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69 Cards in this Set
- Front
- Back
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Thiopental
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IV anesthetic
not good for sick or injured |
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Methohexital
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iv anesthetic
not good for sick or injured oxybarbitol short acting, can use repeatedly and prolonged |
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propofol
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gold standard for routine casesIV anesthetic
rapid recovery time antiemetic effect |
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etomidate
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IV anesthetic
less vasodilation and heart rate depression used for hypovolemics causes post nausea |
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ketamine
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psychomimetic effects can be blunted with comb Tx
dissociative anesthesia patient remains responsive good with trauma pts./ stimulated CV systen and preserves aireway reflexes leading to bronchodilation Increases cerebral blood flow good for hemorrhaging patients, stat c section |
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general characteristics of IV anesthetics
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rapid onset
short duration fill volume of distribution can have high lipid solubility leading to high Vd usually decreased cerebral blood flow |
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tetracain
procaine chloroprocain |
local anesthetic
metabolized in the blood |
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toxicity of local anesthetics
contraindications |
sedation,
seizures, tinnitus decreased contractility, rate and conduction contra:aortic stenoisis coaguopathy and shock |
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types of nervous blockades
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topical (for intubation and dental procedures)
infiltration (sub q for stitches and biopsy) nerve block: inject near nerve to numb who region intravenous limb block: use of tournequet nueraxis block: lowe ab. and limb only |
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lidocaine
bupivicaine mepivicaine |
local anesthetics metabolized in the liver
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nonanesthetics
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narcotics
sedatives muscle relaxants |
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narcotic characteristics
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analgesic, sedative, not anesthetic, not amnestic
intense pain relief reverse with naxolone not good for chronic or post op pain quick, short acting |
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benzodiazapenes
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pre op sedatives, reduce anxiety
produce amnesia and unconsciousness |
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pancuronium
curare succinylcholine |
muslce paralysis only, no analgesic or anesthetic
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H1 organs
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blood vessels
capillaries bronchioles GI uterus Sa node myocardium nerve |
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H2 organs
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sa node
myocardium secretory tissues blood vessels |
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diphenhydramamine
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first generation h1 receptor competitive antagonists
PO, 2-4 hours cause sedation, dry mouth hypotension benadryl allergies motion |
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dimenhydrinate
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first generation h1 receptor competitive antagonists
PO, 2-4 hours cause sedation, dry mouth hypotensiondramamine motion sickness |
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tripelenamine
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first generation h1 receptor competitive antagonists
PO, 2-4 hours cause sedation, dry mouth hypotension allergies |
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hydroxyzine
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first generation h1 receptor competitive antagonists
PO, 2-4 hours cause sedation, dry mouth hypotension allergies pruritis |
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meclizine
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first generation h1 receptor competitive antagonists
PO, 2-4 hours cause sedation, dry mouth hypotension motion sickness antiemetic |
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chlorpheniramine
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first generation h1 receptor competitive antagonists
PO, 2-4 hours cause sedation, dry mouth hypotension allergies |
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promethizine
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first generation h1 receptor competitive antagonists
PO, 2-4 hours cause sedation, dry mouth hypotension antiemetic |
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terfenadine
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with arrythromyaacin causes torsades de pointes
allergies |
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loratidine
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minor tremor, headache rash
for allergies second generation longer lasting no sedative, anticholinergic effects PO |
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cetirizine
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minor tremor, headache rash
for allergies second generation longer lasting no sedative, anticholinergic effects PO |
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fexofenadine
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minor tremor, headache rash
for allergies second generation longer lasting no sedative, anticholinergic effects PO |
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Cimetidine
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h 2 receptor competitive antagonist
PO short duration p450 inhibition anti adrogenic for peptic ulcers CNS confusion |
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ranitadine
nizatidine famotidine |
h 2 receptor competitive antagonist
PO short duration for peptic ulcers CNS confusion |
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isoniazide
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tb TX
pro drug decreases mycolic acid synthesis acetylated in liver then ecreted in urine #1prophylaxis AE peripheral neuropathy risk of hep GI malaise |
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rifampin
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tb TX
blocks bacterial dna dependent RNA pol increased hepatic enzymes cidal used in multi drug tx ORANGE excretions!! |
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ethambutanol
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TB Tx static
limits sx's stops cell wall arabinogalactin synth AE optic neuritis contraindicated in kids who can't do eye exams |
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pyrazinamide
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TB Tx
nicotinimide analog pro drug cidal prophylaxis hepatotoxicity acute episodes of gout |
