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257 Cards in this Set
- Front
- Back
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what inhaled anesthetic is associated with bronchialspasm and secretion
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isoflurane
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inhaled anesthetic associated with spasm
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enflurane
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inhaled anesthetic associated with hepatitis and cardiac arrythmias
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halothane
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what inhaled anesthetics increase HR
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ID Isoflurane and desflurane
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ID Isoflurane and desflurane
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what inhaled anesthetics increase HR
|
|
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what inhaled anesthetics decrease the ole heart rate
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halothane, enflurane sevoflurane
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|
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inhaled anesthetic contraindicated in renal failure
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enflurane
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enflurane is contraindicated in
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renal failure
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inhaled anesthetic that sensitizes the heart to catecholamines
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halothane
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halothane sensitizes the heart to
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catecholamines
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definiteley does not sensitize the heart to catecholamines
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Isoflurane
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relaxes bronchial smooth muscle but decreases renal and hepatic Blood flow
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halothane does theis to bronchial smooth muscle
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halothane does theis to bronchial smooth muscle
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relaxes bronchial smooth muscle but decreases renal and hepatic Blood flow
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potent analgesis but piss poor anesthetic so must be given with other drugs
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Laughing gas
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6 examples of IV anesthetics
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fentanyl, ketamine, midazolam, thiopental, etomidate, propofol
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which inhaled anesthetic is the least hepatotoxic
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NO
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which anesthetic must be used with other anesthetics for surgical anesthesia
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NO
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Which inhaled anesthetic decreases renal and hepatic blood flow
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halothane
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which inhaled anesthetic relaxes bronchial muscle
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halothane
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name 6 IV anesth.
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propofol, fentanyl, ketamine, midazolam, thiopental etomidate
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IV anesth. thats a barbituate
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thiopental
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benzo IV anesth
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midazolam
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IV anesth. thats an opiod
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fentanyl
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thiopenal is used for induction maintenance or both
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induction
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how does recovery occur with the rapid acting barbs
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redist. from the cns to the pns
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thiopentany does what to blood flow, resp. function, blood pressure
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no change decrease decrease
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why should caustion be taken when admin thiopental asthmatic patients
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spasm of the larynx
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barbs are contraindicated in what disease
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AIP
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midazolam offer which type of amnesia making it useful for conciuos sedation
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anterograde
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antidote for midazolam resp. depression
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flumazenil
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fentalnyl comboed with what med causes neuroleptic analgesia
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droperidol
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fentanyl combined with which two meds causes neuroleptic anesthesia
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droperidol and NO
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advers rxn caused by IV fentnyl
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chest wall rigidity
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midazolam offer which type of amnesia making it useful for conciuos sedation
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anterograde
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antidote for midazolam resp. depression
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flumazenil
