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87 Cards in this Set
- Front
- Back
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criteria for binge drinking
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5 drinks/men, 4/women in 2 hours
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area in GI where most alcohol is absorbed?
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duodenum
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factors that affect BAC?(5)
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amount, rate, food, gastric metabolism, hepatic first pass
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ETOH kinetics and TI?
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narrow TI and zero-order kinetics
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first pass metabolism?
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ETOH metabolized in stomach by ADH
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alcohol metabolism steps?
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ETOH metabolized by ADH to acetylaldehyde to acetic acid by ALDH
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fomepizol MOA?
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inhibits ADH
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disulfiram MOA?
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inhibits ALDH
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half of Asians have this ALDH allele?
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ALDH-2 is mostly found in this population
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effect of estrogen and ETOH?
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liver becomes more sensitive to ETOH with estrogen
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methanol metabolism steps?
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methanol to formaldehyde to formic acid
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BAC of what leads to LD50?
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BAC=.4
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role of adenosine transporter and relationship to ETOH?
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adenosine makes you sleepy and ETOH initially inhibits the receptor
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ETOH indirectly acts on these kinases?(4)
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fyn-kinase on NMDA, PKCs and protein kinase A on GABA
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drug group that blocks stimulus properties of ETOH?
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5-HT antagonists
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T or F: tolerance changes metabolize rate and TI of ETOH
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false
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Korsakoff's psychosis?
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memory deficiets caused by ETOH?
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time frame of early minor ETOH withdrawl?
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8-12 post drink, less than 48 hrs.
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delirium tremens?
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late major ETOH withdrawal?
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naltrexone MOA?
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opiate receptor inhibitor?
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acomprosate MOA?
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NMDA receptor and Ca channel inhibitor and decrease glutamate to prevent withdrawal sx. from ETOH (sensitized NMDA state)
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example of anesthetic gas?
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nitrous oxide is an example
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function of anticholinergics in anesthesia?
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amnesia, prevent bradycardia and fluid secretion
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which substances activate K channel receptors and hyperpolarize cells?
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NO, ketamine, xenon
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speed of anesthesia det. by three factors?
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inspired partial pressure, ventilation rate, GA solubility
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which agents smell bad? good?
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desflurane, isoflurane smell bed; halothane, sevoflurane smell good
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MAC?
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minimum alveolar concentration; required to prevent response to painful stimuli in 50% of pts.
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5 factors that increase MAC?
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hyperthermia, chronic EtOH, cocaine, hypernatremia, inc. CNS catecholamine release
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6 factors that decrease MAC?
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hyponatremia, pregnancy, CNS depressents, smoking, increased age, acute alcohol ingestion
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nitrous oxide has all the effects of other anesthesia agents except?
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muscle relaxation not found
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most common termination method for anesthesia?
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expiration
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which drug had MAC>100, good analgesic, rapid onset and recovery?
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NO
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which anesthetic agent sensitizes heart to epi-induced arrhythmias, possible hepatitis?
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halothane
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which agent used for maintenance and is fastest onset and recovery of halogenated GAs, but a airway irritant?
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desflurane
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which agent is good with kids and doesn't cause airway irritation?
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sevoflurane
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which agent is obsolete due to its renal dysfunction affects from F ions?
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methoxyflurane
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reaction of halogenated GA with succinylcholine?
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side effect is malignant hyperthermia
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which anesthetic agents are most and least likely to cause nausea and vomiting?
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NO most likely to cause and isoflurane least likely to cause
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most commonly used barbituate agent?
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thiopental; short action but long half-life
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thiopental MOA?
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GABA-a binder, increasing Cl ion flux and inhibiting CNS
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propofol and etomidate work on which subunits of GABAa receptor?
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beta2 for sedative effects and beta3 for analgesic effect
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5 factors that increase MAC?
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hyperthermia, hypernatremia, acute cocaine use, inc. catecholamine release, chronic alcohol use
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side effects of typical neuroleptics?
