Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
60 Cards in this Set
- Front
- Back
- 3rd side (hint)
|
Opioids
|
Morphine, fentanyl, codeine, heroin, methadone, meperidine, destromethorphan
agonist at mu rectprs,open K+ channels decreasing vesicle release of ACh, NE, 5-HT, glutamate, substance P |
Use: pain, cough suppressant (dextromethorpan), diarrhea (loperamide and diphenoxylate), acute pulmonary edema. maintenance for addicts (methadone)
Toxicity: addiction, respiratory depression, constipation, miosis, additive CNS depression with other drugs, no tolerance to miosis and constipation. treat with naloxone/naltrexone |
|
|
Butorphanol
|
partial agonist at mu receptors and kappa receptors
|
Use: pain, causes less respiratory depression than full agonist
|
|
|
tramodol
|
weak opioid agonist and inhibits serotonin and NE reuptake
|
use: chronic pain
Toxicity: similar to opioids, decreases the seizure threshold |
|
|
Phenytoin
|
increase sodium channel inactivation, increase refractory period, inhibit glutamate release from excitatory neurons
|
Use: GTC seizures, class IB antiarrythmics
nystagmus, diploxia, ataxia, sedation, gingival hyperplasia, hirsuitism, megaloblastic anemia (decreased folate absorption), teratogenesis (fetal hydantoin syndrome), SLE like syndrome, P450 inducer, peripheral neuropathy |
|
|
Carbamazepine
|
increases sodium channel inactivation
|
diplopia, ataxia, blood dyscrasias (agranulocytosis, aplastic anemia), liver toxicity, teratogenesis, P450 inducter, SIADH, stevens-johnson syndrome
|
|
|
Lamotrigine
|
blocks voltage gated sodium channels
|
stevens-johnson
|
|
|
gabapentin
|
inhibits calcium channels
|
sedation, ataxia
|
|
|
topiramate
|
blocks sodium channels, increase GABA action
|
sedation, mental dulling, kidney stones, weight loss
|
|
|
phenobarbital
|
increase GABA action by increasing the duration of Cl channel opening
|
Use: sedative for anxiety, seizures, insomnia, induction of anesthesia (thiopental)
Toxicity: sedation, tolerance, dependence, P450 inducer, respiratory or cardiac depression, drug interactions because of induction of liver microsomal enzymes Treat overdose with symptom management |
|
|
valproic acid
|
increase sodium channel inactivation, increase GABA concentration
|
GI distress, rare but fatal hepatotoxicity, neural tube defects, tremor, weight gain
|
|
|
diazepam
|
facilitate GABA action by increasing frequency of Cl channel opening, decreases REM sleep
|
Use: anxiety, spasticity, status epilepticus, detoxification, night terrors, sleep walking, general anesthetic, hypnotic
Toxicity: dependence, additive CNS depression effects with alochol, less risk of respiratory dpression and coma than with barbituates Treat OD with flumazenil |
|
|
lorazepam
|
facilitate GABA action by increasing frequency of Cl channel opening, decreases REM sleep
|
Use: anxiety, spasticity, status epilepticus, detoxification, night terrors, sleep walking, general anesthetic, hypnotic
Toxicity: dependence, additive CNS depression effects with alochol, less risk of respiratory dpression and coma than with barbituates Treat OD with flumazenil |
|
|
triazolam
|
facilitate GABA action by increasing frequency of Cl channel opening, decreases REM sleep, short acting
|
Use: anxiety, spasticity, detoxification, night terrors, sleep walking, general anesthetic, hypnotic
Toxicity: dependence, additive CNS depression effects with alochol, less risk of respiratory dpression and coma than with barbituates Treat OD with flumazenil |
|
|
oxazepam
|
facilitate GABA action by increasing frequency of Cl channel opening, decreases REM sleep, short acting
|
Use: anxiety, spasticity, detoxification, night terrors, sleep walking, general anesthetic, hypnotic
Toxicity: dependence, additive CNS depression effects with alochol, less risk of respiratory dpression and coma than with barbituates Treat OD with flumazenil |