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fentalnyl comboed with what med causes neuroleptic analgesia
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droperidol
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fentanyl combined with which two meds causes neuroleptic anesthesia
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droperidol and NO
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|
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advers rxn caused by IV fentnyl
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chest wall rigidity
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|
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propfol have good analgesic properties
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no
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color of propofol
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white with lipids
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propofol on BP
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decrease
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propofol on ICP
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decrease
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propofol on maint or induction
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both
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IV anesthiesia that is dissociative
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ketamine
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patient is not concious and feels no pain but appears awake
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dissociative anesthesia by K
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anesthesia that is anti emetic
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propofol
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which IV anesthetic is a CV stimulant (increases BP and CO)
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ketamine
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IV anesth that causes dreams hallucinations
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ketamine
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which IV anesthetic is ultra short acting benzylimidazole used for induction anesthesia and has minimal CV effects
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etomidateare
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are local anesthetics weak acids or bases
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weak bases
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5 examples of AMIDE anesthetics
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lidocaine prilocaine articaine mepivicaine, bupivicaine (all have more than one i)
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|
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give 3 examples of ester local A's
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cocaine, procaine benzocaine (only one i )
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|
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which med when used in combo reduces systemic toxicity and increases the duration of action of local A's
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epi
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|
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where should you not use epi with a local A
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PENIS, digits, nose ears
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|
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type of enzymes that get ride of amide Local A's (LA's)
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amidases in the liver
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|
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enzymes that rid the ester LAs
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esterases in tissues and blood
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MOA of LAs
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inhibition of sodium channels in the axonal membranes via binding to the channels in there inactivated state and preventing structural change in their resting state
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Do LA's need to be ionized or non Ionized to bind to the sodium channel
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ionized
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Do LA's need to be ionized or nonionized to gain acces to the sodium chamel which is on the inner side of the axonal membrane
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nonionized
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|
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all LAs cause vasoD except
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cocaine
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|
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nerve fibers most sensitive to blockade are of small or large diameter
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small
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nerve fibers most sensitive to blockade ahce low or high firing rates
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high
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|
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which nerve fibers are most sensitive to LAs
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Type B and Type C
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|
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which neerve fibers are least sensitive to LAs
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Type A alpha fibers
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|
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what are the adverse effects of LAs
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hypotension except coke, nystagmus, seizures, dizziness and allergic rxns
|
|
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allergic rxns to LAs are
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more associated with Esters via PABA formation
|
|
|
what two opiods are used specifically for diahrrea
