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ALL Pharmacology Medications Study Guide_ Updated Spring 26.
Module 02 – Neurological System Medications
Chapter 24 – Antiparkinsonian Agents Dopaminergic Agents (Dopamine Agonists) Drugs Route Therapeutic Actions Contraindications, Interactions, & Cautions Adverse Effects carbidopa-levodopa ( Duopa, Rytary ) PO Carbidopa decreases metabolism of levodopa in GI tract → increase amount that crosses blood/brain barrier
- Known allergy
- Angle-closure glaucoma
- Lactation
- MAOIs
- Levodopa: nonselective MAOIs, iron salts, TCAs, phenytoin
- Rasagiline: tyramine- rich foods, St. John’s Wort, meperidine, acetaminophen
- Malignant melanoma
- Caution: CV disease, bronchial asthma, hx. Peptic ulcer, UTI obx, psychiatric disorders, pregnancy - Peripheral Dopamine Reactions (palpitations, fainting, anorexia, nausea) - Systemic Dopamine Effects (tachycardia, hypertension, decreased GI motility, urinary retention) - Bone marrow depression - Hepatic dysfunction amantadine ( Gocovil, Osmolex ER ) PO Antiviral that increases release of dopamine; dopaminergic agents apomorphine ( Apokyn, Kynmobl ) bromocriptine ( Parlodel ) pramipexole ( Mirapex, Mirapex ER ) ropinorole ( Requip, Requip XL ) rotigine ( Neupro ) Apomorphine- SQ Rotigine- TD Binds to post-synaptic receptors and is approved for “off” episodes Indication: Can be used to treat restless leg syndrome Dopamine receptor agonists rasagiline ( Azilect ) PO Dopamine agonist; increases dopamine in synapse Inhibits MAO type B; initial monotherapy or in conjunction with levodopa
Anticholinergic Agents (Cholinergic Blocking Agents) Drugs Route Therapeutic Actions Contraindications, Interactions, & Cautions Adverse Effects benztropine ( Cogentin ) diphenhydramine ( Benadryl ) trihexyphenidyl
PO
PO, IV,
IM
PO
Blocks cholinergic receptors Associated with adverse effects Not as effective as levodopa but can be used as adjunct therapy Decrease salivation, spasticity, and tremors
- Known allergies
- C/I: narrow-angle glaucoma, GI/GU obx, prostatic hypertrophy
- C/I: tachycardia/arrhythmias, hypo/hypertension, pregnancy/lactation (only if benefits outweigh risks)
- Hot environments; reflex sweating blocked → heat exhaustion/stroke
- Interacts with other anticholinergics and antipsychotics (can lead to paralytic ileus) - CNS effects: disorientation, confusion, memory loss, agitation, nervousness, dizziness, lightheadedness - Anticipated peripheral anticholinergic effects: dry mouth, nausea, vomiting, paralytic ileus, constipation - Tachycardia, hypotension - Urinary retention/hesitancy - Photophobia and blurred vision - Decreased sweating Adjunct Therapy entacapone ( Comtan ) tolcapone ( Tasmar ) safinamide ( Xadago ) selegiline ( Eldepryl ) Therapeutic Action Used in conjunction with carbidopa-levodopa Use barrier contraceptives Increases plasma concentration & duration of levodopa Inhibits COMT enzyme that destroys dopamine Stalevo- levodopa, carbidopa, entacapone COMT inhibitor to increase plasma levels of levodopa Associated w/ liver damage; C/I in liver disease Entacapone > Tolcapone “off” episodes Inhibits MAO-B Blocks sodium and calcium channel Inhibiting glutamate release Used with carbidopa- levodopa after patients have shown signs of deteriorating response to treatment
Alpha-Selective Adrenergic Agonists Drug Route Indications Therapeutic Actions Contraindications, Interactions, & Cautions Adverse Effects clonidine hydrochloride ( Catapres ) PO, TD Treatment of HTN, chronic pain, ease opiate withdrawal Result form stimulation of alpha- receptors within SNS
C/I:
- Known allergy
- Severe HTN
- Narrow-angle glaucoma
- Hypotension or bradycardia (alpha- 2 selective drugs) Cautions:
- Pregnancy/lactation