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extra-pyramidal, inc. prolactin, tardive dyskinesia, neuroleptic malignant syndrome
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tx. for EPS?
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anticholinergic and beta-blockers
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sx. and tx. of neuroleptic malignant syndrome?
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temp. dysregulation and muscle rigidity, tx. with cooling and dantrolene, bromocriptine (DA agonist)
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atypical anti-psychotics work more on which receptor than typicals?
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5-HT2 than D2
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which atypical may lose properties at high doses?
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risperidone
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receptor that causes the EPS and TD located where?
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A9 in substantia nigra signalling the caudate/putamen causes this
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receptor that causes psychosis is located where?
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A10 on ventral tegmental area signalling the limbic and cortical system causes this
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which receptor causes the pos. sx. in schizo.?
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D2 involved in this sx.
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which receptor involved in the neg. sx. of schizo.?
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5-HT2a
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which atypical has high affinity for D2 receptors and is a add-on major depression?
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aripiprazole
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risk factors for developing TD?
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increased age, african-american, dose and duration of drug, early and severe EPS
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side effect of risperidone?
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ortho. hypotension
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side effect of clozapine?
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seizures, agranulocytosis
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side effect of olanzapine?
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diabetes mellitus
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DOC for all partial seizures?
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carbamazepine
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MOA of phenytoin?
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sustaines refractory state in Na channels to inhibit high freq. repetitive firing
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which drug has improved toxic profile than carbamazepine?
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oxcarbazepine?
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DOC for recurrent seizures in kids, and if no response to diazepam and phenytoin?
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phenobarbital
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which drug can be used in combination with carbamazepine and phenytoin?
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primidone
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DOC for absence seizures and its MOA?
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ethosuximide MOA:dec. Ca channel current in T-type channel located in thalamus
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which anti-epileptic causes spina bifida and hepatotoxicity?
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valproate
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one of most potent antiepileptic with efficacy for absence and myoclonic seizures?
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clonazepam, MOA inc. freq. of Cl channel opening
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lamotrigine major side effect?
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Stevens-Johnson
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which drugs MOA is to block GABA uptake by aminibutyric acid transporter in glial cells
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tiagabine
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side effect of this drug is hypospadias?
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topiramate
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all anti-epileptic drugs have potential of what in infants?
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vit. K def. causing bleeding
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what is present in urine only with heroin use?
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6-monoacetylmorphine
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MOA of inhibitory neurons in pain control?
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release GABA, NE, or opiods, inhibit Ca channels presynapse, K or Cl influx in postsynaptic (hyperpolarization)
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location of presynapse of afferent pain fibers?
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substantia gelatinosa of dorsal horn
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endogenous opiods predominatly affect which receptor?
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kappa receptor
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main role differences in mu and kappa receptors?
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mu causes respiratory depression, euphoria; kappa produces dysphoria
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main role of delta opiod receptor?
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reinforcement of spinal analgesia
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tolerance develops to most of morphine effects except?
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miosis, constipation, and pruritis
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opiod analogs based on three basice opiods?
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morphine, thebaine, and codeine
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MOA of convulsions from opiod overdose?
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stimulation of sigma receptors
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advantages/disadvantages of fentanyl over morphine?
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more potent, less CV effects; respiratory depression can be more severe than morphine
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which opiod metabolite is the inactive form?
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3-glucuronide
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coma, miosis, cyanosis triad indicate?
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opioid poisoning
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use of fentanyl patches?
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used primarily for chronic malignant pain
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which opiod used as antitussive?
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codeine
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tramadol MOA?
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NE and 5HT reuptake blockade
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single highest prescribed drug in USA?
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hydrocodone
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k agonist, m and d antagonist
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pentazocine
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long acting m and k partial agonist, d antagonist
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buprenorphine
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naltrexone vs. naloxone?
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naltrexone is longer acting
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