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loperamide, diphenoxylate (often given with atropine)
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|
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MOA of opiod induced miosis
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increased chilnergic activity in the pupillary constrictoro muscles
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|
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which opiod drug does not cause miosis
|
meperidine (antagonize muscarinic receptor)
|
|
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opiod induce urinary retention is due to
|
increases in ADH
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|
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how do opiods promote emesis
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activate the CTZ in the area postrema
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|
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most lipophillic opiods
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fentanyl and heroin
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|
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least lipophillic opiod
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morphine
|
|
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med given to counteract resp. epression of opioid overdose
|
naloxone (which has a shorter halflife than morphine so must be given multiple times)
|
|
|
weak opioid agonists are
|
codiene, propoxyphene
|
|
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partial opioid agonis
|
Buprenorphine, pentazocine
|
|
|
kappa agonist mu antagonsit
|
pentazocine moa
|
|
|
pentazocine moa
|
kappa agonist mu antagonsit
|
|
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what opoids should not be given to someone on MAOIs
|
meperidine and dextromethorphan because they cause serotonin syndrome
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|
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acetylated morphine is
|
heroin
|
|
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must be metabolized by Cytochrome P-450 2D6 to active morphine
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codiene
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|
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codiene must be activated to
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must be metabolized by Cytochrome P-450 2D6 to active morphin
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|
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where in the midbrain are opioid receptors found
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periaqueductal grey (binding to these receptors leads to activation of descending pathways to the raphe nuclei decreasing transmission throughout the pain pathway)
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|
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morphine induce hypotension and pruritis is due to histamine release from
|
mast cells
|
|
|
why does meperidine not increase the tone of the bladder, biliary tract or ureter
|
because it also is a mu antagonist
|
|
|
what opioid does not cause pupillary constriction
|
meperidine
|
|
|
increased ADH
|
is the MOA of opioid urinary retention
|
|
|
opioids do what during pregnancy
|
decrease uterine contractions
|
|
|
least lipophillic opioid
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morphine (remember that heroin and fentanyl are the most lipophillic)
|
|
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is morphine metabolized by phase I or phase II rxns
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phase II glucuronidation
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which morphine metabolite is analgesically active
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Morphine-6-glucuronidide
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how does naloxone work to counteract respiratory depresssion caused by opioids
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Mu receptor antagonist
|
|
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opioid antagonist for alcoholics
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nalTREXone
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alpha-2 agonist for heroin withdrawal
|
clonidine
|
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examples of weak opioid agonists
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codiene and propoxyphene
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codiene and propoxyphene
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examples of weak opioid agonists
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partial opioid agonists
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buprenorphine and pentazocine
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pentazocine a partial opioid agonist works by
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Kappa agonist, mu antagonist
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Kappa agonist, mu antagonist
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pentazocine a partial opioid agonist works by
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|
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derevative of methadone that is a weak agonist
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propoxyphene
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fentanyl is chemically related to
|
meperidine
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|
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what is morphines oral bioavailability
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low low
|
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acetylated morphine
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heroin
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what adverse drug rxn may be caused by giving the opioid fentanyl IV
|
chest wall rigidity
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|
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chest wall rigidity
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what adverse drug rxn may be caused by giving the opioid fentanyl IV
