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49 Cards in this Set

  • Front
  • Back
ADHD
-methylphenidate
-pemoline
Narcolepsy
dextroamphetimine
Respiratory stim after anesthsia
doxapram
Risk of stimulants
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
CNS depressants
-barbs
-benzos
-alcohols
Effects of inc dose of sedatives
1.sedation/dec anxiety=benzos
2.hypnosis
3.anesthesia=barbs and benzos
4.resp and vasomotor dep
5.coma
What are GABAa rec's activated by
benzos,barbs,GABA
by inc Cl- ions=hyperpol=relaxation
What are GABAb rec's activated by
baclofen
dec k+ efflux=hyperpol
What site do benzos bind to
Y(gamma)only these bind here
bz1=sleep, not as addictive
bz2=memory,sensory-motor,cognitive fxn
zolfidein
bz1 less addictive
what site do barbs bind to
B site
make cl ch. stay open longer
if inc too much it blocks Na ch
Phenobarb
long acting
tx seizures
Amobarb
intermedate acting
Secobarb
intermediate
Phentobarb
intermediate
Thiopental
ultra short barb
tx iv anesthetic
What are barbs used for
seizures
insomnia-dec REM
anesthesia
contraindications with barbs
hypersensitivity
preg and breast feed
hepatic impairment
bad w/ etoh b/c add to CNS dep
what do barbs do to P450
induce which inc metab of other drugs=dec effect=
-tolerence
-resp dep
-w/d after chronic use
-intermittent porphyria->abd pn from enzyme def
Alazopram
benzo
(xanax)
tx panic attack
Clonazepam
benzo
anticonvulsants
Diazepam
benzo
long acting anticonv
Flurazepam
benzo
prodrug
no REM dep
Midazolam
benzo
insomnia
LOT
benzo
lorazepam,oxazepam,temazepam
not metab by liver
Side effects of benzos
sedation
disinhib of aggresion
anterograde amnesia-no new info
bad w/ etoh
tolerence and dependence
rebound w/d = insomnia and anxiety
Flumezanil
iv if od on benzos
should work in 5 min
Zolpidem and Zalepion
non benzos
dont bind to bz1=induce sleep
non addictive
only work for sleep
flumazenil blocks effects
Buspirone
nonbenzo
anxiolytics
dont affect GABA
for gen anxiety disorder
no sedation
takes 1-2 wks to work
agonizes 5HT1a
no w/d or addiction
Alcohols
methanol
ethanol
ethylene glycol
Alcohol Dehdrogenase
metab all alcohols
Ethylene glycol
EG+alch dehyd=>glycoaldehyde(v. bad)+aldehyde dehydrog=>oxalic acid
cns dep
metabolic acidosis
renal toxicity
Fomepizole
tx od of EG is same as etoh
Methanol
meth+alch dehyd->formaldehyde+alhedyhe dehyd->formic acid
blindness
resp dep
metabolic acidosis w/ anion gap
tx same as above
Ethanol
eth+alchol dehyd->acetalehyde+aldehyde dehyd->acetic acid
h/a
hypotn
n/v
sweating
conf

0 order
aldehyde dehydrog
asian women dont have
Disulfiram
antabuse
inhib acetaldehyde dehyd=acc of acetaldhyde
Metronidazole/cephlasporins/sulfonyurea(chlorpropanide)
flagyl
acts like disulfiram
Naltrexone
help alcolhoic crave
blocks opioid rec
Topiramate
helps w/ craving
anticonvulsant
Acute alcolholism tx in ER
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
Etoh w/d
DTs
seizures
arrythmias
ER tx of DTs
iv diazepam
iv thiamine
k,phos,mg
Epilepsy
recc spont seizures
prolong depol then
prolong hyperpol
SHFRF
sustained high freq rt firing
Staus Epilepticus
ER
cont siezure >30 min
=brain damage
Generalized seizures
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
Partial seizures
partial(focal):
simple-pt knows it
complex:
pt not aware
precipitating factors
hypoglycemia
etoh,barb,benzo, w/d
febrile
hypervent
cocaine,pcn G,anticholinergics