- CV disease/vasomotor spasm
- Thyrotoxicosis or diabetes
- Renal or hepatic impairment CNS Effects
- Anxiety, restlessness, depression, fatigue, strange dreams, personality changes CV Effects
- Arrhythmias, ECG changes, BP changes, peripheral vascular problems GI Effects
- Nausea, vomiting, anorexia GU Effects
- Decreased urinary output, difficulty urinating, dysuria, changes in sexual function Drug should be tapered
- Can lead to withdrawals: tachycardia, HTN, arrhythmias, flushing, death clonidine hydrochloride ( Kapvay ) PO Treatment of ADHD dexmedetomidine ( Precedex ) IV (do not use 24+ hrs) Sedation of intubated and mechanically ventilated pts. guanfacine ( Intuniv ) PO Treatment of ADHD midodrine ( Orvaten ) PO Treatment^ of orthostatic hypotension phenylephrine ( Biorphen, Vazculep )
PO, SQ,
IV,
ophthalmic drops, topical Cold/allergies; perioperative hypotension; vasodilatory shock; supraventricular tachycardias; glaucoma; rhinitis; otitis media
Beta-Specific Adrenergic Agonists Drugs Route Indications Therapeutic Actions Contraindications, Interactions, & Cautions Adverse Effects albuterol ( AccuNeb, Proair HFA, Proventil HFA, Ventolin HFA, Vospire Er ) PO, Oral inhalation Treatment/prevention of bronchospasm; acute bronchospasm and exercise- induced bronchospasm Related to stimulation of the beta-adrenergic receptors Desired effects:
- Increased HR
- Conductivity
- Contractility
- Bronchodilat ion
- Increased blood flow to skeletal muscles
- Relaxation of uterus Isoproterenol C/I: - Known allergy - Pulmonary HTN and tachyarrhyth mias - Anesthesia with halogenated hydrocarbons - Eclampsia, uterine hemorrhage, and intrauterine death - Pregnancy/lac tation Cautions - Diabetes - Thyroid disease - Vasomotor problems Isoproterenol CNS Effects: - Restlessness, anxiety, fear, tremor, fatigue, headache CV Effects: - Tachycardia, angina, MI, palpitations Pulmonary Effects: - Difficulty breathing, coughing, bronchospasm, severe PE GI Effects: - Nausea, vomiting, anorexia (slowing of GI tract) Hypokalemia arformoterol ( Brovana ) Nebulizer Long-term maintenance with COPD formoterol ( Foradil, Perforomist ) Oral inhalation, Nebulizer Long-term maintenance of asthma; prevention of exercise induced bronchospasm isoproterenol ( Isuprel )
IV, IM,
SQ
Treatment of shock with low cardiac output, cardiac arrest; treatment of heart block; prevention of bronchospasm during anesthesia; treatment of acute hyperkalemia levalbuterol ( Xopenex ) Nebulizer Treatment and prevention of bronchial asthma and reversible bronchospasm metaproterenol ( generic ) Inhalation, Nebulizer, PO Treatment of bronchial asthma and reversible bronchospasm; by inhalation, treatment of acute asthma attacks olodaterol ( Striverdi, Respimat ) Oral Inhalation maintenance treatment of bronchospasm in adult patients with COPD salmeterol ( Serevent Diskus ) Inhalation Treatment and prevention of bronchial asthma and
carvedilol ( Coreg, Coreg CR ) PO HTN, left ventricular dysfunction after MI, HF decreased renin levels Interactions:
- Liquid general anesthetics
- additive effects to diabetic agents
- carvedilol: verapamil, diltiazem
- amiodarone: carvedilol
- other antiarrhythmics that prolong QT interval, increased risk of torsade de pointes - Arrhythmias, hypotension, HF, PE, stroke Resp. Effects:
- Bronchospasm, cough, rhinitis, and bronchial obx Abruptly Stopping:
- MI, stroke, arrhythmias labetalol ( Trandate )
PO,
IV
HTN,
pheochromocytoma, clonidine withdrawal Nonselective Alpha-Adrenergic Blocking Agents Drugs Route Indications Therapeutic Actions Contraindications, Interactions, & Cautions Adverse Effects phenotalmine ( Oraverse, Regitine ) IV, IM Prevention of cell death and tissue sloughing after extravasation of IV norepi/dopamine; severe HTN reactions of pheochromocytoma Blocks alpha 1- adrenergic receptors, decreasing sympathetic tone in the vasculature and causing vasodilation, leads to lowering of BP; blocks alpha 2- receptors preventing feedback control of norepi release
