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110 Cards in this Set
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Procaine
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Ester
Local anesthetic Used for minor surgical procedures, spinal, topical |
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Lidocaine
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Amide. Local anesthetic.
Used for epidural blockades, antiarrythmic if given IV |
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Benzocaine
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Ester. Local anesthetic.
Topical for cold sores. |
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Cocaine
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Ester. Local anesthetic.
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Nitrous Oxide
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Inhaled anesthetic. Very high MAC (low potency), risk of suffocation.
Good analgesia no malignant hyperthermia |
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Halothane
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Inhaled anesthetic.
Most potent - lowest MAC. Poor analgesia, smells good (induction in children) Tox: arrhythmias, malignant hyperthermia |
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Isoflurane
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Inhaled anesthetic - widely used for maintenance.
Moderate analgesia Not toxic because it's not metabolized (except malignant hyperthermia) |
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Enflurane
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Inhaled anesthetic.
similar to halothane malignant hyperthermia |
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Desflurane
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Inhaled anesthetic - most widely used in outpatient settings - rapid recovery/induction.
Tox: bronchial irritant |
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Sevoflurane
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Inhaled anesthetic - outpatient surgery. Low blood gas coeff (lambda) so it induces anesthesia rapidly
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Thiopental
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Barbiturate - intravenous
facilitates GABAa by increasing duration of Cl channel opening. Rapid onset/high potency, highly lipid soluble, short duration. Not analgesic. Respiratory and CV depression |
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Ketamine
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IV anesthetic.
Causes dissociated anesthesia - awake but not aware. Good for ppl with CV problems. Dis: emergence rxns, respiratory suppression |
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Etomidate
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IV anesthetic
Short acting - modulates GABAa rec. Good for ppl with CV problems. |
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Droperidol
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IV anesthetic (analgesia and sedation)
Targets opioid receptors Sedation for minor procedures |
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Propofol
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IV anesthetic
Potentiates GABAa, no analgesia Rapid, often outpatient, short procedures. anti-emetic. |
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Midazolam
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IV anesthetic
Benzodiazepine - facilitates GABA action by increasing the frequency of Cl channel opening. No analgesia. Anti-anxiety, sedation. |
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Fentanyl
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IV anesthetic
Opioid - 100x more potent than morphine. Mu receptor agonist Analgesia used with inhalation anesthetics |
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Sufentanil
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IV anesthetic
1000x more potent than morphine. Much like fentanyl. |
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morphine
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Opioid analgesic
Strong mu agonist Chronic and acute pain, t1/2 4 hrs Can cause resp depression, n/v, itching, tolerance, euphoria |
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Methadone
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Opioid analgesic. Long acting mu agonist.
Chronic pain, maintenance in addicts. Little euphoria. T1/2 24 hrs |
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Meperidine
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Opioid analgesic.
Mu receptor agonist (also K and D) T1/2 = 2 hrs |
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Fentanyl
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Opioid analgesic. 100x more potent than morphine at mu.
Anesthetic, acute pain. T1/2 5-45 min |
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Codeine
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Opioid analgesic.
Moderate agonist against all receptors (mu, delta, kappa) Used for mild pain, cough. Greater oral bioavailability than morphine |
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Sufentanil
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Like fentanyl - but 1000 more potent than morphine
Opioid analgesic. Also anesthetic |
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Pentazocine
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Opioid analgesic.
Mixed agonist-antagonist at Kappa Weak antagonist at Mu, Delta For acute pain, but may cause morphine withdrawal sx due to antagonist activity |
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Propoxyphene
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Opioid analgesic
Moderate agonist at all receptors. |
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Naloxone
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Opiate antagonist
Rapidly displaces bound opioids. Reverses respiratory depression & coma from overdose. Short T1/2 - repeated doses |
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Naltrexone
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Opiate antagonist
Same as Naloxone, but longer duration of action. Blocks effects of heroine for 48 hours |
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Barbiturates
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Used for insomnia
GABAa receptor modulator - increases duration of Cl channel opening, decreasing neuron firing Changes sleep architecture - withdrawal and rebound. OD causes death! |
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Benzodiazepines
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Used for insomnia - safer than barbiturates.
GABAa receptor modulater - increases the FREQUENCY of Cl channel opening. Withdrawal common. OD - light anesthetic, sleep. Safer. |
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Examples of benzodiazepines
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triazolam, flurazepam
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Zolpidem
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"Ambien" Non-benzo.
Allosteric modulator of GABAa receptor. No change in sleep architecture. Best for sleep onset insomnia. Minimal next day effects |
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Eszopiclone
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"lunesta"
Non-benzo allosteric modulator of GABAa. Best for sleep onset insomnia - long term use. |
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Zaleplon
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Non-benzo, allosteric modulator of GABAa receptor.
Insomnia |
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Ramelteon
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Targets MT1 and MT2 receptors.
