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blocks negative feedback receptors
enhances NE release by blocking inhibitory presynaptic alpha2-adrenoceptors |
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Term
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Definition
weight gain
block of central 5HT2 receptors stimulate appetite and weight gain |
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Definition
stimulation of 5HT3 receptors by serotonin suppresses appetite and cause nausea/vomiting
s/e usually dissipates after several wks |
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Term
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Definition
Some Patients Can Feel Fine Eventually
Sertraline
Paroxetine
Citalopram
Fluoxetine
Fluvoxamine
Escitalopram |
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Term
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Definition
SNRI
lower doses - blocks 5HT uptake
higher doses - blocks 5HT/NE uptake |
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Term
| which antidepressant is dose dependent? |
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Definition
venlafaxine
low doses - 5HT
hight doses - NE |
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Term
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Definition
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Term
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Definition
desipramine (NE)
imipramine(NE/5HT)
clomipramine(5HT/NE) |
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Definition
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Definition
MAOI
irreversible inhibitor of monoamine oxidase |
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Term
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Definition
antidepressant
alpha 2 adronoceptor agonist |
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Term
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Definition
block muscarinic receptors -> dry mouth, urinary retention, blurred vision, constipation, memory impairment, sexual dysfunction; H1 histaminergic -> sedation, weight gain; alpha1 adrenergic -> orthostatic hypotension, sexual dysfunction;
CV - AV block in pts w/ cardiac dz; arrhythmias in OD
CNS - tremors, mania in bipolar pts, lower seizure threshold, death in OD |
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Term
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Definition
hepatic toxicity (phenelzine)
CNS: tremors, insomnia, agitation
CV: orthostatic hypotension
"cheese reaction" - ingestion of sympathomimetic amines (tyramine) normally metabolized by MAO in GI, but since MAO is inhibited, releases more NE which raises BP |
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Term
| s/e of n/v, sex dysfxn, asthenia |
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Definition
SSRIs (sertraline, paroxetine, citaloopram, fluoxetine, fluvoxamine, escitalopram)
venlafaxine(SNRI) |
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Term
| list classes of antianxiety drugs |
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Definition
benzodiaepines
clomipramine
SSRIs
buspirone
z drugs
flumazenil
ramelteon |
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Term
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Definition
| bind at BZ receptor site on GABA-A (between alpha and gamma subunits) increase probability of channel opening so chloride enters producing hyperpolarization and inhibitory effects |
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Term
| pharmacological effects of BZs |
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Definition
1. sedative-hypnotic
2. anti-anxiety
3. anti-convulsant
4. muscle relaxant
5. anterograde amnesia |
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Term
|
Definition
zolpidem
zaleplon
eszopiclone |
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Term
MOA of Z drugs
zolpidem, zaleplon, eszopiclone |
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Definition
| BZ receptor agonist, but have different structure |
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Term
| difference between Z drugs (zolpidem, zaleplon, eszopiclone) and benzodiazepams |
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Definition
z drugs have less abuse potential, little effect on sleep stages, no alcolhol potentiation
do NOT exert anti-anxiety, anticonvulsant, or skeletal muscle relaxant effects |
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Term
|
Definition
melatonin receptor agonist
no abuse potential |
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Term
DOC for anxiety in older patients
why |
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Definition
