Term
| extrapyramidal system (of CNS) |
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Definition
| a complex neuronal network that helps regulate movement |
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Term
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Definition
| abrupt loss of effect of medication that occurs anytime in the dosing interval. Can last for minutes or hours |
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Term
| catechol-O-methyltransferase (COMT) |
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Definition
| an enzyme that deactivates the catecholamines dopa, dopamine, epinephrine and norepinephrine. |
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Term
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Definition
| complete absence of movement |
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Term
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Definition
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Term
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Definition
| type B monoamine oxidase inhibitors prevent dopamine break down |
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Term
| apolipoprotein E4 (apoE4) |
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Definition
| a protein component of lipoprotein complexes found in very low density lipoprotein (VLDL), high density lipoprotein(HDL), chylomicrons and remnats. It facilitates hepatic uptake of chylomicron and VLDL remnants and is elevated in patiens with Type III hyperlipoproteinemia. |
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Term
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Definition
| an amino acid formed from dietary methionine. Elevated plasma levels are associated with an increased risk for AD |
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Term
| acetylcholinesterase(AChE) |
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Definition
| an enzyme present at endings of volunatary nerves and parasympathetic involuntary nerves and autonomic nerve ganglia. It inactivates and prevents accumulation of the neurotransmitter Ach released during nerve impulse transmission by hydrolyzing the substance to choline and acetate. The action reduces excessive firing of neurons at neuromuscular junctions. |
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Term
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Definition
| prominent feature of AD. form inside neurons- result when the orderly arrangement of microtubules become disrupted. Disruption is due to the production of abnormal tau. In healthy neurons tau forms cross bridges between microtubules keeping their configuration stable |
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Term
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Definition
| spherical bodies that form on the outside of neurons, composed of a central core of beta-amyloid surrounded by remnants of axons and dendrites, a hallmark of AD |
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Term
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Definition
| a general term that applies to all types of epileptic events. |
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Term
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Definition
| a seizure that persists for 30 minutes or longer. Types include generalized convulsive SE, absence SE or myoclonic SE. |
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Term
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Definition
| a seizure that takes place while on anticonvulsive medications. |
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Term
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Definition
| a violent shaking of the body or limbs caused by uncontrollable muscle contractions |
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Term
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Definition
| agents used to treat epilepsy not convulsions. |
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Term
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Definition
| fever associated seizures are common among children ages 6mths-5yrs. Typically manifest as generalized tonic-clonic convulsions of short duration. These children do not have a high risk of developing epilepsy later in life: |
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Term
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Definition
| gated pores in the cell membrane that control sodium entry. |
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Term
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Definition
| manifest with discrete symptoms that are determined by the brain region involved. Patient may experience discrete motor symptoms (twitching thumb), sensory symptoms (local numbness, auditory, visual or olfactory hallucinations), autonomic symptoms (nausea, flushing, salivation, urinary incontinence) or psychoillusory symptoms (feelings of unreality, fear or depression). There is no loss of consciousness. |
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Term
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Definition
| may cause convulsive or nonconvulsive & produce immediate loss of consciousness, consist of tonic-clonic seizures (Grand Mal), Absence Seizures 9Petit Mal), Atonic Seizures, Myoclonic Seizures, Status Epilepticus, Febrile Seizures): |
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Term
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Definition
| neuronal discharge spreads throughout both hemispheres of the cerebral cortex. These seizures manifest as major convulsions, characterized by a period of muscle rigidity (tonic phase) followed by synchronous muscle jerks (clonic phase). Often cause urination, but not defecation. Accompanied by marked impairment of consciousness and are followed by a period of CNS depression referred to as the postictal state. Seizure lasts 90 seconds or less. |
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Term
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Definition
| refers to a group of disorders characterized by excessive excitability of neurons in the central nervous system (CNS) the abnormal neuronal activity can produce a variety of sypmtoms, ranging from brief periods of unconsciousness to violent convulsions: |
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Term
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Definition
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Term
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Definition
| used to synthesize the following anticonvulsants: ethotoin, phenytoin, mephenytoin & fosphenytoin |
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Term
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Definition
| a period of CNS depression that follows marked impairment of consciousness that accompany tonic –clonic seizures |
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Term
| Lennox-Gastault syndrome (mixed seizures) |
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Definition
| a severe, difficult to treat, form of epilepsy that usually develops in the preschool years. Characterized by developmental delay & a mixture of partial & generalized seizures (partial, atonic, tonic, generalized tonic-clonic & atypical absence). |
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Term
| secondary generalized seizures |
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Definition
| begin as simple or complex partial seizures, & then evolve into generalized tonic-clonic seizures. Consciousness is lost, seizures last 1-2 minutes |
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Term
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Definition