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streptomyacin
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aminoglycoside
works slowly block protein synth IM or IV cidal |
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ciprofloxacin
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TB tx
blocks bacterial DNA synth cidal especially MAC some tendonitis and joint pain |
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rifabutin
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MAC tx
disseminated |
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ethionamide
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similar to INH
no x resistance |
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cycloserine
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highly toxic
but very effective for TB tx. last resort |
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cromolyn
nedocromil |
prophylactic
inhibits mast cell degranulation inhalation and nasal spray for allergic rhinitis |
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theophylline (caffeine)
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inhibition of PDE
bronchodilation PO but systemic AE CNS tremor increased chronotropy, inotropy increased gastric secretion |
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b agonists
albuterol metorpterenol terbutaline pirbuterol |
bronchodilation
short acting inhaler |
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salmeterol
formeterol |
longer lasting bs agonist
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ipratroprium
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muscarinis antagonist
decreases vagal ACh inhaled 45 min used especially for COPD |
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corticosteroids
beclomethasone triamcinolone fluticasone |
inhaled or PO
(thrush) (withdrawal) (iatrogenic cushings) antiinflammatory not for acute Tx doesn't reverses bronchospasm prophylactic |
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zileuton
zariflukast |
blocks 5 lipoxygenase
blocks LTD4 PO only works for some pts |
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aldosterone
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adrenal steroid
replacement therapy mineralcorticoid AE HTN hypokalemia h20 retention |
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spirolactone
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comeptitive inhibitor of aldosterone
used in CHF or hyperald. AE hyperkalemia gynecomastia, impotence |
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ACTH
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causes release of steroids from the adrenal gland
IV or IM prevent megacolon. test for adrenal fx |
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Hydrocortisone
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upregulates mRNA/protein synth
protein breakdown gluconeogenesis lipolysis buffalo hump moon face due to NA h2o retent increased BP anti inflammatory due to suppression of ICAM, no PMN migration binds albumin and other plasma protein metabolized by liver used for arthritis asthma allergies immunosupression AE osteoporosis hyperglycemia HTN PUD acne |
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prednisone
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#1 PO
short |
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methylprednisone
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#1 INSOLUBLE
short arthritis |
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triamcinolone
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topical
allergic rxns intermed. |
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dexamethasone
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long
asthma poison ivy |
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betamethasone
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long asthma,
hyalin membrane |
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dextromethorphan
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OTC antitussive
decreases medullary cough center reflex poor opiode not analgesic/sedative, addiction etc |
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codeine
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opiode antitussive
can cause sedation addiction, tolerance mucosal drying used for PAINFUL cough |
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demulcents
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cough drops
provides protective coating antitussive |
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local anesthetics (lidocaine
benzocaine tetracaine) |
antitussive
used before bronchoscopy\ tetracain decreases pulmonary stretch receptors |
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iodides
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expectorant
rarely used liquefy secretions and increased secretions unpleasant taste skin eruptions hypothyroid |
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guanifensin
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robutussin
OTC expectorant not clear efficacy |
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mucolytics (acetylcysteine)
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free sulhydril groups
decrease viscosity of mucus good fro chronic bronchitis or CF can cause bronchoconstriction used with bronchodilator |
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proteolytic enzymes
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expectorant
break down lysed cells dnases (dornase) can cause local irritation and allergic rxn |
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phenylephrine
phenylpropanolamine oxymetazaline |
decongestents
alpha adrenergic agonists vasoconstriction of blood vessels topical therefore few systemic AE's but only 2-3 days: downregulation of receptors that can lead to rebound hyperemia |
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pseudoephedrine
ephedrine sudaphed PE |
decongestents
alpha adrenergic agonists vasoconstriction of blood vessels long acting PO: if no congested can't use nasal spray can have increased BP esp. with MAOI |
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nicotine
metabolism mechanism effects |
weak base
rapid absorption into CNS passive diffusion active uptake into choroid plexus biotransformation in the liver cotinine: longer half life, also biotranformation in lung, renal excretion effects at autonomic ganglia, adrenal medulla, NMJ. reward pathway. arousal, relaxation, euphoria, concentration memory AE: bronchoconstriction ACTH release platelet aggregation endothelial damage increase cortisol tolerance, wtihdrawal |
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buproprion
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smoking cessation
decreases norepi, dopamine, seratonin reuptake |
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clonidine
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smoking cessation
decreased norepi release with a2 antagonist |
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naloxone
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opiate antagonist
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Gamma vinyl GABA
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decreases nicotine craving by decreasing brain dopamine activity.
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