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;
56 Cards in this Set
- Front
- Back
|
Nicotine
|
- binds peripheral and central nAchRs with biphasic effects
|
|
|
Bupropion
|
- antidepressant, blocks NE & 5HT reuptake
- treats nicotine dependence |
|
|
Cocaine
|
- local anesthetic, blocks Na-channels
- blocks reuptake of NE & DA peripherally - blocks DA uptake in the nucleus accumbens - no pharmacological treatment for addiciton |
|
|
Amphetamines
|
- blocks DA reuptake and stimulates DA release
- enhances NE & 5HT - longer lasting than cocaine |
|
|
Heroin
|
- lipophilic form of morphine
- treat overdose with benzos, clonidine and others |
|
|
Methadone
|
- produces tolerance to heroin
- use with caution for pain relief, may cause respiratory failure in sensitized patient |
|
|
LAAM
|
- opioid agonist
- used to treat addiction |
|
|
Buprenorphine
|
- partial agonist at mu, antagonist at kappa
- does not cause respiratory depression like morphine - can produce euphoria when given IV |
|
|
Naltrexone
|
- competitive mu and kappa antagonist
|
|
|
Ethanol
|
- general CNS depressant
- withdrawal may lead to grand mal seizures - to detox: crossover to benzos then taper off |
|
|
Disulfiram
|
- irreversibly inactivates aldehyde dehydrogenase
- leads to build-up of acetaldehyde = negative symptoms - Antibuse |
|
|
Barbituates & Benzodiazepines
|
- withdrawal from barbiturates is more severe than benzos or EtOH, there is cross-tolerance b/w the three
- barbiturates have a low therapeutic index, but can be used to manage benzo withdrawal |
|
|
THC
|
- has a natural receptor in the brain
- increases DA in the nucleus accumbens |
|
|
Marinol
|
- oral THC
- used as an antiemetic, appetite stimulant, muscle relaxant, glaucoma, etc |
|
|
MDMA
|
- binds 5HT2A receptor
- combination of mescaline and methamphetamine |
|
|
LSD
|
- binds 5HT2A receptor
- no withdrawal symptoms or dependence - tolerance develops quickly |
|
|
PCP
|
- noncompetitive NMDA antagonist and blocker of the associated Ca-channel
- treat toxicity with benzos or diazepam |
|
|
Ketamine
|
- anesthetic
|
|
|
Lidocaine
|
- anesthetizes mucous membranes
- liver extracts 70% from the blood |
|
|
Procaine
|
- hydrolyzed in plasma by pseudocholinesterase
- rarely used because of lidocaine - novocaine |
|
|
Bupivacaine
|
- may cause hypotention and collapse of the heart
- sometimes used in an epidural with fentanyl |
|
|
Mepivacaine
|
- related to lidocaine
- sometimes used in epidural |
|
|
Increasing concentration of local anesthetics will cause block of (in order):
|
1. somatic sensory/visceral motor
2. somatic motor/visceral sensory 3. motor nerves |
|
|
PGI2 (prostacyclin)
|
- made in vascular tissues by prostacyclin synthase
- spontaneously degrades, not broken down in the lungs! - uses cAMP - vasodilation - GI protection - increase GFR - hyperalgesia - platelet aggregation |
|
|
PGE2
|
- formed in most tissues w/o enzymatic help
- uses cAMP - metabolized by PGDH in lungs - some vasodilation - GI protecting - smooth muscle contraction (crams) - increases GFR - bronchodilates - hyperalgesia - midterm abortion |
|
|
PGF2-alpha
|
- formed in most tissues (+/- enzymes)
- uses PLC - metabolized by PGDH - required for labor - bronchoconstricts |
|
|
TXA2
|
- made in platelets & lungs by thromboxane synthase
- uses PLC - causes platelet aggregation - causes brochoconstriction |
|
|
LTB4
|
- made by PMNs
- uses PLC and cAMP - causes edema - platelet aggregation - hyperalgesia |
|
|
LTC4 & LTD4
|
- use PLC
