NMDA: accelerator (agonists are glutamate, aspartate, coagonist is glycine; antagonists are Zn, Mg [plug])

GABA: brake

NMDA antagonist

lowers HR, BP, CNS activity

PCP: noncompetitive antagonist

ketamine: structurally similar

mainly NMDA antagonist (clinically relevant)

but dirty drug - almost every receptor affected

sympathomimetic anesthesia: increases RR, HR, BP, bronchodilation, puts to sleep

emergency/trauma

also innervates parasymp anesthesia: bronchorrhea, sialorrhea (to prevent, give atropine)

also psychomimetic anesthesia: vivid dreams (give GABA agonist)

S isomer = eutomer

NMDA antagonist

different mode/site of action, near Mg binding site

rapid blocking and unblocking (faster than Mg)

used mainly in Alzheimer's, can be used w AChE-Is

mu opoiod receptor agonist

also NMDA antagonist

difficult pharmacokinetics

chronic pain treatment

high rate of side fx

mu opens K channels (hyperpolarization)

kappa inhibits Ca channels

delta modulate mu receptors

no clean NMDA drugs

lamotrigine: glutamate release inhibitor, Na channel blocker

felbamate: NMDA antagonist and GABA agonist

topiramate: AMPA antagonist, GABA agonist

AMPA unplugs Mg

Na CB, CaCB, AMPA RB, GABA agonist, CA-I

ADR: carbonated drinks taste weird, myopia, glaucoma, paresthesia (due to CAI), nephrolithiasis, decreased sweat production, hyperthermia (due to dopamine release inhibitor), memory problems = stupimax [weight loss]