oxazepam
metabolized via glucuronidation, which isn't decreased w/ age (oxidation is) |
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Term
| sx of withdrawal from BZs |
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Definition
| flu like muscle cramps, abdominal discomfort, diarrhea, rarely seizures |
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Term
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Definition
BZ antagonist
use for BZ OD, but has short t1/2 |
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Term
|
Definition
partial agonist at 5HT1A receptor coupled to K channels
hyperpolarizes neurons via enhancement of K conductance |
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Term
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Definition
anti-anxiety
no drug dependence or withdrawal
takes 4-8 wks to be effective
partial agonist at 5HT receptors coupled to K channels |
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Term
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Definition
clomipramine (TCA)
SSRIs (fluoxetine, fluvoxamine, paroxetine, sertraline)
MUST inhibit serotonin reuptake |
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Term
|
Definition
TCA used to tx OCD
potent SRI |
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Term
|
Definition
BZs
SSRIs (fluoxetine, paroxetine, sertraline, fluvoxamine)
venlafaxine (dose dependent SNRI)
buspirone (5HT/K channel) |
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Term
|
Definition
SSRIs(fluoxetine, paroxetine, sertraline, fluvoxamine)
BZs(alprazolam, clonazepam)
TCAs(clomipramine) |
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Term
|
Definition
|
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Term
|
Definition
|
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Term
| typical antipsychotic drugs |
|
Definition
chlorpromazine (low potency)
haloperidol (high potency) |
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Term
| atypical antipsychotic drugs |
|
Definition
clozapine (D2/5HT2 antagonist)
risperidone (D2/5HT2 antagonist)
olanzepine (D2/5HT2 antagonist)
quetiapine
aripiprazol (D2 partial agonist/5HT2 antagonist)
ziprasidone |
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Term
| which antipsychotics decrease positive symptoms and improve negative symptoms? |
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Definition
| atypical (clozapine, risperidone, olanzepine, quetiapin, aripiprazole, ziprasidone) |
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Term
| how are benzodiazepams and buspirone similar? |
|
Definition
hyperpolarize cells and suppress neuronal firing
BZs - increases chloride conductance
buspirone - increses potassium conductance |
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Term
| where is site of action of atypicals - improve cognitive dysfunction and negative sx? |
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Definition
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Term
| where is the dopamine problem in schizophrenic brains? |
|
Definition
excessive DA activity in limbic system -> postive psychotic sx
reduced DA activity in prefrontal cortex -> negative sx and cognitive defects |
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Term
| what are the 4 DA pathways in the CNS |
|
Definition
1. nigrostriatal pathway (midbrain->basal ganglia) -> motor fxn
2. mesolimbic projections (midbrain->limbic system) -> arousal, motivation, reward
3. mesocortical projections(midbrain->frontal cortex) -> cognition, motivation
4. tuberoinfundibular pathway (hypothalamus->pituitary gland) -> inhibit prolactin secretion |
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Term
|
Definition
atypical antipsychotic
partial agonist at D2 receptors - acts as agonist when little DA is being released, but acts as antagonist when excessive DA is being released |
|
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Term
| chronic tx w/ typical antipsychotics (chlorpromazine, haloperidol) decreases dopaminergic cell firing in which pathways? |
|
Definition
nigrostriatal (midbrain->basal ganglia; motor fxn)
mesocortical(midbrain-> frontal ctx; cognition, motivation) |
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Term
| chronic tx w/ atypical antipsychotics (clozapine) decreases dopaminergic cell firing in which pathways? |
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Definition
| only mesolimbic (arousal, motivation, reward) |
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Term
| which dopaminergic pathway to we want to decrease activity of in schizophrenia? |
|
Definition
| limbic system - overactivity -> positive psychotic sx |