- causes edema - smooth muscle contraction - LTC4 bronchoconstricts |
|
|
Zileuton
|
- 5-lipoxegenase inhibitor
- treats rhinitis and asthma |
|
|
Misoprostol
|
- PGE1 analogue
- supresses gastric ulceration - used for midterm abortion |
|
|
Apirin (acetylsalicylic acid)
|
- irreversible COX inhibitor
- inhibits NF-kB, disrupts adhesion - causes GI blood loss - rarely causes Reye's syndrome in children |
|
|
Acetominophen (Tylenol)
|
- weak COX inhibitor, has other effects
- used when aspirin is contraindicated |
|
|
Celecoxib
|
- selective COX-2 inhibitor
- similar analgesic and antipyretic effects as nonselectives, less GI complications - block PGI2, but not TXA2, dysregulation of platelet homeostasis |
|
|
Rofecoxib
|
- selective COX-2 inhibitor
- similar analgesic and antipyretic effects as nonselectives, less GI complications - block PGI2, but not TXA2, dysregulation of platelet homeostasis |
|
|
Diflunisal
|
- competitive inhibitor of COX
- used as analgesic |
|
|
Ibuprofen
|
- non-selective COX inhibitor
- used for RA, osteoarthritis, analgesic, fever, patent ductus arteriosus |
|
|
Indomethacin
|
- non-selective COX inhibitor
- used for patent ductus arteriosus |
|
|
Ketorolac
|
- non-selective COX inhibitor
- given IM or IV post-surgically - very similar to morphine or meperidine, but without tolerance |
|
|
Mesalamine
|
- given for inflammatory bowel
- does not get absorbed systemically |
|
|
Sulfasalazine
|
- given for inflammatory bowel
- does not get absorbed systemically |
|
|
Misoprostol
|
- prevents gastric ulceration
- approved for midtrimester abortions |
|
|
N-acetylcystein
|
- antidote for acetaminophen toxicity
- repletes glutathione |
|
|
Naproxen
|
- used for dismenorrhea
- approved for RA, osteoarthritis, analgesia, fever |
|
|
Salsalate
|
- reversible inhibitor of COX, but weaker than ASA
- less GI and platelet effects than ASA |
|
|
Sodium Salicylate
|
- similar to salsalate (weaker than ASA, but less GI and platelet effects)
- also blocks NF-kB |
|
|
Sulindac
|
- blocks COX and PPAR-delta
- beneficial for colon cancer - long duration of action b/c of enterohepatic cycling - approved for RA, osteoarthritis, ankylosing spondylitis |
|
|
Nitrous Oxide
|
- alveolar ventilation is maintained
- mild myocardial depression - activates sympathetic nervous system - may impair DNA synthesis or increase the size of a pneumothorax |
|
|
Halothane
|
- potent bronchodilator
- commonly used in pediatrics - little effect on SVR - increased: RR, EDP, intracranial pressure - decreased: TV, baroreceptor function, sympathetic outflow, SA node automaticity |
|
|
Isoflurane
|
- bronchodilator
- very irritating to airways, not used as an induction agent - (+) chronotope, (-) inotrope - decreased: SVR, BP |
|
|
Desflurane
|
- same effects as isoflurane
- lowest blood:gas partition coefficient (rapid sleep/wake) - pungent, only used in maintenence |
|
|
Sevoflurane
|
- smooth, excellent for induciton
- cardio-stable - low blood:gas coefficient (rapid sleep/wake) - hydrolysis by soda lime may lead to toxic intermediates |
|
|
Propofol
|
- rapid sleep/wake
- anti-emetic - used for short procedures |
|
|
Ketamine
|
- potent amnestic and analgesic
- causes sialorrhea, myocardial depression, sympathetic activation, hallucinations, and increased intracranial pressure |
|
|
Etomidate
|
- rapid sleep/wake
- very cardio-stable - no effect on intracranial pressure - used for head injuries |
|
|
Side-effects of injection anesthetics
|
- nausea/vomiting
- increased glucocorticoids/mineralicorticoids - possibly myoclonis on injection |