| consist of sudden muscle contractions that last for just 1 second. Seizure activity may be limited to one limb (focal myoclonus) or the entire body (massive myoclonus) |
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Term
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Definition
| impaired consciousness and lack of responsiveness. At onset, pt. becomes motionless and stares with a fixed gaze, followed by a period of automatism. Seizures last 45 to 90 seconds. |
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Term
| absence seizure (petit mal) |
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Definition
| loss of consciousness for a brief time (10 to 20 sec). mild symmetric motor activity (eye blinking) but may occur with no motor activity. Primarily in children, cease in early teens. |
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Term
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Definition
| seizure activity begins focally in the cerebral cortex and usually undergoes limited spread to adjacent cortical areas. |
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Term
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Definition
| sudden loss of muscle tone; occur mainly in children. |
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Term
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Definition
| achieved by injecting a local anesthetic directly into the immediate area of sx. Or manipulation: |
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Term
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Definition
| achieved by injecting a local anesthetic into or near nerves that supply the surgical field, but at a site distant from the field itself. Produces anesthesia with doses that are smaller than those need for infiltration anesthesia. Drug selection is based on length of procedure. Lidocaine or Mepivacaine are used for shorter procedures and Bupivacaine for longer ones. |
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Term
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Definition
| is achieved by injecting a local anesthetic into the epidural space (within the spinal column but outside the dura mater). |
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Term
| spinal (subarachnoid) anesthesia |
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Definition
| is produced by injecting local anesthetic into the subarachnoid space. Injection is made in the lumbar region below the termination of the spinal cord. Spread of anesthetic determines the level of anesthesia achieved. Movement of anesthetic is determined by 1.) The density of the solution and 2.) the position of the patient. Most commonly used are Bupivacaine, Lidocaine, and Tetracaine. |
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Term
| amide (class of local anesthetic) |
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Definition
| represented by lidocaine; contains an amide linkage. (See table 26-1) |
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Term
| intravenous regional anesthesia |
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Definition
| employed to anesthetize the extremities (hands, feet, arms & lower legs) but not the entire leg (because too much anesthesia would be needed. Anesthesia is produced by injection into a distal vein of an arm or leg. |
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Term
| ester (class of local anesthetic |
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Definition
| one of 2 major groups of local anesthetics, are metabolized in the blood by enzymes known as esterases, allergic reactions more common with ester-type than amides: |
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Term
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Definition
| stop nerve conduction by blocking sodium channels in the axon membrane but do not reduce consciousness. Can be administered topically or by injection. |
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Term
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Definition
| is produced with a combination of Fentanyl (opiod), Droperidol (anti-psychotic). Characterized by quiescence, indifference to surroundings and indifference to pain. Patient appears to be asleep but is not. Used for diagnostic and minor surgery. (bronchoscopy, and repeated changing of burn dressings) |
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Term
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Definition
| loss of pain and other sensation as well; such as temperature, touch, taste). |
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Term
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Definition
| loss of sensibility to pain. |
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Term
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Definition
| one of the classes of the inhalation anesthetics, the only one used now is Nitrous Oxide due to gases extreme flammability, cannot cause anesthetia by itself: |
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Term
| minimum alveolar concentration (MAC) |
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Definition
| the minimum concentration of a drug in alveolar air that will produce immobility in 50% of patients exposed to a painful stimulus. A LOW MAC indicates a HIGH anesthetic potency. |
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Term
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Definition
| the pt. feels dissociated from his or her environment, causes sedation, immobility, analgesia, and amnesia, responsiveness to pain is lost, induction is rapid & emergence begins w/in 10-15 mins., but full recovery may take several hrs: |
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Term
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Definition
| the pt. is unperturbed and passive, but responsive to commands, such as “open your eyes” it persists for an hr. or so & is suitable for minor sxs. & endoscopic procedures, characterized by sedation, analgesia, amnesia, & lack of anxiety: |
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Term
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Definition
| this and gases are two classifications of inhalation anesthetics. Exist in a liquid state at atmospheric pressure but can easily be converted to a vapor for administration by inhalation. These include: Halothane, Enflurane, Isoflurane, Desflurane and Sevoflurane. |
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Term
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Definition
| to the use of combination of durgs to accomplish what we cannot achieve with an inhalation anesthetic alone. It is a technique employed to compensate for the lack of an ideal anesthetic. |
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Term
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Definition
| a rare but potentially fatal reaction that can be triggered by all inhalation anesthetics except nitrous oxide. Predisposition to this reaction is genetic. Characterized by muscle rigidity & profound elevation of temperature. |
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Term
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Definition
| drugs that produce unconsciousness and lack of responsiveness to all painful stimuli |
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Term
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Definition
| (endogenous morphoines) are a family of neuropeptides that inhibit transmission of pain impulses In the spinal chord and brain by binding to mu, kappa, or delta opioid receptors: |
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Term
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Definition