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Term
| why dont we want to decrease DA activity in the frontal cortex, basal ganglia, or hypothalamus? |
|
Definition
frontal cortex - negative sx and cognitive defects
basal ganglia - EPS
hypothalamus - prolactin secretion |
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Term
| s/e of typical antipsychotics (chlorpromazine, haloperidol) |
|
Definition
antiadrenergic: sedation, orthostatic hypotension
anticholinergic: dry mouth, blurred vision, urinary retention, sinus tachycardia, constipation
antihistimine: sedation, weight gain
general: photosensitivity, jaundice, arrhythmias, agranulocytosis
endocrine: gynecomastia, galactorrhea, amenorrhea, weight gain
EPS: dystonia, pseudoparkinsonism, akathisia, tarditive dyskinesias |
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Term
| s/e of low potency (chlorpromazine)vs high potency (haloperidol) typical antipsychotics |
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Definition
low: more anticholinergic, more sedative, more orthostatic hypotension
high: more likely to produce EPS |
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Term
|
Definition
antiadrenergic, cholinergic, histamine
less EPS, no TD
weight gain
neuroleptic malignant syndrome |
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Term
| which antipsychotics are not anticholinergic? |
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Definition
| risperidone and quetiapine |
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Term
| which antipsychotic is very antihistaminic? |
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Definition
|
|
Term
| what is a serious s/e of clozapine? |
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Definition
|
|
Term
| prolactin s/e are seen in which drugs? |
|
Definition
typicals (chlorpromazine and haloperidol)
atypicals - risperidone
(NOT clozapin, olanzapine, or quetiapine) |
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Term
| which antipsychotics cause weight gain? |
|
Definition
|
|
Term
| what are 3 tx choices for bipolar? |
|
Definition
valproate (mania) + lamotrigine (depression
atypical antipsychotics (mania) + lamotrigine (depression)
aripiperazole (mania and depression) |
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Term
|
Definition
| anticonvulsant used to tx mania in bipolar |
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Term
|
Definition
anticonvulsant used to tx mania in bipolar
induces liver enzymes -> drug-drug interactions |
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Term
|
Definition
| atypical antipsychotic used to tx schizophrenia or mania and depression in bipolar |
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Term
|
Definition
|
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Term
|
Definition
|
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Term
| tx for absence seizures if pt can't tolerate ethosuximide? |
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Definition
|
|
Term
| benzodiazepines are use to treat what types of seizures? |
|
Definition
| all generalized seizures except tonic-clonic |
|
|
Term
| which drugs have the broadest spectrum of anti-seizure activity? |
|
Definition
|
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Term
|
Definition
|
|
Term
| brief loss of awareness, sometimes w/ eye-blinking or lip-smacking, but w/o loss of consciousness or body tone, almost always in young chilcren |
|
Definition
absence (petit mal) seizure
tx w/ ethosuximide |
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Term
| DOC for generalized tonic-clonic seizures |
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Definition
|
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Term
|
Definition
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|
Term
| DOC for trigeminal neuralgia |
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Definition
|
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Term
|
Definition
|
|
Term
| tx of status epilepticus if lorazepam or diazepam doesn't work |
|
Definition
|
|
Term
|
Definition
| prolong state of Na channel activation -> reduce frequency at which neurons may generate repetitive action potentials |
|
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Term
|
Definition
| prolong state of Na channel activation |
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Term
|
Definition
| prolong state of Na channel inactivation |
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Term
|
Definition
| prolong state of Na channel inactivation |
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Term
|
Definition
| prolong state of Na channel inactivation |
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Term
|
