Nervous

Potent pain control via µ-opioid receptor agonism. Watch for respiratory depression; reverse with naloxone.

Potentiate GABA for anxiety, seizures, and sedation. Additive CNS depression — deadly with opioids.

First-line antidepressants that raise synaptic serotonin. Delayed onset; watch for serotonin syndrome and early suicidality.

Stabilize neuronal firing to prevent seizures. Many are narrow-therapeutic-index — level monitoring and rash vigilance are essential.

A widely used fever/pain reliever with no anti-inflammatory or platelet effect — but hepatotoxic in overdose.

Dopamine-blocking drugs for psychosis. Watch EPS, NMS, metabolic effects — boxed warning in elderly dementia.

Lithium controls bipolar mania but has a tiny therapeutic window — levels are everything.

Paralyze skeletal muscle for intubation/surgery. Handle with high-alert safeguards (ISMP lists rocuronium): they paralyze but do NOT sedate or relieve pain. Sugammadex reverses rocuronium and vecuronium.

Antidepressants that raise serotonin AND norepinephrine — also treat nerve pain. Watch discontinuation & BP.

Older dual-action antidepressants — effective but "dirty." Anticholinergic effects; LETHAL in overdose.

Powerful older antidepressants — the tyramine "wine-and-cheese" hypertensive crisis defines their risk.

The "others" — bupropion (no sexual SE, lowers seizure threshold), mirtazapine (sleep/appetite), trazodone (sleep).

Dopamine/NE boosters for ADHD & narcolepsy. Schedule II — boxed warning for abuse; watch heart, growth, sleep.

Restore brain dopamine in Parkinson disease. Levodopa-carbidopa is the mainstay; watch wearing-off & impulse control.

Abort acute migraines by constricting cranial vessels. Contraindicated in coronary disease; recognizable by -triptan.

Drugs that abolish sensation or consciousness. Three emergencies to know: local anesthetic systemic toxicity (LAST → lipid rescue), propofol infusion syndrome, and malignant hyperthermia.

Boost acetylcholine (cholinesterase inhibitors) or block glutamate excitotoxicity (memantine) to slow cognitive symptoms. Watch cholinergic bradycardia.