CI:
- Allaergy
- CAD, MI Caution:
- Pregnancy or lactation Interactions:
- Epinephrine: decreased hypertensive and vasoconstrictive effects
- Alcohol: increased hypotension Extension of therapeutic effects:
- Hypotension, orthostatic hypotension (dizziness, headache, weakness)
- Angina, MI, CVA
- Flushing, tachycardia, and arrhythmia
- NVD
Alpha- 1 Selective Adrenergic Blocking Agent (-zosin, - dosin, - losin) Drugs Route Indications Therapeutic Actions Contraindications, Interactions, & Cautions Adverse Effects alfuzosin (Uroxatral) PO BPH (^) Block postsynaptic alpha 1-receptors sites
- Decrease in vascular tone and vasodilation; lower BP
- Does not cause reflex tachycardia
CI:
- Allergy
- Lactation Cautions:
- HF, renal failure
- Pregnancy Interactions:
- Any other rx causing hypotension CNS Effects:
- Headache, dizziness, weakness, fatigue, drowsiness, and depression GI:
- NV, abd. Pain, diarrhea CV:
- Arrhythmias, hypotension, edema, HF, and angina
- Vasodilation: flushing, rhinitis, reddened eyes, nasal congestion, retrograde ejaculation, priapism doxazosin (Cardura) PO HTN and BPH prazosin (Minipress) PO HTN silodosin ( Rapaflo) PO BPH tamsulosin (Flomax) PO BPH terazosin (generic) PO HTN and PBH Nonselective Beta-Adrenergic Blocking Agents (-olol) Drugs Route Indications Therapeutic Actions Contraindications, Interactions, & Cautions Adverse Effects carteolol (generic) Opthalmic Chronic open-angle glaucoma Decreased HR, contractility, and excitability, membrane- stabilizing effect; decreases in arrhythmias,
CI:
- Heart blocks, shock, HF
- Bronchospasm, acute asthma
- Pregnancy (teratogenic)
- Lactation Cautions:
- Diabetes and hypoglycemia
CNS:
- Headache, fatigue, dizziness, depression, paresthesia, sleep disturbances, memory loss, disorientation CV:
- Bradycardia, heart lock, HF, hypotension, levobunolol ( Akbeta, Betagan ) Opthalmic Chronic open-angle glaucoma, ocular HTN nadolol ( Corgard ) PO HTN, chronic angina nebicolol ( Bystolic )
PO HTN
propranolol ( Hemangeol, PO HTN, angina, arrhythmias,
Decreased IOP, open-angle glaucoma
- NSAIDs, rifampin, or barbiturates
- Clonidine, epinephrine, prazosin
- Verapamil, cimetidine, methimazole, or propylthiouracil - NVD, gastric pain GU:
- Decreased libido, impotence, dysuria Hypoglycemia/hyperglycemia Chapter 32 – Cholinergic Agonists Direct-Acting Cholinergic Agonists (Muscarinic) Drugs Route Indications Therapeutic Actions Contraindications, Interactions, & Cautions Adverse Effects acetylcholine chloride ( Michol-E ) Opth induce miosis; relieve IOP of glaucoma Cause increased stimulation of ACh receptor sites, parasympathetic effects (slow HR, decreased myocardial contractility, vasodilation, bronchoconstriction/ secretion, increase GI activity, relaxation of sphincters, pupil constriction) Used sparingly CI/Cautions:
- allergy, bradycardia, hypotension, CAD;
- peptic ulcer disease, intestinal obx, recent GI surgery; asthma; bladder obx or recent bladder surgery; epilepsy and parkinsonism; pregnancy/lactation Interactions:
- acetylcholinesterase inhibitors (neostigmine) PNS Stimulation: bradycardia, heart block, hypotension, cardiac arrest; nausea, vomiting, cramps, diarrhea, increased salivation, involuntary defecation, increased secretions; swallowing difficulties; dehydration, flushing/increased sweats bethanechol ( Duvoid ) PO treat nonobstructive postop/postpartum urinary retention; neurogenic bladder atony carbachol ( Miostat ) Opth relieve increased IOP of glaucoma; surgical procedures cevimeline ( Evoxac ) PO (^) relieve sx. of dry mouth in Sjogren’s syndrome (Salagen); IOP or ocular HTN, IOP after laser surgery pilocarpine ( Isopto Carpine, Salagen )
