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2 IRM > 23 pharmacology of CNS and breathing > Flashcards

23 pharmacology of CNS and breathing Flashcards

1
Q

What are analeptics?

A

respiratory stimulants

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2
Q

What type of drug is Doxapram, and why is it so widely used?

A

it’s an analeptic

came around in the 50’s and we simply don’t have anything better

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3
Q

How long does it take for Doxapram to take effect, and what is its’ half life like?

A

effective in under a minute, it has a short half life , which is problematic

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4
Q

What is the mechanism of Doxapram, what is a problem with this?

A

stimulates CO2 and O2 chemoreceptors to fire more AP’s
It non-specifically enhances electrical activity in the respiratory centre
so it can therefore effect many other hings

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5
Q

What are 2 adverse effects of Doxapram?

A

cardiac arrhythmia

convulsion

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6
Q

When is Doxapram used?

A

clinical emergencies
acute ventilatory failure with hypercapnia (COPD)
maybe with post-op depression

mechanically - assissted respiration preferred

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7
Q

What is the general principle of respiratory depressants?

A

any agent with a generalised CNS depression will do this

the neurones in the respiratory centres aren’t special, so we have a lot of potential drugs

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8
Q

How does respiratory function respond to respiratory depressants?

What is the clinical significance of this?

A

it resists it tbh, which is interesting

we therefore normally give people GA’s

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9
Q

What are the 2 main types of GA’s?

A

volatile anaesthetics like haloethane

injected ones

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10
Q

What is the physiologcial action of volatile GA’s?

A

decreased response of CO2 chemoreceptors

partial pressure of arterial CO2 will rise

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11
Q

name 2 benxodiazepines

A

Diazepam (Valium)

Temazepam

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12
Q

Why might people be given benzodiazepines before a GA?

A

to relieve anxiety (also used to manage epilepsy too)

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13
Q

What is the physiological action of benzodiazepines?

A

decrease hypoxic drive, at higher doses we see an effect on central chemoreceptor action, although this is still not fatal

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14
Q

How might GABA inhibit neurone activity?

A

When GABA binds to an ion channel, it opens it to allow Cl- in, inhibiting depolarisation

Benzodiazepine has an allosreric effect, allowing more Cl- in

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15
Q

name 2 barbituates

A

phenobarbital or thiopental

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16
Q

What is the physiological action of barbituates?

A

decreased response of central chemoreceptors

decreased hypoxic drive

17
Q

What is the mechanism of action of barbituates?

A

increased inhibitory neurotransmission via GABA(A) receptors

18
Q

What problems are associated with barbituaes?

A

they work on their own without GABA so can be fatal
the dose at which they produce an anaesthetic effect is very close to the fatal dose

they’re just abused

19
Q

What is the mechanism of action of alcohols?

A 
increased GABA(A) inhibitory transmission
decreased NMDA excitatory transmission 
inhibits release of neurotransmitter by inhibiting VGC Ca2+ channels
20
Q

What is the physiological effect of alcohols?

A

decreased response to CO2

21
Q

Name 3 types of opioids

A

Morphine
Fentanyl
Heroin

22
Q

Which opioid receptors are targeted for analgesia?

A

mu

23
Q

What problem arises with opioid tolerance?

A

people come off it (great!) which decreases their tolerance again, but then they might go back to the same high doses, which can be fatal

24
Q

What is the ideal situation with opioids?

A

achieving analgesia without respiratory depression

25
Q

What is the mechanism of action of opioids?

What is the physiologcial effect?

A

Opens K+ channels with GCPR’s
this hyperpolarises the membrane, decreasing excitability

CO2 receptor response decrease

26
Q

Name 1 opioid receptor antagonist

When is it used?

A

Naloxone

to quickly treat an overdose

27
Q

What will the effect be of mixing benzodiazepines, opioids, and alcohol?

A

death

28
Q

What will be the effect of using benzodiazepines with a GA or opioid?

A

assissted ventilation use

29
Q

Name a benzodiazepine antagonist and its’ use

A

flumazenil
useful for benzodiazepine or alcohol overdoses

although if their respiratory function is good enough we would just wait until they’ve metabolised the benzodiazepine

2 IRM (26 decks)

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