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;
53 Cards in this Set
- Front
- Back
|
what can inactivates an cholingerixmimetic
|
anticholinestrase or cholinesterase
|
|
|
What drug is an example of a direct cholinergic stimulant
|
methoacholine (provocholine)
|
|
|
What is impt to know about the absorbption of methacholine
|
it doesn't cross the blood brain barrier and has poor absportion from the GI tract
|
|
|
What type of patients is methacholine contraindictaed in
|
recent heart attacks, strokes, uncontrolled HTN, known severe airway diease or an aortic anuerysm
|
|
|
When is a indriect class of drug used to inhhibit cholinesterase to allow an increase in ACH transmission
|
Used diagnostically and in treatment of myasthenia gravis and revese non-depolarizing paralyzing muslce relaxants
|
|
|
What are the 3 agents used in indirect test
|
endrophonium (Tensilon) M.G
Neostigmine (prostigmin) Muscular stimulation Pyridostigmine (regonol) |
|
|
why are neuromusuclar blockers used
|
during surgery, and to paralyze th ept to control for mech. vent and forpt safety.
|
|
|
what are the 2 ways theat neurmuscular agents work
|
blocks receptor sites by competeing with ACH (nondepolarizing)
Stimulation and prolonged depolarization of post synpatic receptors (depolarizing agents) |
|
|
What benefit do nondeploarizing agents have over depolarizing agents
|
longer duration of action
|
|
|
what is the mode of action of a nondeploariaing agent
|
attaches to cholingeric receptors, blocks and competes with Ach
|
|
|
what agent can be given to reverse a nondepolarizing agent
|
atropine or tensilon
|
|
|
What are some examples of nondepolarizing agents
|
tubocurarine (curare)
Pancuronium bromide (pavulon) Vecuronium (norcuron) Atracurium besylate (tracrium) |
|
|
what drug is the only avail depolarizing agent
|
succinycholine (anectiine)----not reversible
|
|
|
what relays infor traveling from different areas of the brain, when depressed info flow to the cortex is decreased
|
thalamus
|
|
|
what ingreated fxn of ANS when depressed ednocrine glands are depressed, vasomotor refelxes slowed causeing hypotension.
|
hypothalamlus
|
|
|
what part of the brain maintains BP, bentilation, depression of the medulla may result on death due to depression of the resp center and or CV collapse
|
brain stem
|
|
|
agents that are CNS & respiratory stimulants are called
|
analeptics
|
|
|
where is the RAS located
|
in the midbarin and brainstem
|
|
|
what are the 2 fxn of the RAS
|
stimulates the cortex to maintain wakefulness
filters or blocks extraneous sensory info, prvents sensory overload, enhances the baility to concnertrate |
|
|
what class of drugs include barbiturates and nonbarbiturates
--hypnoci sleep, sedation,relaxation |
sedatives and hypnotics
|
|
|
where are barbiturates metabolized
|
in the liver
|
|
|
Absurers of barbituraies require what if they ever need inuction for anesthesia problems
|
higher and higher doses
|
|
|
how are barbituartes excreted
|
renally
|
|
|
What is the mode of action of barbiturates
|
thought to produce a sedation, sleep or anesthesia by reverisbly depressing the excitabilty of neurons in the RAS
|
|
|
Barbiturateds are not indicated for which of the following: anxiety, sleep,sedation or anesthesia
|
anxiety
|
|
|
what drug prevents seizures by depressing brain activity
|
phenobarbital
|
|
|
what are some examples of nonbarbiturates (CNS depressants)
|
Paraldehyde -used with alcoholics
Propofol( diprivan) Chloral Hydrate Glutethimide (doriden) Methaqualone (quallude) Ethyl Alcohol |
|
|
what tyep of drug i a minor traquilizer and doesn't cause resp. derpession in sedative doses, & has a higher therapeutic index
|
Benzodiazepines
|
|
|
What is the mode of action of a Benzodiazepine
|
does not directly depress retuclar formation, but blocks it
|
|
|
what is benzodiazepine used to Tx
|
nerveness and anxiety
|
|
|
What are the general effects of a benzodiazepine
|
muscle relaxation, antianxeity, anticonvulsant, sedative hypnotic
|
|
|
What class of drug is used to alleviate synptoms of major mental disorders
|
antipsychotics (major tranquilizers)
|
|
|
what is the current theory of action of neuroleptic
|
either receptors for dopamine in the brain (limbic system) become hypersensitive or the sunthesis or the release of dopamine is increased. End result is excessive stiulation of dopamine receptor sites
|
|
|
What does Neuroleptics agents block
|
dopamine receptor sites in the Limbic System
|
|
|
What is dopamne and where is it found in the body
|
neurochemical transmitter for other fxn's basal ganglia (CTZ) in the hypothalmus
|
|
|
What are some other effects of neuroleptics besides the common side effects
|
sedations, ataxia at high doeses depresses respiration and cause death (CV collapse) Very long half life
|
|
|
What are some side effects of neurolptics
|
muscle rigidity and tremors, antemetic(vomitting) effects blcoking hypothalamus decreasing release of hormones
|
|
|
What are the 2 types of depression
|
reactive - realtes to a traumatic life event
endogenous- neurotransmitter imbalance |
|
|
What are the 2 neurontransmitters involved in depression
|
serotinion and norepinephrine
|
|
|
Antidepressants are divided into 2 categories what are they
|
Trycyclic anti's-inhibit re-uptake of neurotransmitters
MAO inhibitors- inc levels of neurotransmitter |
|
|
Analhesics are divided into 2 groups what are they
|
narcotics and nonnarcotics
|
|
|
What tyoe of analgesi are derivates from opium and and synthetic
|
Narcotics
|
|
|
What type of analgesic alleviates mild to moderate pain and have atipyretic and anti inflammatory activity
|
non-narcotic
|
|
|
what are the 3 types of pain
|
superficial, cutaneous
joint or muslce ache deep visceral |
|
|
What are the 2 most prominet opium than conatins alkaloids 25 %
|
morphine and codeine
|
|
|
What does morhine effect and what is its action
|
effectos on CNS and bowel
decrease CNS fxn, ventilation dribes and increases constipation |
|
|
How does Morphine produce analgesia
|
by elevating the pain threshold, euphoris, drowniess, sleep , lethargy
|
|
|
what are some side effects of MS
|
decrease resp center, decrease response to PaCO2, derease vent rate.
|
|
|
What are some derivated of MS
|
Codeine, Heroin, Oxymorphone, Pentazocine, Synthetic analgesics( demrol, methadone, darvon)
|
|
|
What effects does a OD on MS cause
|
deep sleep, decrease of ventilation Cheyne stokes- resp failure, pt may present in acute pulmonary edema
|
|
|
what is the narcotic antagoinst of choice
|
naloxone (narcan)- occupies opiate receptoe, its reapisdly metabolized so freq doses are required
|
|
|
If a pt OD on Salicyaltes what happnes
|
pt present initally in resp alkalosis leading to metabolic acidosis
|
|
|
What can resp stimulants do to the body
|
directly stimulates the CNS
inc activity of brain, not depres it Increase ventilation causing restlessness Inc Vt slighly inc RR bu indirect activation or peripheral chemorectpors increase stimulation can cause convolusions dec PaCo2, inc PaO2 by alveloar vent |