|
|
midzolam
|
facilitate GABA action by increasing frequency of Cl channel opening, decreases REM sleep, short acting
|
Use: anxiety, spasticity, detoxification, night terrors, sleep walking, general anesthetic, hypnotic
Toxicity: dependence, additive CNS depression effects with alochol, less risk of respiratory dpression and coma than with barbituates Treat OD with flumazenil |
|
|
chlordiazepoxide
|
facilitate GABA action by increasing frequency of Cl channel opening, decreases REM sleep
|
Use: anxiety, spasticity, detoxification, night terrors, sleep walking, general anesthetic, hypnotic
Toxicity: dependence, additive CNS depression effects with alochol, less risk of respiratory dpression and coma than with barbituates Treat OD with flumazenil |
|
|
alprazolam
|
facilitate GABA action by increasing frequency of Cl channel opening, decreases REM sleep
|
Use: anxiety, spasticity, detoxification, night terrors, sleep walking, general anesthetic, hypnotic
Toxicity: dependence, additive CNS depression effects with alochol, less risk of respiratory dpression and coma than with barbituates Treat OD with flumazenil |
|
|
zolpidem
|
act via the BZ1 receptor subtye and is reversed by flumazenil
|
Use: non-anxiety related insomnia
Toxicity: ataxia, headaches, confusion. short duration with rapid metabolism by liver. only modest day after psychommotor depression and few amnestic effects |
|
|
zaleplon
|
act via the BZ1 receptor subtye and is reversed by flumazenil
|
Use: non-anxiety related insomnia
Toxicity: ataxia, headaches, confusion. short duration with rapid metabolism by liver. only modest day after psychommotor depression and few amnestic effects |
|
|
eszopiclone
|
act via the BZ1 receptor subtye and is reversed by flumazenil
|
Use: non-anxiety related insomnia
Toxicity: ataxia, headaches, confusion. short duration with rapid metabolism by liver. only modest day after psychommotor depression and few amnestic effects |
|
|
halothane
|
myocardial depression, respiratory depression, nausea/emesis, increased cerebral blood flow (decreases demand)
|
hepatotoxicity
|
|
|
enflurane
|
myocardial depression, respiratory depression, nausea/emesis, increased cerebral blood flow (decreases demand)
|
proconvulsant
|
|
|
isoflurane
|
myocardial depression, respiratory depression, nausea/emesis, increased cerebral blood flow (decreases demand)
|
|
|
|
sevoflurane
|
myocardial depression, respiratory depression, nausea/emesis, increased cerebral blood flow (decreases demand)
|
|
|
|
methoxyflurane
|
myocardial depression, respiratory depression, nausea/emesis, increased cerebral blood flow (decreases demand)
|
nephrotoxicity
|
|
|
nitrous oxide
|
myocardial depression, respiratory depression, nausea/emesis, increased cerebral blood flow (decreases demand)
|
expansion of trapped gas
|
|
|
thiopental
|
IV anesthetic, high potency, high lipid solubility
|
induction of anesthesia and short surgical procedures
effect terminated by redistribution to fat and tissue , decreases cerebral blood flow |
|
|
midazolam
|
IV anesthetic, adjunctively with gaseous anesthetics and narcotics
|
most common drug for endoscoppy
postoperative respiratory depression, decreased BP (treat OD with flumazenil), and amnesia |
|
|
Ketamine
|
IV anesthetic, dissociative anesthetic, blocks NMDA receptors
|
cardiovascular stimulant
disorientation, hallucination, bad dreams, increases cerebral blood flow |
|
|
morphine and fentanyl
|
IV anesthetic with other CNS depressants during general anasthesia
|
|
|
|
propofol
|
IV anesthetic, potentiates GABA receptor
|
rapid anesthesia induction and short procedures
less post-operative nausea than thiopental |
|
|
Local anesthetics - esters
|
procaine, cocaine, tetracaine
|
|
|
|
Local anesthetics - amides
|
lidocaine, mepivacaine, bupivacaine
|
|
|
|