| 1 of 3 family of peptides that have opioid like properties,which serve as neurotransmitters, neurohormones, and neuromodulators, they are found in the CNS and in peripheral tissues, found in the neurons of the brain and spinal cord are weker analgesic than other endorphins but is more potent and logner lasting than morphine |
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Term
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Definition
| a behavior pattern characterized by continued use of a psychoactive substance despite physical, psychologic, or social harm. |
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Term
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Definition
| a state in which a larger dose is required to produce the same response that could formerly be elicited by a smaller dose. |
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Term
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Definition
| a state in which an abstinence syndrome will occur if drug use is abruptly stopped. |
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Term
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Definition
| act as antagonists at Mu and Kappa receptors. Do not produce analgesia or any of the other effects caused by opioid agonists. Principal use is reversal of respiratory and CNS depression caused by overdose of opioid agonists. Narcan is the prototype. |
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Term
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Definition
| activate Mu and Kappa receptors. They can produce analgesia, euphoria, sedation, respiratory depression, physical dependence, constipation and other effects. Sub-divided into two groups, strong (Morphine) and moderate to strong (Codeine). |
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Term
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Definition
| collection of symptoms that appear when a drug is withheld. |
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Term
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Definition
| Drugs that relieve pain without causing loss of consciousness. |
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Term
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Definition
| tolerance to one drug confers tolerance to another, ususally starts w/ drugs of same class: |
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Term
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Definition
| a general term defined as any drug, natural or synthetic that has actions similar to those of morphine |
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Term
| patient-controlled analgesia (PCA) |
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Definition
| a method of drug delivery that permits the patient to self-administer parenteral (transdermal, IV, subQ, epidural) opioids on an as needed basis. Often used postoperatively as well as for those with cancer, trauma, MI, vaso-occlusive sickle cell crisis & labor |
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Term
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Definition
| dependent on two factors: half-life and degree of physical dependence. It is withdrawal symptoms. |
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Term
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Definition
| drug use that is inconsistent with medical or social norms. |
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Term
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Definition
| Has been used to mean analgesic, CNS depressant & any drug capable of causing physical dependence. May also be used in legal contexts as a result opioid is preferable to use than narcotic. |
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Term
| agonist-antagonist opioids |
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Definition
| Pentazocine (Talwin) is the prototype: Given Alone> Produce analgesia. Given with a pure opioid agonist, they can antagonize analgesia caused by the pure agonist. |
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Term
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Definition
| type of opioid receptor. Activation of these receptors can produce analgesia & sedation. May also underlie psychotomimetic effects seen with certain opioids |
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Term
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Definition
| type of opioid receptor. Opioid analgesics act primarily by activating these receptors. Responses to activation of mu receptors include analgesia, respiratory depression, euphoria & sedation as well as physical dependence |
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Term
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Definition
| chronic pain & is characterized by increased sensitivy to painful stimuli, the perception of innocuous stimuli as painful, and spontaneous pain results from abnormal processing of sensory information by the peripheral & central nervous systems: |
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Term
| World Health Organization (WHO) analgesic ladder |
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Definition
| designed to help guide drug selection. The first step is for mild to moderate pain treated with non-opioid analgesics (NSAIDS and Acetaminophen). The second step is for more severe pain and adds opioid analgesics of moderate strength (Oxycodone, Hydrocodone). The top step for severe pain substitutes powerful opioids (Morphine and Fentanyl for the weaker ones. Adjuvant analgesics, effective against neuropathic pain, can be used on any step of the ladder. |
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Term
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Definition
| form of nociceptive pain that results from injury to somatic tissues. Described as localized and sharp. |
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Term
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Definition
| form of nociceptive pain that results from injury to visceral organs. Described as vaguely localized with a diffuse, aching quality. |
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Term
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Definition
| pain that results from injury to tissues. May be either somatic or visceral. Responds well to opioids & nonopioids. |
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Term
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Definition
| pharmacology a drug or agent added to another drug or agent to enhance its medical effectiveness |
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Term
| Agency for Healthcare Research and Quality (AHRQ) |
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Definition
| recommendations are made by AHRQ involving patient and family in its clinical approach to pain management. |
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Term
| The Joint Commission (TJC) |
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Definition
| the authority that accredits hospitals and other healthcare institutions in the US. |
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Term
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Definition
| used for young children and for patients with cognitive impairment, who may have difficulty understanding the descriptive & numeric scales. |
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Term
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Definition
| a subtype of cholinergic receptor that causes contraction of skeletal muscle. |
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Term
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Definition
| a subtype of cholinergic receptor that promotes neuronal ganglionic transmission at all ganglia of the sympathetic and parasympathetic nervous systems. Activation of these receptors releases epinephrine from the adrenal medulla. |