Definition
| prolong state of Na channel inactivation |
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Term
|
Definition
blocks glutamate (excitatory) receptor
acts as Kainate receptor antagonist |
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Term
|
Definition
| reduce low threshold calcium (T)currents |
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Term
|
Definition
| enhance GABA mediated increases in Cl conductance |
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Term
|
Definition
| increase frequency of GABA channel opening |
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Term
|
Definition
|
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Term
|
Definition
| hirsutism, gingival hyperplasia, osteomalacia, megaloblastic anemia |
|
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Term
|
Definition
|
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Term
|
Definition
| bone marrow depression, aplastic anemia, agranulocytosis, hyponatremia |
|
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Term
|
Definition
| osteomalacia, megaloblastic anemia, hemorrhage in newborn, prophyria, CNS depression if combined w/ alcohol |
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Term
benztropine
tx for:
MOA:
effect: |
|
Definition
parkinsons
muscarinic cholinergic antagonist
balance DA/ACh ssytems by reducing cholinergic dominance |
|
|
Term
diphenhydramine
tx:
MOA:
effect: |
|
Definition
parkinsons
antihistimine
central muscarinic blockade |
|
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Term
|
Definition
|
|
Term
|
Definition
| carbidopa is peripheral DOPA decarboxylase inhibitor |
|
|
Term
bromocriptine
tx:
MOA:
effect: |
|
Definition
parkinsons
dopamine agonist
stimulates D2 receptors directly |
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Term
|
Definition
parkinsons
dopamine agonist |
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Term
|
Definition
monoamine oxidase B inhibitors
elevate DA levels, possible neuroprotective action |
|
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Term
|
Definition
parkinsons
catechol-o-methyltransferase inhibitor
anjunct to levodopa/carbidopa therapy; blocks peripheral conversion of L-dopa to O-methyl dopa |
|
|
Term
| how does carbidopa alter metabolism of L-dopa? |
|
Definition
| carbidopa is a DOPA decarboxylase inhibitor that doesn't cross the BBB and blocks peripheral conversion of L-dopa to DA -> decrease s/e, increase amt of dopa going to brain |
|
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Term
|
Definition
release catecholamines from intraneuronal stores
block catecholamine reuptake
prolong action of catecholamines at the synapse |
|
|
Term
| sx of actue amphetamine toxicity |
|
Definition
marked CNS stimulation
paranoid psychosis
hypertensive crisis, tachycardia, arrhythmias
hyperthermia
convulsions, coma |
|
|
Term
| sx of chronic toxicity of amphetamines |
|
Definition
psychological and physiological dependence
amphetamine psychosis - hallucinations, delusions of persecution, feeling of omnipotence |
|
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Term
|
Definition
amphetamine
dextroamphetamine
methylphenidate |
|
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Term
|
Definition
ritalin
tx of ADHD
release NE and DA from neurons and block reuptake |
|
|
Term
|
Definition
tx of narcolepsy
(NOT for ADD)
releases DA, NE, and 5HT in different areas of the brain |
|
|
Term
|
Definition
modafanil
release DA, NE, 5HT in different areas of the brain |
|
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Term
|
Definition
caffeine
theophylline (aminophylline) |
|
|
Term
| sites of action of aspirin and ibuprofin |
|
Definition
| central and peripheral prostaglandin synthesis |
|
|
Term
| site of action of acetaminophen |
|
Definition
| central prostaglandin synthase |
|
|
Term
| nite of action of local anesthetics (lidocaine) |
|
Definition
|
|
Term
| site of action of genral anesthetics (sevoflurane, desflurane) |
|
Definition
| K, Ca, Na channels, GABA-A receptore-Cl channel system |
|
|
Term
| site of action of injectable anesthetics (propofol, etomidate, thiopental) |
|
Definition
|
|
Term
| site of action of ketamine |
|
Definition
|
|
Term
| site of action of methadone |
|
Definition
| opiate receptors and NMDA receptors |
|
|
Term
| site of action of tramadol |
|
Definition
| opiate receptors and 5HT and NE reuptake |
|
|
Term
| renal excretion of aspirin is dependent on ? |
|
Definition
pH
more salicylate is excreted in alkaline urine |
|
|
Term
| MOA of salicylates (aspirin) and propionic acid (ibuprofin) |
|
Definition
| inhibit prostaglandin synthase cox I and II at central and peripherla sites |
|
|
Term
| what's the difference between COX I and II? |