PO,
Opth
Indirect-Acting Cholinergic Agonists (Nicotinic) and Medications for Nicotine Withdrawal/Abstinence Drugs Route Indications Therapeutic Actions Contraindications, Interactions, & Cautions Adverse Effects bupropion ( Wellbutrin ) PO (^) depression, smoking cessation inhibiting neuronal reuptake of norepinephrine and dopamine
CI:
- Bupropion: seizure disorder
- Allergy Cautions:
- Pregnancy/lactation Interactions:
- Bupropion: MAO’S
- Medications metabolized by CYP2D
- Insulin, propranolol, acetaminophen, caffeine
- Adrenergic agonists
- Varenicline and alcohol
- Tachycardia, HTN
- Seizures
- Neuropsychiatric adverse events
- Nausea, dry mouth, dizziness, skin rash, strange dreams varenicline ( Chantix ) PO smoking cessation acts as nicotine receptor and partial agonist
Chapter 33 – Anticholinergic Agents Anticholinergic Agents/Parasympatholytic Drugs Indications Therapeutic Actions Contraindications, Interactions, & Cautions Adverse Effects aclidinium ( Tudorza, Pressair ) atropine ( Atropen ) darifenacin ( Enablex ) dicyclomine ( Bentyl ) fesoterodine ( Toviaz ) flavoxate (generic) glycopyrrolate ( Cuvposa, Glyrx-PF, Lonhala Magnair ) hyoscyamine ( Symax ) ipratropium ( Atrovent HFA ) methsocoplamine ( Pamine ) oxybutynin ( Ditropan XL, Gelnique, Oxytrol ) propatheline (generic) revefenacin ( Yupelri ) scopolamine ( Transderm Scop ) solifenacin ( VESIcare ) tiotropium ( Spiriva ) tolterodine ( Detrol, Detrol LA ) trospium (generic) umeclidium ( Incruse Ellipta ) Vary with specific drugs Routes: Oral, IV, IM, inhaled, transdermal Conditions requiring anticholinergic effects Competitively blocks ACh receptors at the muscarinic cholinergic receptor sites responsible for mediating effects of parasympathetic postganglionic impulses
CI:
- Known allergy
- Any condition that could be exacerbated by blocking o the parasympathetic nervous system Cautions:
- Cardiac arrhythmias, tachycardia, myocardial ischemia
- Impaired liver/kidney function
- Pregnancy/lactation
- HTN, spasticity or brain damage Interactions:
- Antihistamines, antiparkinsonism drugs, MAOIs, TCAs
- Phenothiazines
- Herbal therapies Table 33.2 Therapeutic Effects Nondesirable effects:
- R/t dose
- Blurred vision, pupil dilation, photophobia, IOP
- Weakness, dizziness, insomnia, confusion, psychosis
- Altered taste, nausea, heartburn, constipation, paralytic ileus
- Tachycardia, palpitation, HTN, fever
Module 03 – Neuro Medications Pt. 2
Chapter 20 – Anxiolytic and Hypnotic Agents Drugs Route Indications Therapeutic Actions CI, Interactions, Cautions Adverse Effects BENZODIAZEPENES (-pam, - lam) alprazolam (Xanax) , chlordiazepoxide, clonazepam (Klonopin) , clorazepate, diazepam (Valium) , estazolam, flurazepam, lorazepam (Ativan) , midazolam, oxazepam, quazepam, temazepam, triazolam Benzodiazapene-Like Drugs: zolpidem (Ambien)
- Used for insomnia NOT anxiety
- Schedule IV
- Amnesia PO, IM, IV (^) Anxiety disorders, alcohol withdrawal (delirium tremors), panic disorders, restless leg syndrome, seizure disorders, insomnia Does not have much associated sedation Act in limbic system and RAS - Make GABA more effective - Cause interfere nce with neurons firing Peak: 30min – 2 hrs Reversal available CI/Cautions: - Allergy - Psychosis - Narrow-angle glaucoma - Shock, coma - Alcohol intoxication - Pregnancy RISK OF FALLS Cannot be stopped without tapering off Sedation, drowsiness, resp. depression, lethargy , amnesia, blurred vision, “sleep driving”, headaches, apathy, light- headedness, amnesia, confusion, GI and CV problems, hematological conditions, GU effects, withdrawal syndrome BARBITURATES (-barbital) butabarbital (Butisol) pentobarbital (Nembutal) , phenobarbital (generic) , secobarbital (Seconal) PO, IV, IM Relief of S/S of anxiety, sedation, insomnia, preanesthetic, seizures General CNS depressants, Inhibit neuro impulse conduction in ascending RAS, Depress cerebral cortex/motor output CI/Cautions:
