + Ceftaxime
Special case
Child w/H. influenzae
Corticosteroids
Adult w/S. peumoniae
+
Acute Aseptic Meningitis (viral, fungal, tb)
abx, antifungal, supportive
Chronic Meningitis
+
Encephalitis & Myelitis
HSV Type I
oral acyclovir
VZV
IV acyclovir
Arboviral infx
supportive
Rabies
vaccination + post-exposure immunoglobs
Focal Intracranial Infx
Subdural empyema
+
Intracranial abscess
+
Brain abscess
NO lumbar puncture!!
Abx + surgery
Septic thrombophlebitis
Abx + early anticoag drugs
Epilepsy
Antiepileptic Drugs (AEDs) by Mechanism
Enhance GABA
PHB
BZP
Designer drugs
Block GABA reuptake
Tiagabine
Block GABA metabolism
Vigabatrin
Block Ca Channels
Ethosuximide
Block Na channels
Carbamazepine (CBZ)
#
Oxcarbazepine (OXC)
Phenytoin (PHT) aka dilantin
Lamotrigine (LTG)
#
ZON
BROAD SPECTRUM AEDs
Lamotrigine
Topiramate
Valproic Acid
Levetiracetam
Zonisamide
AED's by CHOICE
Focal/Partial 1st line AEDs
OXC
Levetiracetam
CBZ
LTG
PHT
Topiramate
Zonisamide
Idiopathic
All 5 Broad spectrum AED
Contraindicated
CBZ
PHT
Gabapentin
Absence
5 BS AEDs
ONLY absence sx: Ethosuximide
Myoclonic
5 BSAEDs
Clonazepam
#
Status Epilepticus
Benzodiazepines
Phenytoin
Phosphenytoin
Phenobarbital
Psych
Bipolar disorder
Lithium
Anticonvulsants
Lamotrigine
Carbamazepine
Divalproex sodium
Antipsychotics
olanzapine
Aripiprazole
Quetiapine
Ziprasidone
Risperidone
Anxiolytics
Clonazepam
Antidepressants
#
Depression; AD = antidepressants
Schizoaffective Disorder, w/depression
antipsycotics + AD
Bipolar Disorder, w/depression
Mood stabilizers + antipsychotics (usually no AD)
Persistent Depressive Disorder (Dysthymia)
cognitive behavioral therapy (CBT) and/or AD
Depression due to another underlying mental or medical condition
Tx underlying condition
Major depressive disorder (MDD)
w/out psychosis
AD + CBT +/- ECT
w/psychosis
AD + antipsychotics
Other
Postpartum
Premenstrual dysphoric disorder
Season Affective Disorder (SAD)
light tx
Atypical depression
MAOi's
Classes of ADs
Serotonin Selective Reuptake Inhibitors (SSRI)
Sertraline (Zoloft)
Fluoxetine (Prozac)
Paroxetine (Paxil)
Combined Serotonin-Norepinephrine Reuptake Inhibitors (SNRI)
Desvenlafaxine
Duloxetine (Cymbalta)
Venlafaxine (Effexor)
Levomilnacipran
Monoamine Oxidase Inhibitors (MAOi)
Iproniazid (tb drug/1st discovered)
MAOb inhibitors
Selegiline
MAOa & MAOb inhibit
Phenelzine
Tranylcypromine
Isocarboxazid
2nd/3rd gen heterocyclic atypical ADs
Vortioxetine
Bupropion
Vilazodone
Mirtazapine
Trazodone & Nefazodone
Tricyclic ADs (TCA)
Imipramin
e
Desipramine
Non-pharmacologic
Electroconvulsive Shock Therapy (ECT)
Deep Brain stimulation
Vagal nerve stimulation
Transcranial magnetic stimulation
Cognitive behavior Tx (CBT)
Ketamine infusion
Anxiety Disorders
Types of Anxiety
OCD
Panic disorder
Social Anxiety Disorder
PTSD
General Anxiety Disorder (GAD)
TREATMENTS