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CNS STIMULATORS - Coggle Diagram
CNS STIMULATORS
D5-HT1 agonists
DRUGS: zolmitriptan & sumatriptan
Mechanism of action: 5-HT1 receptors mediate vasoconstriction thereby relieving symptoms that are believed to result from the dilatation of intra- and extra cranial vessels.
INDICATIONS: Treatment of acute migraine & Cluster headache.
CONTRA-INDICATIONS:
Ischaemic heart disease or coronary vasospasm. Peripheral vascular disease. Previous stroke or TIA. Severe hypertension.
SIDE EFFECTS: Dizziness, Paraesthesia, Tinnitus, A transient rise in blood pressure, Tachycardia and palpitations & Very rarely, MI.
STORAGE CONDITIONS: room temperature dry place
ROUTE OF ADMINISTRATION:
5-HT3 antagonists
DRUGS: Ondansetron & granisetron
MECHANISM OF ACTION: 5-HT3 receptors in the CTZ in the area post rema of the medulla contribute to the perception of nausea and the control of vomiting.
INDICATIONS: PONV, Nausea and vomiting associated with cytotoxic drugs (chemotherapy) and radiotherapy.
CONTRAINDICATIONS: Prolonged QT interval and cardiac conduction defects & Hypersensitivity.
SIDE-EFFECTS: GI disturbance, Headache, & Flushing.
STORAGE CONDITIONS
ROUTE OF ADMINISTRATION: oral, IM, IV, Transdermal.
Antihistamine anti-emetics
DRUGS: Cyclizine, promethazine
MECHANISM OF ACTION: H1 receptor antagonists directly inhibit the CTZ in the medulla.
Cyclizine also increases lower oesophageal sphincter tone and reduces the sensitivity of the labyrinthine apparatus.
INDICATIONS: Nausea and vomiting, Hyperemesis in pregnancy, Vomiting in labyrinthine disorders & Nausea associated with motion sickness.
CONTRA-INDICATIONS: Severe prostatic hypertrophy, Caution in patients at risk of closed-angle glaucoma.
SIDE-EFFECTS: Drowsiness, Headache, Tachycardia, Psychomotor impairment & Antimuscarinic effects.
STORAGE CONDITIONS: room temperature
ROUTE OF ADMINISTRATION: oral
Antipsychotics – typical
DRUGS: Haloperidol, chlorpromazine, prochlorperazine, flupentixol
MECHANISM OF ACTION: Typical antipsychotics exert their predominant neuroleptic effect through blockade of dopamine D2 receptors.
INDICATIONS: Mania, sedation & Anxiety and psychomotor agitation, Schizophrenia and other psychoses & Nausea and vomiting.
CONTRA-INDICATIONS: CNS depression and coma, Severe cardiovascular disease,
SIDE-EFFECTS: Sedation or agitation, Extra-pyramidal symptoms, Postural hypotension, Cardiac arrhythmias, Antimuscarinic effects, Hyperprolactinaemia, Rarely, neuroleptic malignant syndrome.
STORAGE CONDITIONS: Room condition
ROUTE OF ADMINISTRATION: IV, oral, IOky MI
Dopamine antagonist anti-emetics
CONTRA-INDICATIONS: Phaeochromocytoma, GI obstruction, Prolactin-releasing pituitary tumor & Perforation.
SIDE-EFFECTS: rashes, confusion, Extra-pyramidal symptoms, Hyperprolactinaemia, Neuroleptic malignant syndrome, Drowsiness.
INDICATIONS: Nausea and vomiting
STORAGE CONDITIONS
MECHANISM OF ACTION: anti-emetic effect is due to a combination of prokinetic activity, up-regulation of the parasympathetic nervous system and antagonism of dopamine D2 receptors in the CTZ.
ROUTE OF ADMINISTRATION: PO, IV, IM
DRUGS: Domperidone, metoclopramide
Carbamazepine
CONTRA-INDICATIONS: AV conduction abnormalities, History of bone marrow suppression, Acute porphyria.