- allergy
- addiction to sedative/hypnotic drugs
- latent/manifest porphyria
- hepatic impairment/nephritis
- resp distress/resp dysfunction More severe adverse effects , CNS depression, GI S/S, CV, hypoventilation/low RR , hypersensitivity RISK OF FALLS
Chapter 21 – Antidepressant Agents Drugs Route Indications Therapeutic Actions CI, Cautions, Interactions Adverse Effects TRICYCLIC ANTIDEPRESSANTS AMINES (-ine, - amine): amitriptyline (generic) , amoxapine (generic) , clomipramine (Anafranil) , doxepin (generic) , imipramine (Tofranil) , trimipramine (Surmontil) SECONDARY AMINES: desipramine (Norpramin) , nortriptyline (Aventyl, Pamelor) , protriptyline (Vivactil) TETRACYCLIC: maprotiline (generic) PO Inhibit reuptake of 5HT and NE accumultation in synaptic cleft, increased stimulation of postsynaptic receptors; Depression; Pain, neuropathy, fibromyalgia, anxiety disorders Peak: 2 - 4 hrs 10 - 14 days for effect CI/Cautions:
- Allergy, MI, myelography, MAOIs , pregnancy/lactation
- CV disorders, anticholinergic effects
- Manic-depressive patients
- Suicidality, hx of seizures
- Hepatic/renal disease Interactions:
- Cimetidine, fluoxetine, ranitidine, anticoagulants CNS and PNS effects; GI anticholinergic effects; GU effects; anticholinergic effects ; CV effects; withdrawal syndrome MAOIs isocarboxazid (Marplan) , phenelzine (Nardil) , seligiline (Emsam) , tranylcypromine (Parnate) PO, TD Irreversibly Inhibit MAO, higher levels of available amines Increased stimulation of receptors Tx of S/S of depression who don’t tolerate safer antidepressants Peak: 2 - 3 hrs, clinical changes slow CI/Cautions:
- Allergy, pheochromocytoma, CV disease, known abnormal CNS vessels, hx of headaches, renal/hepatic impairment
- Suicidal More serious/fatal than other antidepressants GI effects; CV effects Foods high in Tyramine: aged cheeses; aged/fermented/pickled meats, fish, poultry;
- Bipolar disorder, elective surgery soon, pregnancy/lactation Interactions:
- Antidepressants, sympathomimetic drugs, antidiabetic medications
- Tyramine , pressor amines Brewer’s yeast; red wines; soy sauce; avocados; beer; liquor; chocolate; grapes; sour cream; yogurt SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIs) citalopram (Celexa) , escitalopram (Lexapro) , fluoxetine (Prozac, Sarafem) , fluvoxamine (Luvox) , paroxetine (Paxil) , sertraline (Zoloft) , vilazodone (Viibryd) , vortioxetine (Brintellix) PO Block reuptake of 5HT, increases levels in synaptic cleft Tx of depression, OCDs, panic attacks, bulimia, PMDD, PTSD, phobias, anxiety disorders; May take up to 4 weeks for full effect; First-line therapy for depression/anxiety disorders CI/Cautions:
- Allergy
- Renal/hepatic function; severely depressed/suicidal patients; pregnancy/lactation Interactions:
- MAOIs, TCAs , other drugs that raise 5HT
- Aspirin, NSAIDs , antiplatelet drugs, anticoagulant drugs Effects of increased 5HT levels; CNS, GI, GU effects; resp. changes; Serotonin syndrome:
- Confusion, agitation, disorientation, hallucinations, delirium, seizures, tachycardia, diaphoresis, fever, hyperreflexia, tremors, NVD, abd. pain, coma SEROTONIN- NOREPI INHIBITORS (SNRIs) desvenlafaxine (Pristiq) , duloxetine (Cymbalta) , levomilnacipran (Fetzima) , milnacipran PO Decrease uptake of serotonin and norepi, inhibit little bit of dopamine; Tx MDD and fibromyalgia (milnacipran) CI/Cautions:
