Name : Shannen Elam Anak Hanley

ID : IKCH-1218-8016
Topic : Central Nervous System Agent
Lecturer's
Name : Mdm Wong Yi Lu
 What are Central nervous system agents?
• Central nervous system agents are medicines that
affect the central nervous system (CNS). The
CNS is responsible for processing and
controlling most of our bodily functions, and
consists of the nerves in the brain and spinal
cord.
• There are many different types of drugs that work
on the CNS, including anesthetics,
anticonvulsants, antiemetics, antiparkinson
agents, CNS stimulants, muscle relaxants,
narcotic analgesics (pain relievers), nonnarcotic
analgesics (such as acetaminophen and NSAIDs),
and sedatives.
 What are CNS stimulants?
• CNS stimulants are medicines that stimulate the brain,
speeding up both mental and physical processes.
• They increase energy, improve attention and alertness,
and elevate blood pressure, heart rate and respiratory
rate.
• They decrease the need for sleep, reduce appetite,
improve confidence and concentration, and lessen
inhibitions.
• They may also have other effects, depending on the
actual drug. For example, phentermine possibly
indirectly increases leptin levels – leptin is a substance
that tells us we feel full.
 What are CNS stimulants used for?
• CNS stimulants may be useful for the treatment of certain conditions
characterized by symptoms such as prolonged fatigue, inability to
concentrate, or excessive sleepiness.
• CNS stimulants have been used for the following conditions:
• Attention deficit disorder
• Chronic lethargy
• Morbid obesity unresponsive to other treatments
• Narcolepsy
• Neonatal apnea
• Postural orthostatic tachycardia syndrome
• Prolonged depression that is unresponsive to traditional antidepressants
 What are the differences between CNS stimulants?
• CNS stimulants differ in their ability to increase
levels of certain neurotransmitters which
determines what effect they have in the body
and their side effects.
• Some CNS stimulants have been modified to
improve their effect, for example, a methyl
group was added to amphetamine to make
methamphetamine which lasts longer than
amphetamine, penetrates the brain better, and is
less likely to detrimentally affect the heart.
 What are the side effects of CNS stimulants?
• CNS stimulants are associated with a number
of severe and undesirable side effects such
as:
• Depersonalization (a feeling that you are an
observer of yourself)
• Dizziness
• Headaches
• Inability to sleep
 What are Anticonvulsants?
• Anticonvulsants helps to normalise the way nerve impulses
travel along the nerve cells which helps prevent or treat seizures.
• When the brain is working normally the nerve cells talk to each
other using controlled electrical signals from one nerve cell to
another.
• This tells the body to do everything it needs or wants to do.
• During a seizure there is a change in the level of nerve cell
electrical signals from a normal level to an excessive or
abnormal amount of nerve signals
• This increased nerve activity is responsible for the signs and symptoms
of a seizure.
• What causes the change is nerve impulses can be the result of an injury
to part of the brain, stroke, brain tumor, genetic causes, metabolic
problems or toxicity issues.
• Anticonvulsants can also be used to treat nerve pain and bipolar
disorder.
 How they work
• Anticonvulsants keep the nerve cell impulses to a normal level
so they don’t become excessive and uncontrolled, which is
why they are used in seizure disorders and epilepsy.
• The way anticonvulsants control the nerve impulses is not
fully understood but is thought to be by their action on
neurotransmitters like GABA, or acting on receptors such as
glutamate or by changing the electrical channels in the nerve
cell.
 What they treat
• Anticonvulsants stabilize the level of nerve cell
impulses and are used for a range of conditions
including:
• epilepsy
• seizure disorders
• nerve pain (neuropathic pain)
• bipolar disorder
 What are Antiparkinson agents?
• Antiparkinson agents aim to replace
dopamine either by drugs that release
dopamine or those that mimic the action of
dopamine.
• Parkinson's disease is a degenerative
disorder of movement that occurs due to
dopamine deficiency in the basal ganglia.
• Antiparkinson agents attempt to replace
dopamine and treat or halt the symptoms
such as tremor, hypokinesia, and so on.
 Types of Antiparkinson agents
Anticholinergic antiparkinson agents
 Anticholinergic antiparkinson agents or acetylcholine
antagonists block the muscarinic acetylcholine receptors
and cholinergic nerve activity.
 Activation of muscarinic receptors has an excitatory
effect, opposite to that of dopaminergic activation, so
suppression of the effects of acetylcholine compensates
for a lack of dopamine in Parkinson's disease.
Dopaminergic antiparkinsonism agent
• Dopaminergic antiparkinsonism agents aim to replace
dopamine or prevent the degradation of dopamine.
• Drugs that replace dopamine are generally given with
peripherally acting dopa carboxylase inhibitors, to prevent
the metabolism of levodopa to dopamine peripherally.
• Selective monoamine oxidase (MAO-B) inhibitors bind to
the enzyme MAO-B and prevent dopamine from being
broken down
 Definition of anesthesia

• Anesthesia is a temporary
state that causes
unconsiousness, loss of
memory, lack of pain and
muscle relaxation.
 Types of anesthesia

• Local anesthesia
• General anesthesia
• Regional anesthesia
 Local anesthesia
• Local anesthesia is the temporary loss of sensation or
pain in one part of the body produced by a topically
applied or injected agent without depressing the level of
consciousness.
 General anesthesia
• General anesthesia is a combination of medications that put you in a sleep-like
state before a surgery or other medical procedure. Under general anesthesia,
you don't feel pain because you're completely unconscious. General anesthesia
usually uses a combination of intravenous drugs and inhaled gasses
(anesthetics).
• Drugs that can be used intravenously to produce anesthesia or sedation, the
most common are:
• Barbiturates
• Etomidate
• Ketamine
• Propofol
Barbiturates
Etomidate

Ketamine Propofol
 Regional anesthesia
• is a type of pain management for surgery that numbs a large
part of the body, such as from the waist down.
• Another type of regional anesthesia is a spinal block. Spinal
block is stronger and is used during procedures such as
cesarean deliveries, also known as C-sections.
• Bupivacaine also known as Marcaine and is more commonly
used for spinal block in caesarean procedures.
• Levobupivacaine is another amide S isomer of bupivacaine that
is used for spinal anaesthesia for caesarean section