Sleep onset insomnia. Can cause amenorrhea, galactorrhea, decreased libido. |
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Dephenhydramine
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antihistamine - OTC sleep aid.
significant next day drowsiness |
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Phenobarbital
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barbiturate
Anti-seizure Increase GABAa by increasing DURATION of Cl channel opening. 1st line for pregnant women and children in partial and generalized tonic-clonic Induces P450! |
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Carbamazepine (Tegretol)
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Antiseizure
Prolongs inactivation of Na channels. Blocks T type Ca channels in Thalamus 1st line for Generalized tonic-clonic, trigeminal neuralgia, partial seizures. Toxic: hyponatremia, drowsiness, liver tox, ataxia, many more! Induces P450 |
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Phenytoin (Dilantin)
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Anti-seizure
Prolongs inactivation of Na channels. Generalized tonic-clonic, status epilepticus. Tox: hepatitis, gingival hyperplasia, hisutism, ataxia, and more. Induces p450. Displaces other drugs from plasma proteins. |
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Clonazepam (Klonopin)
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Anti-seizure
Benzodiazepine Partial and generalized tonic-clonic Contraindicated in absence and myoclonic!! Tox: drowsiness, ataxia, personality changes |
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Ethosuximide
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Anti-seizure.
Blocks T-type Ca channels in thalamus. 1st line for generalized absence. AE: n/v, anorexia, drowsiness, euphoria. Safe! no interactions |
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Primidone
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Anti-seizure
Converted to phenobarbital Partial and generalized tonic-clonic. |
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Valproid Acid
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Anti-seizure
Against tonic-clonic - prolongs Na inactivation, increases GABA synthesis Against absence - blocks T-type Ca AE: anorexia, n/v fulminant hepatitis. Competitive enzyme inhibition with other drugs. |
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Felbamate
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Anti-seizure.
Prolongs inactivation of Na channels, inhibits NMDA glutamate receptors. Used in Partial and secondarily generalized seizures. AE: aplastic anemia, hepatic failure, GI upset, HA |
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Diazepam
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Anti-seizure
Benzodiazepine 1st line: status epilepticus AE: low acute tox, drowsiness, ataxia |
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Gabapentin (Neurontin)
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Anti-seizure
Promotes GABA release Add on for partial and generalized seizures. Very low AE |
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Lamotrigine
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Anti-seizure
Prolongs inactivation of Na channels. Generalized and partial seizures |
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Topiramate
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Anti-seizure
Prolongs inactivation of Na channels, enhances GABA Add on for partial seizures. |
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Tiagabine
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Anti-seizure
Inhibits GAT-1 (GABA reuptake transporter) Add on for partial or sec gen tonic-clonic Contraindicated in abscene |
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Zonisamide
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Anti-seizure
Prolongs inactivation of Na channels Add on for partial seizures |
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Levetiracetam
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Anti-seizure, unknown mechanism
Add on for partial and sec gen tonic-clonic |
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Triazolam
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Benzodiazepine
sedative, hypnotic |
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Flurazepam
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Long acting benzo
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Estazolam
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Sedative, hypnotic, benzo
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Zolpidem
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Ambien!
an imidazopyridine Acts via BZ1 receptor AE: ataxia, HA, confusion, modest day after effects and amnesia |
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Eszopiclone
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Lunesta
Sedative and hypnotic. A Pyrazolopyridine. Basically - long term ambien AE: bad taste, dry mouth |
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Zaleplon
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Sonata
A sedative and hypnotic, insomnia. A Pyrazolopyrimidine. Same as ambien |
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Diazepam
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Valium
Anti-anxiety, benzodiazepine anti-seizure |
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Oxazepam
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Anti-anxiety
Benzodiazepine Short acting |
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Alprazolam
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Anti-anxiety
Benzodiazepine |
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Midazolam
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Anti-anxiety
Benzodiazepine |
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Clonazepam
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Anti-anxiety, anti seizure (absence, myoclonic, atonic)
Benzodiazepine Enhances binding of GABA to receptor, increases |
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Chlordiazeperoxide
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Anti-anxiety Anti-seizure
Benzodiazepine |
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Lorazepam (ativan)
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Anti-anxiety, anti-seizure (status epilepticus)
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Buspirone
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Anti-anxiety, antidepressant
Serotonergic anxiolytic, partial 5HT agonist. No dependence or withdrawal. |
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Venlafaxine
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SNRI
Effexor Anti-anxiety, antidepressant, chronic pain Blocks reuptake for Ne and 5HT, AE: HTN |
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SSRIs
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Anti-anxiety
Selective serotonin reuptake inhibitor |
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Desipramine
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Tricyclics
for Affective Disorders, or backup for depression Block reuptake pumps for 5HT and NE. AE: sedation, weight gain |
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Imipramine
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Triclyclic
Affective disorders, backup for depression, chronic pain Inhibits 5HT reuptake more than NE. |
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Nortriptyline
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Tricyclics
For affective disorders, depression, chronic pain. Inhibits more NE reuptake than 5HT |
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Amitriptyline
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Tricyclics
Affective disorders, depression, chronic pain. Inhibits 5HT reuptake more than NE |
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Trazodone
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Heterocyclics
Affective disorder, depression, Serotonin 2a antagonist, SSRI, results in increased 5HT1a stimulation. AE: sedation, orthostatis hypotension |
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Phenelzine
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Irreversible MAO inhibitor
Used in depression that doesn't respond to other drugs |
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Tranylcypromine
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MAOI
Much like phenelzine Used for depression not helped by other drugs. |
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Lithium carbonate
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Used for Depression, mania, bipolar.
