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49 Cards in this Set
- Front
- Back
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ADHD
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-methylphenidate
-pemoline |
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Narcolepsy
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dextroamphetimine
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Respiratory stim after anesthsia
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doxapram
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Risk of stimulants
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controlled subst:
-dependence=cant live w/o it get psycological and physiological w/dr -abuse=inc tolerence so inc dose to get the same effect |
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CNS depressants
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-barbs
-benzos -alcohols |
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Effects of inc dose of sedatives
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1.sedation/dec anxiety=benzos
2.hypnosis 3.anesthesia=barbs and benzos 4.resp and vasomotor dep 5.coma |
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What are GABAa rec's activated by
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benzos,barbs,GABA
by inc Cl- ions=hyperpol=relaxation |
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What are GABAb rec's activated by
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baclofen
dec k+ efflux=hyperpol |
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What site do benzos bind to
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Y(gamma)only these bind here
bz1=sleep, not as addictive bz2=memory,sensory-motor,cognitive fxn |
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zolfidein
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bz1 less addictive
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what site do barbs bind to
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B site
make cl ch. stay open longer if inc too much it blocks Na ch |
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Phenobarb
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long acting
tx seizures |
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Amobarb
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intermedate acting
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Secobarb
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intermediate
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Phentobarb
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intermediate
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Thiopental
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ultra short barb
tx iv anesthetic |
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What are barbs used for
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seizures
insomnia-dec REM anesthesia |
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contraindications with barbs
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hypersensitivity
preg and breast feed hepatic impairment bad w/ etoh b/c add to CNS dep |
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what do barbs do to P450
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induce which inc metab of other drugs=dec effect=
-tolerence -resp dep -w/d after chronic use -intermittent porphyria->abd pn from enzyme def |
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Alazopram
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benzo
(xanax) tx panic attack |
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Clonazepam
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benzo
anticonvulsants |
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Diazepam
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benzo
long acting anticonv |
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Flurazepam
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benzo
prodrug no REM dep |
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Midazolam
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benzo
insomnia |
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LOT
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benzo
lorazepam,oxazepam,temazepam not metab by liver |
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Side effects of benzos
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sedation
disinhib of aggresion anterograde amnesia-no new info bad w/ etoh tolerence and dependence rebound w/d = insomnia and anxiety |
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Flumezanil
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iv if od on benzos
should work in 5 min |
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Zolpidem and Zalepion
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non benzos
dont bind to bz1=induce sleep non addictive only work for sleep flumazenil blocks effects |
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Buspirone
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nonbenzo
anxiolytics dont affect GABA for gen anxiety disorder no sedation takes 1-2 wks to work agonizes 5HT1a no w/d or addiction |
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Alcohols
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methanol
ethanol ethylene glycol |
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Alcohol Dehdrogenase
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metab all alcohols
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Ethylene glycol
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EG+alch dehyd=>glycoaldehyde(v. bad)+aldehyde dehydrog=>oxalic acid
cns dep metabolic acidosis renal toxicity |
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Fomepizole
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tx od of EG is same as etoh
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Methanol
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meth+alch dehyd->formaldehyde+alhedyhe dehyd->formic acid
blindness resp dep metabolic acidosis w/ anion gap tx same as above |
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Ethanol
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eth+alchol dehyd->acetalehyde+aldehyde dehyd->acetic acid
h/a hypotn n/v sweating conf 0 order |
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aldehyde dehydrog
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asian women dont have
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Disulfiram
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antabuse
inhib acetaldehyde dehyd=acc of acetaldhyde |
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Metronidazole/cephlasporins/sulfonyurea(chlorpropanide)
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flagyl
acts like disulfiram |
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Naltrexone
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help alcolhoic crave
blocks opioid rec |
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Topiramate
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helps w/ craving
anticonvulsant |
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Acute alcolholism tx in ER
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dont want resp dep and asp on vomit
give iv glucose to stop hypoglyc give iv thiamine to stop wernike encephalopathy:ataxia,paralyzed eyes,conf give k if vomit |
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Etoh w/d
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DTs
seizures arrythmias |
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ER tx of DTs
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iv diazepam
iv thiamine k,phos,mg |
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Epilepsy
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recc spont seizures
prolong depol then prolong hyperpol |
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SHFRF
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sustained high freq rt firing
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Staus Epilepticus
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ER
cont siezure >30 min =brain damage |
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Generalized seizures
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1. convulsive siezures:
tonic-clonic(grand mal) 2. non convulsive: petit mal in kids if an eeg is 3sec spike wave kid stares and brain goes slow |
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Partial seizures
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partial(focal):
simple-pt knows it complex: pt not aware |
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precipitating factors
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hypoglycemia
etoh,barb,benzo, w/d febrile hypervent cocaine,pcn G,anticholinergics |
