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Pain Management
Adjunctive Drugs
51
Pharmacology
Graduate
07/15/2010

Additional Pharmacology Flashcards

 


 

Cards

Term
What receptors does Benadryl block?
Definition
*Competitively blocks H-1 receptors
Term
What does Benadryl suppress?
Definition

*Allergic symptoms

*N/V

*Cough

*EPS

Term
What are some effects of Benadryl?
Definition

*Anti-emetic

*Sedation (keeps ventilatory drive intact)

*Hyponotic

Term
What drugs does Benadryl potentiate?
Definition

*Barbiturates

*Benzos

*Opioids

Term
What receptor does Cimetidine block?
Definition
*H-2 receptors
Term
What does H-2 antagonists do?
Definition

*Prevents stress ulcers

*H pylori

*More interested in side effects

Term
H-2 antagonist Cimetidine is an enzyme inhibitor.  This results in:
Definition

*Reduced hepatic blood flow

*Reduced CYP450

*Helpful with high tolerance patients

Term
What is droperidol?
Definition
*A dopamine antagonist
Term
What other neurotransmitters besides dopamine does Droperidol antagonize?
Definition

*Serotonin

*Norepinephrine

*GABA

Term
What drug is droperidol structurally related to?
Definition
*Haloperidol
Term
*What %age of droperidol is protein bound?
Definition
*>98%
Term
What is the alpha distribution (onset) of Droperidol?
Definition
*Long, 10 minutes
Term
What is the duration of action of Droperidol?
Definition
*24 hours
Term
How can use of Droperidol effect hemodynamics?
Definition
*Mild a-adrenergic effect therefore decreased ABP by peripheral vasodilatoin
Term
What drug was fentanyl+droperidol?
Definition
*Innovar
Term
What are the characteristics of Innovar?
Definition

*Analgesia, immobility, Amnesia

*Neuroleptic analgesia

*Dissociative state similar to ketamine.

Term
What is clonidine?
Definition
*Alpha 2 adrenergic agonist
Term
Does clonidine pass through the BBB?
Definition
*Yest, it is highly lipid doluble
Term
What advantageous effects does clonidine have?
Definition

*Decreases sympathetic outflow

*Analgesia effects in spinal cord

Term
What is the onset and DOA of clonidine?
Definition

*30-60min

*6-12 hours

Term
What can result if a dose of clonidine is missed?
Definition
*Rebound HTN
Term
What can clonidine withdrawal cause?
Definition
*MI, CHF, CVA
Term
How does Clonidine work?
Definition

*Stimulates alpha 2 receptors in the brain, leads to decreased CO2, PVR, and BP

*Presynaptic A2 this binding decreases presynaptic calcium levels, & inhibits th release of NE.

Term
What is a new use for Clonidine?
Definition
*ADHD
Term
What classification is Dexmedetomidine?
Definition
*Selective A2 agonist
Term
In comparison to Clonidine, Dexmedetomidine is ......
Definition
*More selective than Clonidine
Term
High doses of Dexmedetomidine cause .......
Definition
*Alpha One agonist stimulation
Term
What effect does Demedetomidine have on opioids?
Definition
*Opioid sparing effects
Term
What are some side effects of Dexmedetomidine?
Definition
*Bradycardia and hypotension
Term
What is the loading dose for Dexmedetomidine?
Definition
*1mcg/kg IV over 10 minutes
Term
What is the maintenance dose for Dexmedetomidine?
Definition
*0.2-0.7mcg/kg/hr
Term
What is the half life of Demedetomidine?
Definition
*2 hours
Term
What class is Ketamine?
Definition

*Phenycyclidine

*Hallucinogenic 

*Stereospecific Receptors

Term
How does Ketamine create a dissociative anesthesia?
Definition

*Dissociates the thalamus from the limbic 

*State of excitement and depression

Term
What receptors does Ketamine work at?
Definition

*N-methyl-D-aspartate (NMDA)

*Opioid receptors 

Term
How is Ketamine absorbed?
Definition

*Skipped IV

*IM peak 10-15 minutes

Term
What is the distribution of Ketamine?
Definition

*> lipid soluble than Thiopental, < protein 

*Distribution half life 10-15 minutes

*Redistribution

Term
How is Ketamine metabolized?
Definition

*By the liver resulting in several metabolites (Norketamine)

*Enzyme inducting, tolerant

Term
How is Ketamine excreted?
Definition
*Excreted in urine after metabolism
Term
What hemodynamic effects does Ketamine have?
Definition

*Increased arterial blood pressure

*Increased HR

*Increased CO

Term
How does ketamine cause its hemodynamic effects?
Definition

*Indirect central stimulation of sympathetics

*Blocks reuptake of norepinephrine

Term
How does Ketamine effect the heart and lungs?
Definition

*Increased Pulmonary arterial pressure

*Increased myocardial work load

Term
In what patients should ketamine be avoided in?
Definition

*CAD

*CHF

*HTN

Term
Large doses of Ketamine are........
Definition
*Cardiac depressive 
Term
Ketamine is beneficial in ________ shock.
Definition
*Hypovolemic
Term
Ketamine is excellent for asthma due to.....
Definition

*Potent bronchodilator

*Upper airway reflexes intact 

Term
What side effect of Ketamine r/t airway should the anesthetist be aware of?
Definition
*Increased Salivation
Term
How does ketamine affect the brain?
Definition

*Increased CBF

*Increased CMRO2

*Increased ICP

Term
What type of brain lesions should Ketamine not be used in?
Definition
*Space occupying lesions
Term
What type of neurological side effects can Ketamine cause?
Definition

*Myoclonic d/t subcortical electrical activity

*Psychotomimetic side effects

Term
What property does Ketamine have that other anesthetic agents lack?
Definition
*Excellent Analgesic
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