- Allergy, MAOIs
- Severe depression, suicidal, bipolar, pregnancy/lactation Interactions:
- MAOIs, SSRIs, TCAs
- Serotonergic substances, coagulation drugs Effects of 5HT/NE levels; nausea, constipation, dizziness, headache, tachycardia, hyperhidrosis, erectile dysfunction, tachycardia, vomiting, palpitations; Serotonin syndrome;
quetiapine, risperidone, ziprasidone Neuroleptic malignant syndrome : hyperpyrexia, muscle rigidity, AMS BIPOLAR DRUGS aripiprazole (Abilify) , cariprazine (Vraylar) , lithium (Lithobid) , lurasidone (Latuda) , olanzapine (Zyprexa) , quetiapine (Seroquel) , risperidone (Risperdal , ziprasidone (Geodon) Lithium: alters sodium transport in nerve and muscle cells, inhibits the release of norepi and dopamine Bipolar disease, schizophrenia, major depressive disorder, irritability with autism, Tourette’s syndrome Lithium toxicity: 1.4-2.5 (toxicity) >2.5 (coma, seizure, death) t herapeutic range 0.4-1. CI/Cautions: Pregnancy/lactation, significant renal/cardiac disease, metabolic disorders, conditions with low sodium Interactions: carbamazepine- increased CNS toxicity; lithium-iodide combination- hypothyroidism; diuretics- toxicity due to loss of sodium; anticholinergic; NSAIDs Usually R/t blood vessels: <1.5: CNS problems 1.5-2: increased CNS problems, ECG changes, Brugada’s syndrome 2 - 2.5: CNS effects to ataxia, clonic movements, hyperreflexia, seizures; ECG changes, hypotension; large output of dilute urine; pulmonary toxicity, renal toxicity >2.5: multiorgan toxicity and failure/death ADHD/NARCOLEPSY armodafinil, atomoxetine, clonidine hydrochloride, dexmethylphenidate, dextroamphetamine, guanfacine, lisdexamfetamine, methylphenidate, modafinil Treatment of ADHD Sleep disorders, narcolepsy Behavioral syndroms CNS: nervousness, insomnia, dizziness, headache, blurred vision GI: anorexia, nausea, growth suppression, weight loss CV: HTN, arrhythmias, angina, heart attack Skin rashes Dependance Anticholinergic effects: dry mouth, constipation, nausea, urinary hesitancy
Guanfacine & Clonidine: sedation, dry mouth, constipation, hypotension, bradycardia, and impotence Chapter 23 – Antiseizure Agents Drugs Route Indications Therapeutic Actions CI, Cautions, Interactions Adverse Effects HYDANTOINS fosphenytoin, phenytoin (Dilantin)
IV
IV,
PO
Less sedating/less dependency than barbiturates or benzodiazepines Stabilize nerve membranes in CNS, decreases excitability and hyperexcitability to stimulation Decrease conduction, reduce tonic-clinic, muscular, and emotional response to stimulation Seizures; status epilepticus Allergy Pregnancy/lactation Discontinuing drug immediately
- seizures Older adults- CNS depression Renal/liver dysfunction (increased toxicity of phenytoin) Interactions: alcohol, other CNS depressants Primrose- seizures Ginkgo- lower effectiveness Depression, confusion, drowsiness, lethargy, fatigue, constipation, dry mouth, anorexia, cardiac arrhythmias, changes in BP, urinary retention, loss of libido Severe liver toxicity, bone marrow suppression, gingival hyperplasia Stevens-Johnson Syndrome BARBITURATE/ BARBITURATELIKE DRUGS phenobarbital (Solfoton, Luminal) , primidone
PO,
IM,
IV
Seizures Same as hydantoins Interactions: alcohol, other CNS depressants decreased effectiveness of warfarin CNS depression: sedation, hypnosis, anesthesia, resp. depression, coma Physical dependence and withdrawal syndrome BENZODIAZEPINES clobazam, clonazepam, diazepam PO Seizures; panic attacks; restless leg movements; acute manic episodes; schizophrenia Potentiate effects of GABA (limbic system and RAS), decrease excitability Same as hydantoins Interactions: alcohol, other CNS depressants CNS depression Physical dependence and withdrawal syndrome