Mood stabilizer. Long term prevention, slow onset. Narrow therapeutic window. |
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Fluoxetine
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SSRI for depression
Selective and more potent than TCAs, fewer AE AE: sexual dysfunction, suicide Half life: days |
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Paroxetine
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SSRI for depression
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Sertraline
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SSRI for depression
|
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Citalopram
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SSRI for depression
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Escitalopram
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SSRI for depression
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Fluvoxamine
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SSRI for depression
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Chlorpromazine
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a Phenothiazine
antipsychotic Dopamine inhibitor |
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Thioridazine
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a Phenothiazine
Blocks D2 receptors, decreasing + Sx for schizophrenia AE: amenorrhea, gynecomastia, arrythmia, stroke |
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Fluphenazine
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A phenothiazine
much like thioridazine antipsychotic, dopamine antagonist, too many AE for use in most pts |
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Haloperidol
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a Butryphenone
antipsychotic antidopaminergic Helps delusions and hallucinations AE: extrapyramidal: pseudoparkinsonism, dystonias |
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Pimozide
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a butyrophenone
For tourette syndrome and tics extrapyramidal side effects |
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Olanzapine
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2nd gen antipsychotic, mood stabilizer.
Schizophrenia, depression, mania, PTSD |
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Risperidone
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2nd gen antipsychotic/mood stabilizer
similar to olanzapine |
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Quetiapine
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2nd gen antipsychotic/mood stabilizer
typical schizophrenia, psychosis, depression, mania, bipolar |
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Aripiprazole
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2nd generation antipsychotics mood stabiliers
Major depression |
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Ziprasidone
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2nd gen antipsychotic mood stabilizer
AE QT prolongation |
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Paliperidone
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2nd generation antipsychotic/mood stabilizer
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Lysergic acid diethylamide LSD
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Psychotomimetic
5HT1 and 5HT2 agonist Produces hallucinations, delusions, paranoia Most potent hallucinogenic |
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Mescaline
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Psychotomimetics
Hallucinogen with amphetamine like properties |
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Methylenedioxymethamphetamine
MDMA |
Strong psychedelic effects
Hallucinations, delusions, paranoia Neurotoxicity and degeneration of serotonergic neurons |
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Psilocybin
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Psychotomimetics
metabolized to psilocin - partial agonist to 5HT2A and 1A Mushrooms |
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Phenylcyclidine PCP
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Psychomimetics
Blocks NMDA type glutamate receptors Anesthetic, impairs consciousness, delirium and hallucinations |
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Methamphetamine
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CNS stimulant
Stimulates release of dopamin, inhibits catecholamine reuptake pump AE: cardiac arrhythmia, involuntary motor activity, anorexia, paranoia |
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Amphetamines
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same as methamphetamines
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Cocaine
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CNS stimulant
inhibits catecholamine and serotonin reuptake pumps |
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Opiates:
|
Heroin
Methadone Buprenorphine Morphine |
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Ephedrine
|
Sympthomimetic
released stored NE for asthma, cough, congestion |
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Nicotine
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sympathomimetic
Binds to nicotinic ACh, excites neurons. Release of DA from nucleus accumbens |
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Ethanol
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CNS depressant
Binds to ACh, GABA, 5HT, and NMDA receptors. Euphoria, relaxation, vomiting, impaired motor and sesory function |
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Marijuana THC
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Cannabinoid
GPCR inhibit adenylate cyclase Relaxation, impairs cognition and motor fxns, tox causes memory distortion and hallucinations Decreases sperm count and testosterone in males |
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St. John's Wort
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Herbal compound
CYP450 interactions Used for depression AE: photosensitivity, serotonin syndrome |
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Ginseng
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aphrodisiac, stimulant, sexual dysfunction type II DM
Interacts with warfarin |
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Garlic
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alters pharmacokinetic variables of acetaminophin, decreases warfarin concentration, interacts with aids drugs
|
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Gingko
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Possible antagonist of GABA activity
Can cause hemorrhages when mixed with NSAIDs and aspirin |
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Green Tea
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Procoagulant
opposite of warfarin |