|
|
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antiemetic IV anesthetic
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propofol which can be used for induction and maintenace
|
|
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ultrashort actingIV anesthetic benzylimidazole used for induction of anesthesia and has minimal CV effects
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Etomidate
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Etomidate is
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ultrashort actingIV anesthetic benzylimidazole used for induction of anesthesia and has minimal CV effects
|
|
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how do LAs prevent causing a structural change in the resting state
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by making sure they only bind to inactivated Na channels
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|
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adverse Drug rxn of fentanyl IV
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chest wall rigidity
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propofol does what to BP and IntraC pressure
|
decreases both
|
|
|
thiopental does what to BP and Resp fxn
|
decreases both of them associates
|
|
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etomidate i what
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ultra-short actingbenzylimidazole used for induction of anesthesia and has minimal CV effects
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|
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all LAs cause
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VasoD except the coke
|
|
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presynaptic inhibition of calcium influx
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binding opiod receptors in the pre
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|
|
post synaptic K efflux is increased
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binding post synaptic opie receptors
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|
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opioid receptors are coupled to what type of protein
|
G inhib
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|
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opioids Increase
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intracranial pressure
|
|
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opioids Increase
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intracranial pressure
|
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periaquiductal grey
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where opoids receptors are located
|
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Im itching what opioid am I on
|
morphine induces Histmine release from mast cells causing pruritis and hypotension
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|
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increases ADH
|
opioids
|
|
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3-8 hour acting Barbs
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amo, seco barbital
|
|
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30 minute duration barbs
|
thiopental
|
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1-2 day barbs
|
pentobarb, phenobarb
|
|
|
increase heme synthesis
|
barbituates
|
|
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barbituate withdrawal is treated with
|
longaacting benzodiazepines
|
|
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sedating antihistmines besides diphenyhydramine
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doxylamine, Hydroxyzine
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sedating antihistmines besides diphenyhydramine
|
doxylamine, Hydroxyzine
|
|
|
buspirone is a
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partial agonists at serotonin 1a used for GAD
|
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partial agonists at serotonin 1a used for GAD
|
buspirone is a
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buspirone is a
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partial agonists at serotonin 1a used for GAD
|
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buspirone is a
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partial agonists at serotonin 1a used for GAD
|
|
|
CUD BOX
|
adverse effects of MAOI
C - constipation U - urinary retent. D - drowsiness B - Blurriness O - ORTHOSTATIC HYPOTENS X - Xerostomia |
|
|
CUD BOX
|
adverse effects of MAOI
C - constipation U - urinary retent. D - drowsiness B - Blurriness O - ORTHOSTATIC HYPOTENS X - Xerostomia |
|
|
selegiline treats parkinsons and is characterized by
|
at low concentrations inhibiting MAOb but at high conc. inhibiting both
|
|
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serotonin syndrome is
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life threatening side effect of MAOiS and SSRIs used together
|
|
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life threatening side effect of MAOiS and SSRIs used together
|
serotonin syndrome is
|
|
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serotonin syndrome is
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MAOis and SSRIs used together
|
|
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MAOis and SSRIs used together
|
serotonin syndrome
|
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MAOis and SSRIs used together causes serotonin syndrome which is characterized by
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sweaty Hot (hyperthermia) seizures with ANS instability and Myoclonus
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MAOis and SSRIs used together causes serotonin syndrome which is characterized by
|
sweaty Hot (hyperthermia) seizures with ANS instability and Myoclon
|
|
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MAOis and SSRIs used together causes serotonin syndrome which is characterized by
|
sweaty Hot (hyperthermia) seizures with ANS instability and Myoclon
|
|
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name nonselective MAOIs
|
tranylcypramine, phenalzine, isocarboxazid
|
|
|