|
Definition
cox II: inducible, responsible for inflammatory response
cox I: constitutive, beneficial in gastric mucosa and kidney |
|
|
Term
| what does aspirin do that ibuprofen doesnt? |
|
Definition
decrease platelet aggregation -> protect against stroke and MI
irreversibly inhibits cox II in platelets and blocks synthesis of thromboxane A2 |
|
|
Term
| what are the s/e of aspirin and ibuprofin |
|
Definition
both - reduction in renal blood flow and edema
aspirin - Rey's syndrome, prolonged bleeding, gastric irritation
ibuprofen - birth defects |
|
|
Term
| what causes drug interactions with aspirin/ibuprofen |
|
Definition
| highly bound to plasma proteins so displace anticoagulants, phenytoin, etc |
|
|
Term
| how is acetaminophen different from aspirin and ibuprofen? |
|
Definition
| acetaminophen doesn't have anti-inflammatory properties |
|
|
Term
| toxicity of acetaminophen |
|
Definition
| hepatic glutathione depletion -> hepatic necrosis |
|
|
Term
| long-term abuse of acetaminophen can lead to |
|
Definition
|
|
Term
|
Definition
| inhibit cox I and II mediated prostaglandin synthesis |
|
|
Term
|
Definition
short term management of severe pain
analgesic much more than antipyretic or anti-inflammatory |
|
|
Term
| areas of the CNS involving pain signal transmission |
|
Definition
dorsal horn of spinal cord
periaqueductal gray
rostral ventral medulla
thalamic nuclei |
|
|
Term
| what type of receptors do opiates bind to? |
|
Definition
| GTP dependent Protein Coupled Receptors |
|
|
Term
| what are pre- and post- synaptic actions of opiate agonists? |
|
Definition
pre: decrease voltage gated Ca influx and reduce excitatory neurotransmitter release
post: increase K conductance via activation of receptor operated K currents leading to hyperpolarization and reduction in responsiveness of postsynaptic neuron |
|
|
Term
| how do opiates cause analgesia |
|
Definition
inhibit nociceptive reflexes at spinal and supraspinal sites acting at mu receptors
dont feel pain, dont care about pain |
|
|
Term
| how do narcotic analgesics cause respiratory depression |
|
Definition
decreased sensitivity of CNS respiratory center chemoreceptors to CO2
direct effects to decrease respiratory rhythmic cycle |
|
|
Term
|
Definition
morphine
fentanyl
methadone |
|
|
Term
|
Definition
"Partially Blocks Bummer Narcotics"
pentazocine
butorphanol
buprenorphine
nalbuphine |
|
|
Term
|
Definition
naloxone
naltrexone
nalmefene |
|
|
Term
| mechanism for tolerance of opiates |
|
Definition
| nitric oxide mediated reduction in glutamate (NMDA) reeptor ion channel function w/ increased drug use |
|
|
Term
| why are narcotic analgesics contraindicated in head injury? |
|
Definition
| respiratory depression -> increased CO2 -> increased cerebral blood floow -> increased intracranial pressure |
|
|
Term
| what is the only opiate that doesn't cause pinpoint pupils? |
|
Definition
|
|
Term
|
Definition
partial opiate agonist
use to decrease opiate craving in addicts |
|
|
Term
| 2 types of local anesthetics |
|
Definition
esters - procaine
amides - lidocaine |
|
|
Term
| esters (procain) metabolized by |
|
Definition
| plasma cholinesterase -> kidney |
|
|
Term
| amides (lidocaine) metabolized by |
|
Definition
|
|
Term
| amides (lidocaine) metabolized by |
|
Definition
|
|
Term
| amides (lidocaine) metabolized by |
|
Definition
|
|
Term
| amides (lidocaine) metabolized by |
|
Definition
|
|
Term
| esters (procain) metabolized by |
|
Definition
| plasma cholinesterase -> kidney |
|
|
Term
| how does pH affect local anesthetics? |
|
Definition
uncharged (lipophilic) base penetrates across the nerve sheath
water soluble (charged) form binds to active site |
|
|
Term
|
Definition
| bind to and block voltage gated Na channels thereby blocking Na conductance and the ability of nerve fibers to initiate and conduct action potentials |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
midozolam - benzodiazepine - antianxiety
propofol - anesthetic
etomidate - anesthetic
ketamine - dissociative anesthetic |
|
|
Term
| what does the blood-gas partition coefficent tell you about inhalational anesthetics? |
|
Definition
determines how rapidly the solubility equilibrium is reached between the concentrations in the alveolus vs the blood
higher blood-gas coefficient means slower onset/offset |
|
|
Term
| what does the oil-gas partition coefficient tell you about inhalational anesthetics? |
|
Definition
solubility of agent in the brain - relates to lipid solubility - MAC - correlates with potency
lower oil-gas coefficient means lower MAC and lower potency |
|
|
Term
| what effect does inhalational anesthitic have on the CNS? |
|
Definition
irregularly descending depression of the CNS
