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38 Cards in this Set

  • Front
  • Back
Which opiod is used for cough?
Dextromethophan
Which opiods are used for diarrhea? (2)
1. Loperamide
2. Diphenoxylate
Where do opioids act
Opioid receptors
What are the 3 different receptors (3)
1. Mu = morphine
2. delta = enkaphalin
3. Kappa = Dynorphin
What happens to synaptic transmission
K+ channels open and Ca2+ channels close which leads to decreased synaptic transmission
What NT's are inhibited (5)
1. Ach
2. NE
3. Seratonin
4. Glutamate
5. Substance P
Besides pain what are 4 other uses for opiods?
1. Cough - dextro
2. Diarrhea - see other card
3. Acute pulmonary edema
4. Addict maintenance
What are the 5 toxicities of opiod use?
1. Addiction and tolerance
2. Constipation
3. Miosis - pinpoint pupils
4. respiratory depression
5. CNS depression is additive with other drugs
Which side effects don't obtain tolerance?
Miosis and constipation
How is opioid overdose treated and how do these agents work?
Naloxone or naltrexone - both are opioid antagonists
What type of drug is butorphanol?
Mixed agonist/antagonist
At which receptors does it act and how?
Mixed agonist/antagonist at mu
Agonist at kappa
What is the clinical use and why is it preferred?
Pain - it's preferred because it causes less respiratory depression than full agonists
What is the toxicity?
Don't mix it with other opioids because it will induce withdrawl if the oterh opioid is a full agonist
How does tramadol work?
Very weak opioid agonist
What other NT's does tramadol affect and how?
Inhibits serotonin and NE reuptake
What is the indication for tramadol and why is it preferred?
Chronic pain - it is non-addictive
What are the toxicities?
1. Similar to opioids
2. Decreases seizure threshold
What is the mechaism of phenytoin? (3)
1. Use dependent blockade of Na+ channels
2. Increases nerve refractory period
3. Inhibits glutamate release
What are the 2 indications for phenytoin?
1. Tonic-clonic seizures
2. Class IB antiarrhythmic
See seizure card set for SE of phenytoin
Barbituriates: what is the common suffix for these drugs?
"-barbital"
Barbituriates: mechanism
Decrease neuronal firing: they enhance the action of GABA by decreasing the DURATION of chloride channel opening
Barbituriates: uses (4)
1. Sedative for anxiety
2. Siezures
3. Insomnia
4. Thiopental is used to induce anesthesia
Barbituriates: overdose management?
Symptomatic management so… assist with airway and BP
Barbituriates: see seizure drug list for SE of barbituriates
Benzodiazepine: what is the suffix for almost all of them?
"zepam" or "zolam"
Benzodiazepine: which is used for EtOH withdrawl
chlordiazepozide
Benzodiazepine: Which has the shortest 1/2 life?
alprazolam (xanax)
Benzodiazepine: what happens to REM sleep
it decreases
Benzodiazepine: machanism
Enhance GABA by increasing the frequency of chloride channel opening
Benzodiazepine: what are the short acting ones?
"MOAT"
1. Midazolam
2. Oxazepam
3. Alprazolam
4. Triazolam
Benzodiazepine: which types of benzos have the highest addictave potential?
The short acting ones
Benzodiazepine: which are used for status epilepticus
Lorazepam and diazepam
Why are benzos preferred to barbituriates?
Less respiratory depression
How is benzo OD treated and how does this agent work?
Flumazenil - competitive antagonist of GABA receptor
What 3 drug classes bind the GABA receptor
1. Benzo
2. Barb
3. EtOH
What type of receptor is GABA
Ligand gated chloride channel