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Term
| acetylcholine, acetylcholinesterase |
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Definition
| Ach binds to receptors located on the postjunctional cell, upon dissociating from its receptors, Ach is destroyed by AChE an enzyme present in abundance on the surface of th epostjunctional cell. AChE degrades Ach into 2 inactive products: acetate and choline. |
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Term
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Definition
| adrenergic transmitter that activates alpha 1, alpha 2, and beta 1 receptors. Does not activate beta 2 or dopamine receptors. |
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Term
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Definition
| Alpha 2 receptors of the peripheral nervous system are located on nerve terminals and not on organs innervated by the autonomic nervous system. These receptors are referred to as postsynaptic or ___. |
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Term
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Definition
| Alpha 2 receptors of the peripheral nervous system are located on nerve terminals and on the organs innervated by the autonomic nervous system; (known as presynaptic or prejunctional ) Alpha 1 receptors are located in the eyes, blood vessels ,male sex organs, prostatic capsule and bladder. Ocular alpha1 are present on the radial muscle of the iris. Activation of these leads to mydriasis (dilation of the pupil). |
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Term
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Definition
| carry nerve impulses away from the central nervous system to effectors such as muscles or glands (and also the ciliated cells of the inner ear). |
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Term
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Definition
| chemicals affecting contractility, the most important positive inotropic agents are epinephrine and norepinephrine released from the sympathetic nervous system, other positive inotropes include thyroid hormone and dopamine, the most important negative inotropic agent is acetylcholine released from the vagus nerve |
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Term
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Definition
| contain a catechol group and an amine group, due to their chemistry they cannot be used orally, they have a brief duration of action, & they cannot cross the blood-brain barrier: |
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Term
| parasympathetic nervous system |
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Definition
| Division of the Autonomic nervous system that has 7 functions. 1. Slowing of the heart rate. 2. Increasing gastric secretion. 3. Emptying the bladder. 4. Empting the bowel. 5. Focusing the eye for near vision. 6. Constricting the pupil. 7. Contracting smooth bronchial muscle. All preganglionic and postganglionic neurons of the parasymphathetic nervous system use acetylcholine as their transmitter. |
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Term
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Definition
| element of the feedback loop system of the autonomic nervous system (a reflex). Makes appropriate adjustments to the process in response to instructions from the CNS sent via nerves of the ANS |
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Term
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Definition
| is a major division of the peripheral nervous system and is divided into sympathetic and parasympathetic. Its three main functions are to regulate the heart, secretory glands and smooth muscles. |
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Term
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Definition
| mediated by acetylcholine: |
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Term
| peripheral nervous system |
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Definition
| nervous system outside the central nervous system (brain and spinal cord) comprised of the autonomic and somatic nervous systems. |
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Term
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Definition
| neurons that go from the parasympathetic ganglia to the effector organs. Sympathetic use NE, ACh and Epi. Parasympathetic always uses ACh. |
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Term
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Definition
| neurons that go from the spinal cord to the parasympathetic ganglia. These, in both the sympathetic and parasympathetic nervous systems, use acetylcholine as their neurotransmitter. |
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Term
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Definition
| refers to the steady, day to day influence exerted by the autonomic nervous system on a particular organ or organ system. It provides a basal level of control over which reflex regulation is superimposed. |
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Term
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Definition
| subdivided into the brain & spinal cord: |
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Term
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Definition
| the most important feedback loop (in pharmacology) of the autonomic nervous system; because it helps regulate blood pressure. The reflex is important because it opposes our attempts to modigy blood pressure with drugs. |
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Term
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Definition
| type of adrenergic receptor. can activate alpha1, beta1, and dopamine receptors. only neurotransmitter capable of activating dopamine receptors |
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Term
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Definition
| type of cholinergic receptor. muscarinic receptors are located on all organs regulated by the parasympathetic nervous system (ie., organs innervated by postganglionic parasympathetic nerves). Muscarinic receptors are also located on sweat glands. |
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Term
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Definition
| adrenergic receptor subtypes*1 (1 heart)-increases heart rate, force of contraction, velocity of conduction in AV node, kidney renin release/ 2 ( 2 lungs)-bronchial dilation, relaxationof uterine muscle, vasodilation, glycogenolysis, dopamine dilates renal blood vessels |
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Term
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Definition
| adverse effect of the blockade of alpha1 receptors & some other drugs. So called first dose effect. Patients feel light headed or dizzy when moving from a supine or sitting position to an upright position |
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Term
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Definition
| is a catecholamine & neurotransmitter of the peripheral nervous system. Principle transmitter released by the adrenal medulla. can activate all alpha and beta receptors, but not dopamine receptors. Used to treat anaphylactic shock. |
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Term
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Definition
| receptors that mediate responses to epinephrine and norepinephrine. |
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Term
| intrinsic sympathomimetic activity (partial agonist activity) |
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Definition
| the ability of certain beta blockers –especially pindolol- to act as partial agonists at beta-adrenergic receptors |
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