Local anesthetics`
|
block Na channels on inner portation of channel preferentially at activated NA channels (rapidly firing neurons)
|
in infected tissue, alkaline anesthetics are charged, so they can't penetrate tissue - need more
small diameter nerve fibers blocked more readibly than large, myelin more than non-myelin and size matters more |
|
|
Local anesthetics Use
|
minor surgical procedures, spinal anesthesia
|
toxicity: CNS excitation, severe CV toxicity (bupicaine), hypertension, hypotension, arrythmias (cocaine)
|
|
|
Succinylcholine
|
selective for motor nicotinic receptor, depolarizing NM blocking drug
|
Phase I - prolonged depolarization (no antidote)
Phase II - repolarized but blocked, reverse with neostigmine |
|
|
tubocurarine
|
nondepolarizing muscle blocking drugs, compete with ACh for receptors
|
reverse blockade with cholinesterase inhibitors
|
|
|
atracurium
|
nondepolarizing muscle blocking drugs, compete with ACh for receptors
|
reverse blockade with cholinesterase inhibitors
|
|
|
mivacurium
|
nondepolarizing muscle blocking drugs, compete with ACh for receptors
|
reverse blockade with cholinesterase inhibitors
|
|
|
pancuronium
|
nondepolarizing muscle blocking drugs, compete with ACh for receptors
|
reverse blockade with cholinesterase inhibitors
|
|
|
vecuronium
|
nondepolarizing muscle blocking drugs, compete with ACh for receptors
|
reverse blockade with cholinesterase inhibitors
|
|
|
rocuronium
|
nondepolarizing muscle blocking drugs, compete with ACh for receptors
|
reverse blockade with cholinesterase inhibitors
|
|
|
dantrolene
|
prevents release of Ca from sarcoplasmic reticulum of skeletal muscle
|
Use: malignant hyperthermia from inhalation anesthetics and succinylcholine & neuroleptic malignant syndrome
|
|
|
Bromocriptine
|
agonize dopamine receptors
|
Use: Parkinson's
|
|
|
pramipexole
|
agonize dopamine receptors
|
Use: Parkinson's
|
|
|
ropinirole
|
agonize dopamine receptors
|
Use: Parkinson's
|
|
|
amantadine
|
agonize dopamine receptors and may increase dopamine levels
|
Use: parkinson's and antiviral against influenza A
|
|
|
L-dopa/Carbidopa
|
L dopa can cross BBB and is converted to dopamine in CNS and carbidopa inhibits peripheral conversion
|
Use: Parkinsonism
Toxicity: arrhythmias from peripheral conversion, long term can cause dyskinesia after administration and akinesia between doses; these are limited by carbidopa |
|
|
selegiline
|
selective MAO B inhibitor which preferentially metabolizes dopamine over NE and serotonin, increasing availability of dopamine
|
Use: Parkinson's with L-dopa
Toxicity: may enhance adverse of L-dopa |
|
|
entacapone
|
COMT inhibitor, prevents L dopa degredation and increases availability
|
Use: Parkinson's
|
|
|
tolcapone
|
COMT inhibitor, prevents L dopa degredation and increases availability
|
Use: Parkinson's
|
|
|
benzotropine
|
curb excess cholinergic activity, antimuscarinic
|
Parkinson's; improves tremor and rigiditiy but has little effect on bradykinesia
|
|
|
essential/familial tremors
|
beta blockers
|
|
|
|
memantine
|
NMDA receptor antagonist that helps prevent excitotoxicity
|
Use: Alzheimer's
Toxicity: dizziness, confusion, hallucinations |
|
|
donepezil
|
acetylcholineresterase inhibitor
|
nausea dizziness, insomnia
|
|
|
galantamine
|
acetylcholineresterase inhibitor
|
nausea dizziness, insomnia
|
|
|
rivastigmine
|
acetylcholineresterase inhibitor
|
nausea dizziness, insomnia
|
|
|
reserpine and tetrabenazine
|
amine depleting
|
huntington's
|
|
|
haloperidol
|
dopamine receptor antagonist
|
huntington's
|
|
|
sumatriptan
|
5HT1b/1d agpnost. causes vasconstriction and inhibits trigeminal activation and vasoactive peptide release, t1/2 = less than hours
|
Use: acute migraine, cluster H/As
Toxicity: coronary vasospasm (contraindicated in patients with CAD and prinzmetal's angina), mild tingling |