1) ascending reticular activating system and spinal cord
2) medullary area |
|
|
Term
| what effect do inhalational anesthetics have on cerebral blood flow? |
|
Definition
| small increase in cerebral blood flow due to decreased cerebral vascular resistance |
|
|
Term
| what effect does sevoflurane have on the CV system? |
|
Definition
decreases contractility and cardiac output
(desflurane and isoflurane produce minimal cardiac depression) |
|
|
Term
| how do inhalational anesthetics affect vascular smooth muscle? |
|
Definition
| all inhalational anesthetics decrease vascular smooth muscle tone -> decrease BP |
|
|
Term
| what effect does desflurane have on BP? |
|
Definition
| can increase BP via sympathetic activation when rapid increases in concentration occur |
|
|
Term
| what affect to inhalational anesthetics have on the respiratory system? |
|
Definition
direct depression of respiratory center
decrease in sensitivity of medullary respiratory center to CO2
decrease in tidal volume
increase in PaCO2 (can be countered w/ assisted mechanical ventillation) |
|
|
Term
| what do inhalational anesthetics do to the neuromuscular system? |
|
Definition
| increase GABA -> reduce signal strenght in spinal polysynaptic interneurons -> skeletal muscle relaxation |
|
|
Term
| adverse affects of desflurane |
|
Definition
CV: rapid increase -> activate sympathetic NS -> increase HR and BP
Resp: arryway irritation (so pretreat w/ narcotics)
Toxicity: formation of CO |
|
|
Term
| adverse effects of sevoflurane |
|
Definition
| toxicity: CO formation, nephrotoxic compound A formation in rats |
|
|
Term
| why cant nitrous oxide be used as an inhalational anesthetic? |
|
Definition
| MAC = 105% (so you wouldn't have room for O2) |
|
|
Term
| what are benzodiazepines (midazolam) used for in IV general anesthetics? |
|
Definition
reduce anxiety, sedation
NOT analgesic |
|
|
Term
| why do you have to use regional anesthesia, nitrous oxide, or narcoticx along with propofol? |
|
Definition
| it's NOT analgesic (supraspinal effect but not spinal) |
|
|
Term
|
Definition
| increase inhibitory synaptic transmission via facilitation of GABA-a receptor ion channel function -> CNS depression |
|
|
Term
| what are propofol's affects on respiration and CV and GI? |
|
Definition
depression of respiration
depression of CV system ] reduced systemic vascular resistance -> hypotension
anti-emetic |
|
|
Term
|
Definition
inhalational anesthetic
NOT analgesic (use w/ N2O or narcotic)
moa: GABA
s/e: myoclonus, adrenocortical supression, n/v |
|
|
Term
| what drug produces a cataleptic trance like state in which the pt may appear awake? |
|
Definition
|
|
Term
| what drug produces a cataleptic trance like state in which the pt may appear awake? |
|
Definition
|
|
Term
|
Definition
inhalational anesthetic
NOT analgesic (use w/ N2O or narcotic)
moa: GABA
s/e: myoclonus, adrenocortical supression, n/v |
|
|
Term
| what drug produces a cataleptic trance like state in which the pt may appear awake? |
|
Definition
|
|
Term
|
Definition
non-competitive antagonist of NMDA glutamate receptor
reduce synaptic Ca channel conduction -> decreased excitatory synaptic transmission |
|
|
Term
| drug combo used for conscious sedation |
|
Definition
| iv opiate (fentanyl) + anti-anxiety agent (midalzolam) |
|
|
Term
| rate limiting factor of alcohol metabolism |
|
Definition
|
|
Term
| blood alcohol concentration depends on: |
|
Definition
quantity and rate of consumption
speed of absorption
body weight and percentage total body water
rate of metabolism |
|
|
Term
| neurotransmitter effects of aclohol at lower concentrations |
|
Definition
increased neuronal signaling (stimulatory)
decreases GABA (disinhibition)
increases DA in nucleus accumbens (pleasure) |
|
|
Term
| neurotransmitter effects of alcohol at higher concentrations |
|
Definition
decreased neuronal signaling (depressant)
enhances inhibitory signaling
inhibits glutamate effects at NMDA receptor |
|
|
Term
effects of alcohol on CV and resp
acute vs chronic |
|
Definition
acute: small doses - cutaneous vasodilation; toxic doses - myocardial depression, central vasomotor and respiratory depression
chronic: hypertension, irreversible cardiomyopathy |
|
|
Term
| changes in neurotransmitter sstems due to physical dependence on alcohol |
|
Definition
downregulation of inhibitory GABA receptors
upregulation of excitatory glutamate (NMDA receptors)
increased central norepinephrine activity |
|
|
Term
|
Definition
alpha 2 adrenergic agonist
used to decrease alcohol withdrawal symptoms |
|
|
Term
|
Definition
long acting narcotic antagonist
help reduce craving for alcohol |
|
|
Term
|
Definition
used as aversive deterrent to alcohol ingestion
inhibit hepatic aldehyde dehydrogenase