SIDE-EFFECTS: Generalised erythematous rash, Cardiac conduction disturbances, Leucopenia, Nausea and vomiting,
Drowsiness .
INDICATIONS: Epilepsy, Prophylaxis of bipolar disorder,Trigeminal neuralgia.
STORAGE CONDITIONS: Keep away from children, store in a cool and dry place. store at room temperature.
MECHANISM OF ACTION: blocks the excitation of neurones that are firing repeatedly.
ROUTE OF ADMINISTRATION: Tablets, IV
DRUGS: Carbamazepine
Drugs for dementia
CONTRA-INDICATIONS: Hypersensitivity
SIDE-EFFECTS: GI disturbance, Weight gain, Hypertension, Dizziness and drowsiness, Leucopenia, Visual disturbances.
INDICATIONS: Partial seizures with or without secondary generalisation, Neuropathic pain.
STORAGE CONDITIONS
MECHANISM OF ACTION : Their clinical benefits are not mediated by the action on GABA receptors within the CNS but through binding to a subunit on T-type Ca2+ channels and selectively inhibiting the release of various neurotransmitters.
ROUTE OF ADMINISTRATION:
Drugs: cholinesterase inhibitors and memantine.
Antipsychotics – atypical
MECHANISM OF ACTION: Atypical antipsychotics act predominantly via dopamine and 5-HT receptors.
INDICATIONS: Schizophrenia and other psychoses, Mania, sedation & Anxiety and psychomotor agitation.
CONTRA-INDICATIONS: CNS depression and coma, Severe cardiovascular disease.
SIDE-EFFECTS: Sedation or agitation, Postural hypotension, Antimuscarinic effects, Weight gain, Neutropenia and agranulocytosis, Myocarditis and cardiomyopathy, Hyperglycaemia, Rarely, neuroleptic malignant syndrome.
STORAGE CONDITIONS: should be stored in a cool dry place. Unless specified on the label, medicines should not be stored in refrigerators.
ROUTE OF ADMINISTRATION: Intravenous oral and intramuscular administrations.
DRUGS: Clozapine, olanzapine, quetiapine, risperidone, amisulpride
Gabapentin and pregabalin
CONTRA-INDICATIONS: cardiac disease, asthma, patients susceptible to peptic ulcers ,renal impairment.
SIDE-EFFECTS: GI disturbance, Gastric or duodenal ulcers, Drowsiness and confusion & Rarely, arrhythmias and SA node/AV node block.
INDICATIONS: Mild to moderate dementia in Alzheimer’s disease, Mild to moderate dementia in Parkinson’s disease.
STORAGE CONDITIONS: Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture.
MECHANISM OF ACTION: inhibition of acetylcholinesterase thereby preventing the breakdown of ACh.
ROUTE OF ADMINISTRATION:oral
DRUGS: Gabapentin and pregabalin
Benzodiazepines
CONTRA-INDICATIONS: Respiratory depression, A neuromuscular disease affecting muscles of respiration, Acute pulmonary insufficiency, Should not be used as monotherapy to treat depression.
SIDE-EFFECTS: Drowsiness and lightheadedness, Dependence, Confusion & Amnesia.
INDICATIONS: Short-term use in anxiety or insomnia, Acute alcohol withdrawal, Sedation, Status epilepticus & Muscle spasm.
STORAGE CONDITION: Keep away from children. Keep in a cool, dry place, away from direct sunlight. Store at room temperature.
MECHANISM OF ACTION: This increases theaffinity of GABA to its receptor and opens Cl- channels resulting in hyperpolarisation of the cell membrane, thereby preventing further excitation.
ROUTE OF ADMINISTRATION: intramuscular, intravenous, oral, sublingual, intranasal, or rectal gel forms.
DRUGS: Diazepam, lorazepam, chlordiazepoxide, midazolam, temazepam