name nonselective MAOIs
|
tranylcypramine, phenalzine, isocarboxazid
|
|
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isocarboxazid
|
name nonselective MAOIs
|
|
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phenalzine,
|
name nonselective MAOIs
|
|
|
tranylcypramine
|
name nonselective MAOIs
|
|
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life threatening condition that develops on MAOIs and Tyramine
|
HTN crisis
|
|
|
HTN crisis
|
life threatening condition that develops on MAOIs and Tyramine
|
|
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serotonin like syndrome occurs when
|
MAOIs are used with dextrometh, or demerol (meperidine)
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|
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serotonin like syndrome occurs when
|
MAOIs are used with dextrometh, or demerol (meperidine)
|
|
|
nortryptaline
|
inhibits reuptake of NE and is active metabolite of amitriptaline
|
|
|
inhibits reuptake of NE and is active metabolite of amitriptaline
|
nortriptyine
|
|
|
nortriptyine
|
inhibits reuptake of NE and is active metabolite of amitriptaline
|
|
|
despiramine
|
active metabolite of Imipramine that inhibits reuptake of NE
|
|
|
active metabolite of Imipramine that inhibits reuptake of NE
|
despiramine
|
|
|
MOA of tricyclics
|
inhibit reuptake of NE and Serotinin while antagonizing muscarinic, alpha adrenergic and histaminergic receptors
|
|
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MOA of tricyclics
|
inhibit reuptake of NE and Serotinin while antagonizing muscarinic, alpha adrenergic and histaminergic receptors
|
|
|
MOA of tricyclics
|
inhibit reuptake of NE and Serotinin while antagonizing muscarinic, alpha adrenergic and histaminergic receptors
|
|
|
tricyclic for OCD
|
clomipramine
|
|
|
tricyclic for OCD
|
Clomipramine has a C in it like oCd
|
|
|
tricyclic for kids wetting the bed
|
imipramine (desipramine is metabolite)
|
|
|
increases contraction of internal sphincter of the bladder and decreases stage 3,4 sleep
|
imipramine (desipramine is metabolite)
|
|
|
increases contraction of internal sphincter of the bladder and decreases stage 3,4 sleep
|
imipramine (desipramine is metabolite)
|
|
|
imipramine (desipramine is metabolite) works to decrease bedwetting by
|
increases contraction of internal sphincter of the bladder and decreases stage 3,4 sleep
|
|
|
imipramine (desipramine is metabolite) works to decrease bedwetting by
|
increases contraction of internal sphincter of the bladder and decreases stage 3,4 sleep
|
|
|
takes TCAs how long to work
|
4-6
|
|
|
takes TCAs this long to work
|
4-6
|
|
|
inhibits reuptake of NE into the presynaptic neurons thereby increasing NT conc. in the cleft
|
amoxapine, maprotaline
|
|
|
amoxapine, maprotaline
|
inhibits reuptake of NE into the presynaptic neurons thereby increasing NT conc. in the cleft
|
|
|
inhibits reuptake of NE into the presynaptic neurons thereby increasing NT conc. in the cleft
|
amoxapine, maprotaline
|
|
|
inhibits reuptake of serotonin into the presynaptic neurons thereby increasing NT concentrations in the cleft
|
nefazodone, trazadone
|
|
|
amoxapine, maprotaline
|
inhibits reuptake of NE into the presynaptic neurons thereby increasing NT conc. in the cleft
|
|
|
nefazodone, trazadone
|
inhibits reuptake of serotonin into the presynaptic neurons thereby increasing NT concentrations in the cleft
|
|
|
inhibits reuptake of serotonin into the presynaptic neurons thereby increasing NT concentrations in the cleft
|
nefazadone, trazadone
|
|
|
nefazadone, trazadone
|
inhibits reuptake of serotonin into the presynaptic neurons thereby increasing NT concentrations in the cleft
|
|
|
inhibits reuptake of serotonin into the presynaptic neurons thereby increasing NT concentrations in the cleft
|
nefazadone, trazadone
|
|
|
priapism
|
trazadone - inhibits reuptake of serotonin into the presynaptic neurons thereby increasing NT concentrations in the cleft
|
|
|
nefazodone edverse effect
|
inhibits p450
|
|
|
inhibits p450
|
nefazodone edverse effect
|
|
|
nefazodone edverse effect
|
inhibits p450
|
|
|
MOA of bupropion
|
weak inhibitor of DA, Serotonin, and NE
|
|
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buproprion
|
weak inhibitor of DA, serotonin and DA
|
|
|
weak inhibitor of DA, serotonin and DA
|
buproprion
|
|
|
buproprion
|
weak inhibitor of DA, serotonin and DA
|
|
|
alpha-2 anatag for sex dysfunc
|
yohimbine
|
|
|
yohimbine
|
alpha-2 anatag for sex dysfunc
|
|
|
weigh gain is major side effect of this
|
clonidine that alpha-2 antagonist
|
|
|
venlafaxine MOA
|
potent inhibitor of serotonin and NE reuptake and weak dopa reuptake inhibitor
|
|
|
venlafaxine MOA
|
potent inhibitor of serotonin and NE reuptake and weak dopa reuptake inhibitor
|
|
|
side effect of venlafax
|
HTN
|
|
|
atypical depression is treated by
|
MAOis
|
|
|
examples of SSRIs (6)
|
fluoxetine, paroxetine, fluvoxamine, sertraline (zoloft), citalopram, escitalopram
|
|
|
examples of SSRIs (6)
|
fluoxetine, paroxetine, fluvoxamine, sertraline (zoloft), citalopram, escitalopram
|
|
|
halflife of fluoxetine
|
5 days
|
|
|
pmdd is treated by what SSRI
|
fluoxetine
|
|
|
bulemia PMDD OCD panic disorder and selective mutism
|
fluoxetine
|
|
|
specifically for OCD ssri
|
fluvoxamine (columbine shooter took this
|
|
|
fluvoaxamine
|
specifically for OCD ssri
|
|
|
SAD GAD and PTSD SSRI
|
paroxetine
|
|
|
paroxetine
|
SAD GAD and PTSD SSRI
|
|
|
drug interactions of SSRIs
|
cyp450 inhibition
|
|
|
drug interactions of SSRIs
|
cyp450 inhibition
|
|
|
norfluoexinte
|
active metabolite of fluoxetine
|
|
|
active metaboliet of fluoxetine
|
norfluoxetine
|
|
|
Binds to gaba B receptors to decrease release of aspartae and glutamate into alpha motor neurons
|
baclofen MOA
|
|
|
baclofen MOA
|
Binds to gaba B receptors to decrease release of aspartae and glutamate into alpha motor neurons
|
|
|
DOC (drug of Choice) to stop persistent status epilepticus
|
Diazepam or more recently Lorazepam
|
|
|
valproic acid is used to prevent or stop seizures or both
|
prevent prevent prevent
|
|
|
if someone is highly sensitive to midazolam what is the most likely maifestation
|
resp. depression
|
|
|
phenobarbitol is used to stop seizures caused by drugs such as lidocaine only if...
