Step 1: Neuro Vi Drugs Ii

Front 1

Which IV anaestheic is used for rapid induction of anesthesia, and for short surgical procedures?
- affect on cerebral BF?

Back 1

Thiopental (Barbiturate)
- decreases it, the opposite of the inhaled anesthetics and Ketamine (arylcyclohexylamine class).

Front 2

Most common drug used for endoscopy anesthesia?
- potential adverse affects?

Back 2

Midazolam.
- Respiratory depression, \\BP, amnesia... tx OD with flumazenil.

Front 3

What anestheics are related to PCP? Mechanism of action?
- CV effects?
- SE?
- effect on CBF?

Back 3

Arylcyclohexylamines (Ketamine)
- block NMDA receptors.
- CV stimulants
- disorientation, hallucination, and bad dreams.
- increases it.

Front 4

Anestheic is administered, and now the pt complains of disorientation, hallucination, and bad dreams. Drug that was given?

Back 4

Ketamine (arylcyclohexylamine).

Front 5

Two types of anesthetics that increase CBF.

One that decreases it.

Back 5

all inhaled, and IV Ketamine (arylcyclohexylamine)

IV Barbiturates (Thiopental)

Front 6

Which two opiates are often used with other anesthetics during surgery?

Back 6

morphine and fentanyl

Front 7

what is a drug that is used for rapid anesthesia induction and short procedures that does NOT cause nausea? Mech?
- DOES cause nausea?

Back 7

Propofol
- potentiates GABA-a

Thiopental (barb: increases DURATION of GABA opening)

Front 8

Two classes of local anesthetics?
- shared mechanism?
- most effect in which type of tissue? why?

Back 8

Esters and Amides (have two "i's")
- block Na channels by b/specific receptors on inner portion of channel.
- rapidly firiing neurons, b/c they preferentially b/Na channels that are already activated.

Front 9

Which form of the tertiary amine local anesthetics gets into the cell? which form binds the Na receptor?

Back 9

- uncharged (more lipid like)
- charged

Front 10

Are local anesthetics basic or acidic? What does this mean re: tx'ing infected tissue?
- solution?

Back 10

basic.
- infected tiss is often acidic, which would knock the anesthetic into "charged" form and then it won't penetrate the cell.
- give higher doses in pts with infection/acidic tissue.

Front 11

What is the order of the nerves blockaded by local anesthetics?
- thus, order of sensory loss?

Back 11

It prefers small > large diameter, and Myelinated > unmyelinated.
- pain > temperature > touch > pressure.

Front 12

What are the local anesthetics often co-admin'ed with in order to enhance local action?
- exception?

Back 12

vasoconstrictors (usually Epi): \\bleeding, ^^ anesthesia by \\systemic concentration.
- cocaine.

Front 13

Which local anesthetic has SEVERE cardiovascular tox?

Which can cause HTN, hypotension, and arrhythmias?

What do all local anesthetics cause in the CNS?

Back 13

Bupivacaine

Cocaine

CNS excitation.

Front 14

Succinylcholine does what?
- class of drug?
- antidote for first phase of depolarization (state of prolonged depolarization)?
- antidote for second phase (repolarized, but still blocked)?

Back 14

selectively blocks NMJ Nicotonic receptors, and leaves autonomic ACh receptors alone.
- "Depolarizing" NMJ blocker
- none, AChE inhibitors will POTENTIATE blockade.
- AChE inhibitors (will potentiate ACh to act elsewhere).

Front 15

drugs with -cur- in them are what?
- antidote?

Back 15

nondepolarizing NMJ blockers
- compete with ACh for bindings sites.
- all cholinesterase inhibitors (AChE inhibitors)

Front 16

What is used to tx malignant hyperthermia AND NMS?
- mech?

Back 16

Dantrolene
- prevents release of Ca from sarcoplasmic reticulum of skeletal muscle.

Front 17

What can cause malignant hyperthermia?

Back 17

Concurrent use of inhaled anestetics (except N2O2) and succinylcholine.

Front 18

What is Selegiline?

Entacapone, tolcapone?

Uses?

Back 18

selective MAO-B inhibitor

COMT inhibitors

preventing DA breakdown in Parkinson pts.

Front 19

How can you remember the types of drugs used to tx parkinsons?

Back 19

BALSA
Bromocriptine, Amantadine, Levodopa, Selegiline (and COMTi), and Antimuscarinics (benzotropine).

Front 20

Fx of amantadine in Parkinson's tx? other uses?
- SE?

Back 20

increases DA release. Used to tx influenza A and rubella.
- ataxia

Front 21

Benzotropine is used to tx Parkinson's why?
- which sx does it help?

Back 21

curb excess ACh activity in the putamen.
- tremor and rigidity, but not bradykinesia.

Front 22

Why can't we just tx Parkinson's with DA, why must we use L-DOPA?
- toxicities?
- co-admined with? why?

Back 22

L-DOPA can cross BBB and then gets converted to DA.
- arryhytmias from peripheral converstion to DA, long term use can lead to dyskinesia following admin, w/akinesia b/t doses.
- carbidopa, a peripheral DA decarboxylase inhibitor.

Front 23

Memantine
- use
- mech
- tox

Back 23

- Alzheimers
- NMDA receptor antagonist; helps prevent excitotoxicity (mediated by Ca)
- dizziness, confusion, hallucinations
-

Front 24

Donepezil
- use
- mech
- tox
- other similar agents

Back 24

- Alzheimers
- AChE inhibitor
- nausea, dizziness, insomnia
- glanantamine, rivasigmine.

Front 25

What drugs are often used to tx Huntington's and why?

Back 25

Disease has an ^^DA, and \\GABA and ACh.

Thus, we tx with Reserpine and tetrabenazine to DEPLETE the amines, and Haloperidol to antagonize DA receptors.

Front 26

Haloperidol?
- use
- mech
- tox

Back 26

- Huntingtons
- antagonist of DA receptors
- ???

Front 27

Sumatriptan
- use
- mech
- tox

Back 27

- acute migrane, Cluster HA ATTACKS, not prevention.
- 5-HT-1b/1d agonist --> vasoconstriction, inhibition of trigeminial activation, and vasoactive peptide release.
- coronary vasospasm, mild tingling.

Front 28

Which HA drug is contraindicated in pts with CAD and Prinzmetals' angina?
Why?

Back 28

Sumitriptan, because it can cause coronary vasospasm.