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11 Cards in this Set
- Front
- Back
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what are the 4 effects, in order by dose, of depressents?
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sedation, hypnosis, anesthesia, coma
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what has the best fat/water PC of the barbiturates? what barbiturate has the fastest onset of action?
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thiopental. accordingly, thiopental has a very rapid onset of action
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CNS depressants reduce which CNS fxns?
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ALL: motor, sensory, autonomic, intellectual
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what is barbiturates MOA?
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potentiate postsyn action at all GABA-A-Rs (fast inhibitory Rs).
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how can barbiturates lead to more pain sensation at low doses?
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they can inhibit the normal inhibition which filters away unnecessary stimuli
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how can CNS depressants affect breathing? what is effect of breathing 100% O2?
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-CNS depressants reduce all forms of respiratory drive. giving 100% O2 can further reduce the O2 drive. however, at lower doses, the protective reflexes in the lung (and everywhere else) are de-inhibited, and thus hyperreactive.
the main cause of death of overdose is respiratory failure. |
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what is the least lipid soluble barbiturate?
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phenobarbital
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discuss "high-flow viscera" and what this means for barbiturate actions
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brain is a high flow/low volume organ, vs muscle/fat which is relatively lower flow due to its high volume. thus, the drug immediately distributes to brain, and its effects are rapid. as it "redistributes" to other parts of the body, its effects wane, though it is technically still distributing
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compare/contrast thiopental, etomidate, propofol and ketamine
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-all used for IV anesthesia
regarding MAP and CO: thiopental and propofol reduce MAP and CO. Etomidate is unique in that it has no effects on MAP, CO, or HR. Thiopental, Etomidate and Propofol all reduce brain VO2, thus reduce CBF and ICP. Ketamine is unique in that it increases MAP, HR and CO; also increases CBF and ICP (thus ketamine is useful in cardiogenic/hypovolemic shock, but not ischemic stroke or HTN) |
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how to reduce [toxic] of barbiturates?
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alkalinize urine.
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barbiturates: tolerance? dependence?
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tolerance does develop - mostly metabolic (vs functional).
-dependence - at very high doses, physical dependence can occur. psych dependence will also occur |