|
the usual measure such as treatment with a Benzodiazepine do not work
|
|
|
inhibits decarboxylation of peripheral DOPA
|
carbidopa
|
|
|
reversible inhibitor of peripheral comt
|
entacapone tocapone
|
|
|
what causes the side effect of impotence when taking for instance chlorpromazine
|
alpha blockade
|
|
|
what APs would one most likely see dry mouth and urinary retention
|
thioridazine, clozapine
|
|
|
risperidone is an atypicl AP so you know it blocks Seritonin 2 receptors but what else
|
D2, alpha-1
|
|
|
makes so one can give a lower dose of levodopa
|
carbidopa, means there will be less formation of Dopamine in the periphery
|
|
|
give the four DOpamine agoinists for PD
|
bromocript and pergolide
ropinorole and prampexole |
|
|
NSAIDs with lithium do what
|
increase the renal absorption of lithium because NSAIDs reduce the excretion of lithium
|
|
|
often adm as a patch behind the ear for motion sickness
|
scopalamine
|
|
|
in opthalmic exams scopalamine can
|
produce mydriasis and cycloplegia to help determine refractive errors
|
|
|
setrons block
|
serotonin 3
|
|
|
APs with low anticholinergic activity
|
Halo, flu, quitepine, ziprasodone
|
|
|
molecular unwanted side-effect of demerol
|
blocks Serotonin reuptake so should not be given to someone on MAOIs
|
|
|
early sign of lithium toxicity
|
GI upset
|
|
|
decreases the incidence of seizures by stopping glutamate release via blockade of Na channels allso has some anti-folate characteristics
|
Lamotrigine
|
|
|
preferred to phenobarbitol in kids
|
Carbamezipine which is structurally similar to TCAs
|
|
|
the most serious problem with valproic acid is
|
liver failure
|
|
|
preventing recurrent febrile seizures Tx
|
Diazepam which also is the DOC for status epilepticus
|
|
|
prevent seizures during surgery
|
Phenytoin
|
|
|
intermediate acting barbituate that has been prescribed for insomnia
|
secobarbitol however the nondiazepam, zoplidem and zopiclone are more appropriate
|
|
|
methohexiatal
|
fast Anesthetis agent even faster than thiopental
|
|
|
barbituate with the longest HAlflief
|
phenobarbitol
|
|
|
partial dopamine agonist AP
|
ariprazole
|
|
|
positive effect on pain caused by fibromyalgia and is the first SSRI approved for peripheral neuropathy
|
Duloxetine
|
|
|
EEG of generalized abscence seizures
|
spike/wave pattern of 3Hz
|
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spike/wave pattern of 3Hz
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EEG of generalized abscence seizures
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looks like a tricyclic that is also effective in treating pain of neurologic origin and some psychiatric disorders such as bipolar and intermittent explosive disorder
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carbemazepine
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phenytoin is for prenvention or stopping acutely
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pheny is for prevention
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anti convulsant that prevents neuronal and glial uptake of GABA
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tiagabine
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anti convulsant that prevents neuronal and glial uptake of GABA
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tiagabine
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tiagabine
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anti convulsant that prevents neuronal and glial uptake of GABA
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sinus tach associated with TCAs is due to
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there antimuscarinic properties
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responsible for the cardiotoxicity of Tricyclics
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well remember the tricyclics block the uptake of NE and Serotonin so increased catecholamines are the culprit here
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what is doxepin
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A TCA
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phenalzine is what
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an MAO inhib
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its metabolite blocks the reuptake of serotonin and that is why this drug can cause a serotonin like syndrome with concomitant use of an MAOI
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mperedine which has a metabolite called normeperidine that blocks reuptake of Serotonin
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ranitidine is an
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H2 antagonsit for GI disorders
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most appropriate for rapid treatment of a panic attack
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Alprazolam (Xanax) as opposed to valium (diazepam) which has a longer half-lief
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when glutamate binds to an NMDA receptor what happens
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in rolls a calcium storm
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caspasaicin acts by
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decreasing pain by decreasing stores of substance P
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what is peroxicam
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an NSAID
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greatest depression of resperiation is caused by
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Isofluroane the least is NO
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desfluorane and NO have what in common
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lowest blood to gass coefficient so they work and stop the quickest
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dude comes in after free basing some coke and wont calm down so what does he need
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valium
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rapidly enters the brain and then redistributes to places without a lot of blood flow
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thiopental since it is so goddamn lipid loving just like heroin...its rapid induction and abatement is not relieved by its metabolism infact it is broken down slowly
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