can lead to aldehyde syndrome |
|
|
Term
|
Definition
NMDA receptor antagonist
used to decrease relapse rate in alcoholics |
|
|
Term
| what causes cutaneous vasodilation, throbbing headache, respiratory difficulties, nausea, copius vomiting, sweating, chest pain, blurred vision, hypotension, orthostatic syncope, confusion after drinking alcohol |
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Definition
| alcohol + disulfiram or metronidazol -> aldehyde syndrome |
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Term
| pt comes in w/ headache, vertigo, vomiting, dyspnea, blurred vision 8-36 hrs after ingesting something. he also has profound alterations in respiration and metabolic acidosis. what did he ingest, what are you worried about, and what do you do? |
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Definition
methanol (wood alcohol, windshield washer)
formic acid produces destructive inflammation of retinal ganglion cells and can produce bilateral blindness
correct acidosis, administer ethanol to block metabolism of methanol |
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Term
| pt comes in with CNS depression, metabolic acidosis, and renal failure after ingesting something. what was it, and what do you do? |
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Definition
ethylene glycol (antifreeze)
administer ethanol to compete for alcohol dehydrogenase and block oxalic acid formation |
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Term
| pt comes in drunk w/ gastritis, pain, and vomiting, stays intoxicated for a long time, then goes into coma. what did he drink? how do you test for it? |
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Definition
isopropyl alcohol (rubbing alcohol)
look for ketoacidosis and kenones in urine |
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Term
|
Definition
|
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Term
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Definition
| cisatracurium, vecuronium, succinylcholine |
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|
Term
| spinal inerneuron blocker |
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Definition
|
|
Term
| blocks skeletal muscle contractile process |
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Definition
|
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Term
|
Definition
| cleaves presynaptic proteins involved in exocytosis of synaptic vesicles containing ACh |
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|
Term
| competitive NMJ blocking agents |
|
Definition
| cisatracurium, vecuronium |
|
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Term
| how can you reverse a nerve block produced by cisatracurium or vecuronium? |
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Definition
| acetylcholinesterase inhibitors increase synaptic ACh |
|
|
Term
| non-competitive (depolarizing) NMJ blocker |
|
Definition
|
|
Term
| what are the phases of a NMJ block by succinylcholine? |
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Definition
Phase I: sustained depolarization; increased ACh intensifies blockade
Phase II: competitive blockade; at this point, increased ACh can reverse the blockade |
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Term
| effect of NMJ blocking agents on pts w/ myasthenia gravis: vecuronium vs succinylcholine |
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Definition
vecuronium (competitive) - more sensitive
succinylcholine (noncompetitive) - resistant |
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|
Term
| contraindication to using succinycholine? |
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Definition
| burn injuries or severe CNS trauma -> hyperkalemia |
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|
Term
| centraling acting muscle relaxants |
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Definition
|
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Term
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Definition
centrally acting muscle relaxant
GABA-B agonist
reduces release of glutamate from spinal neuonal circuits
ust to tx flexor spasms and rigidity due to MS and spinal cord injury |
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|
Term
peripheral acting muscle relaxant
moa |
|
Definition
dantrolene
inhibits ryanodine receptor Ca channel function in sarcoplasmic reticulum thereby inhibiting the release of Ca during excitation contraction coupling |
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|
Term
| prophylaxis for anesthetic induced malignant hyperthermia |
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Definition
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