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35 Cards in this Set
- Front
- Back
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what must drugs be in order to be an anesthetic?
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- lipid soluble
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drugs w/ low blood solubility have what type of induction?
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low blood solubility --> RAPID induction and rapid recovery time
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drugs w/ high lipid solubility ...
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have an INCREASED potency
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what is potency equal to?
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1/MAC ; MAC --> minimal alveolar concentration when 50% of population is anesthetized
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"ANE"
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-inhaled anesthetics
- hrt,resp dprssn - n,emesis - increased cerebral blood flow |
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iv anesthetic - thiopental; uses?
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high potency, lipid slblity, rapid entry into brain
- anesthesia for short procedures |
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iv anesthetic - benzos (midazolam)
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- most commonly used for endoscopy
- usd w/ gaseous anesthetics y narcotics |
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severe side fx of midazolam as anesthetic?
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postoperative respiratory depression, treat with flumazenil
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Ketamine (Arylcyclohexylamine)
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-pcp analogue ; block nmda receptors
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local anesthetics - esters / amides
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esters - procaine,cocaine,tetracaine
amide- ildocaine,mepIvacaine,bupIvIcaine |
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Amides have 2 I's ...
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in their name
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moa of local anesthetics
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block na+ channels via binding of rcptrs on inner portion of channel
- most fctive in rapidly firing neurons b/c binds to Na+ channels |
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what is the order of sensation loss with the use of anesthetics?
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pain first > temp> touch> pressure last
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clinical uses of local anesthetics?
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-minor surgery
- spinal anesthesia - if allergic to esters (procaine,etc.) give amides (iiodocaine, etc.) |
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side fx of local anesthetics?
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- cns excitation
- cv toxicity (bipuvicaine) - htn/hypotnsn - arrythmias (cocaine) |
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neuromuscular blocking drugs
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depolarizing and non-depolarizing
- used for muscle paralysis in surgery - nicotinic recptr selectivity |
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how do we reverse the blockade?
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phase 1 - (long depolarization) - no antidote
phase 2 - (rplrzd but blocked) - cholinesterase inhibitors r antidote (neostigmine) |
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examples of depolarizing drugs? non-depolarizing?
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succinylcholine ;
"-ium" + tubocurarine |
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moa of non-depolarizing drugs? how do you reverse the blockade?
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compete w/ Ach for receptors
; neostigmine, edrophonium, (cholinesterase inhibitors) |
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what is used to treat, Malignant hyperthermia and Neuroleptic malignant syndrome?
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dantrolene
- mlgnt hyprthermia csd by inhalation of anesthetics y succinylcholine - nms --> overdose of antipsychotics |
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moa of dantrolene?
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prevents release of Ca2+ from sarcoplasmic reticulum in skltl mscle
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park's - cause?
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- loss of dopaminergic neurons and excess cholinergic activity
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Rx strategy for parks?
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- agonize DA rcptrs
- increase DA - Prvnt DA breakdown - lower cholinergic excessive activity "BALSA" |
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BALSA!! - parkinsons Rx
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B-bromocriptine
A- amantadine L- levodopa (w/ carbidopa) S- Selegiline (y COMT inhibitors) A- Antimuscarinics |
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moa of amantadine?
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- increase dopamine release
- also used in influenza A y rubella - toxicity = ataxia |
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moa of carbidopa?
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dcrses peripheral conversion of levadopa to dopamine...thus increasing CNS levels of DA
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moa of selegiline? entacapone/tolcapone?
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prevents breakdown of dopamine ; MAOB inhibitor
- entacapone/tolcapone (COMT inhibitors) prvnts DA breakdown |
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what drugs decrease cholinergic activity?
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Benztropine --> Antimuscarinic, improves rigidity and tremor
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what drugs do u use for essential or familial tremors?
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b-blockers
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moa of levadopa/carbidopa? toxicities?
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- incrse DA in brain
ldopa can x bbb , carbidopa cannot tox-> arrythmias, long term (dyskinesias) |
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what enzyme converts levadopa to dopamine?
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dopa decarboxylase
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moa and use of SUMATRIPTAN?
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5HT1b/1d agonist --> causes vasoconstriction, dcrses trigem stimulation and vasoactive peptide release
uses--> migraines and cluster headaches |
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toxicities of sumatriptan?
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- coronary vasospasm
--> contra'd in CAD or PRINZEMETAl's angina |
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Memantine,donepezil...what disease is it used for?
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Alzheimers ;
memantine --> nmda rcptr antagonist --> prevents Ca2+ excitotoxicity |
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moa of donepezil?
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acetylcholinesterase inhibitor
- n,v,dizziness |
