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🄼💊 M2 Adrenergic/Cholinergics > 8-24 Muscle Relaxers/Serotonin/Dopamine/Opiods/ Anesthetics > Flashcards

8-24 Muscle Relaxers/Serotonin/Dopamine/Opiods/ Anesthetics Flashcards

1
Q

Baclofen:

Mechanism of Action

A

GABA agonist

Inhibits neurotransmitter
release from skeletal muscle sensory afferent- (by inhibiting calcium influx and therefore reducing the release of excitatory transmitters)

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2
Q

Baclofen:

Rx

A

ºmuscle spasticity assoc.

with multiple sclerosis or Spinal Cord Injury

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3
Q

Baclofen:

Side Effects (1)

A

Drowsiness

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4
Q

Diazepam:

Mechanism of Action

A

Benzodiazepine receptor agonist

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5
Q

Diazepam:

Rx (2):

A
  1. Muscle spasm due to local injury (inflammation),

2. muscle spasticity due to loss of descending inhibitory input, (e.g.cerebral palsy)

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6
Q

General for benzodiazepines
(Diazepam, cloneazepam…)

Mechanism of Action (1):

A

Facilitate GABA mediated pre-synaptic inhibition

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7
Q

General for benzodiazepines
(Diazepam, cloneazepam…)

Clinical usages (2)

A
  1. Spinal Spasticity

2. Multiple Sclerosis

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8
Q

General for benzodiazepines
(Diazepam, cloneazepam…)

Side effects (2)

A

Sedation

Drowsiness

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9
Q

Rocuronium

Duration of Action

A

25 mins

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10
Q

Rocuronium

MOA

A

[Non-Depolarizing Muscular Nicotinic BLOCKER]

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11
Q

Rocuronium

Location of Elimination

A

Liver

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12
Q

Rocuronium

Rx (2)

A
  1. Intubation

2. Muscle relaxation during surgery or ventilation

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13
Q

Mivacurium

Duration of Action

A

15-20min

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14
Q

Mivacurium

MOA

A

[Non-Depolarizing Muscular Nicotinic BLOCKER]

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15
Q

Mivacurium

Elimination

A

Plasma cholinesterase

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16
Q

Mivacurium

Rx. (2)

A
  1. Intubation

2. Muscle relaxation during surgery or ventilation in pts w/ renal failure

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17
Q

Vecuronium

Duration of action

A

30-45 min

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18
Q

Vecuronium

MOA

A

[Non-Depolarizing Muscular Nicotinic BLOCKER]

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19
Q

Vecuronium

Elmination (2)

A
  1. Liver (metabolism and clearance)

2. Renal (elimination)

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20
Q

Vecuronium

Rx (2)

A

Adjuvant in Surgical Anesthesia for:
1) Abdominal Wall Relaxation

2) Orthopedic Procedures

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21
Q

Bromocriptine

Mechanism of Action

A

D2 Agonist

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22
Q

Bromocriptine

Rx

A

Parkinson’s Disease

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23
Q

Carbidopa

Mechanism of Action

A

Aromatic acid decarboxylase inhibitor

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24
Q

Carbidopa

Rx

A

Parkinson’s Disease

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25
Q

Carbidopa

Side Effects (2)

A

Same as L-Dopa since it increases L-Dopa –> arrhythmia, dyskinesia

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26
Q

Selegiline

Mechanism of Action

A

MAO-b inhibitor

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27
Q

Selegiline

Rx

A

Parkinson’s disease

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28
Q

Talcapone

Mechanism of Action

A

COMT inhibitor

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29
Q

Talcapone

Rx

A

Parkinson’s disease

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30
Q

Methylphenidate

Mechanism of Action

A

Dopamine reuptake inhibitor

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31
Q

Methylphenidate

Rx

A

ADHD

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32
Q

Methylphenidate

Side effect

A

Tachycardia

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33
Q

Mu (OP3)

Locations (6)

A

Brain:

  • cortex (lamina III-IV)
  • Thalamus
  • Striosomes
  • periaqueductal gray

Spinal Cord
- substantial gelatinosa

-Intestinal tract

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34
Q

Mu - subtype 1

Function (2)

A
  • Supraspinal analgesia

- physical dependence

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35
Q

Mu - subtype 2

Function (5)

A
  • Respiratory depression
  • miosis
  • euphoria
  • reduced GI mobility
  • physical dependence

” Mu2 was a kinda GRUMP “

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36
Q

Mu - subtype 3

Function

A

unknown

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37
Q

Naloxone

Receptors - antagonist/agonist (3)

A

mu-R: antagonist
Delta-R: antagonist
Kappa-R:antagonist

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38
Q

Naloxone

A: Used for:

B: Its indication helps prevent/reduce effects such as…(3)

C: Has NO _______ properties characteristic of other narcotic antagonist

A

Naloxone

A: antidote for opioid overdose

B: prevents or reverses effects of opioids including respiratory depression, sedation and hypotension

C: NO [agonistic or morphine-like] properties characteristics of other narcotic antagonist

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39
Q

Naloxone

Side Effects (4)

A
  1. Change in mood
  2. Trembling
  3. Change in heart rhythm
  4. Block the action of pain-lowering endorphins
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40
Q

MethaDone

Receptor - Antagonist/agonist (2)

A

mu - agonist
delta- agonist

  • (M)etha(D)one *
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41
Q

MethaDone

Side effects

Firm occupancy of opioid receptors by MethaDone ____ (INC/DEC) desire for other opioid intake, because it is producing a _______ but ___ (INC/DEC) effect which attenuates withdrawal manifestations.

A

dependence

Firm occupancy of opioid receptors by MethaDone DEC desire for other opioid intake, because it is producing a LONGER but DEC EFFECT which attenuates withdrawal manifestations.

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42
Q

MethaDone

Function

A

Treats Opioid Dependence

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43
Q

Tizanidine

Physiological effect:

A

[CENTRAL a2 agonist] that acts on pre and post-synpatic nerves of Spinal Cord —> Inhibition

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44
Q

Tizanidine

Indication (2)

A

Multiple sclerosis

Spinal spasticity

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45
Q

Tizanidine

Toxicity (2)

A

Drowsiness

Hypotension

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46
Q

Dantrolene

Physiological Actions

A

Blocks calcium release from SR of skeletal muscle

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47
Q

Dantrolene

Indications (5)

A
  • SPASMS 2º to Stroke
  • SPASMS 2º to Spinal Cord Injury
  • Malignant Hyperthermia
  • Cerebral Palsy
  • Multiple Sclerosis
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48
Q

Dantrolene

Toxicity (3)

A
  • Muscle weakness
  • Sedation
  • Hepatitis
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49
Q

Metaclopramide

MOA:

Side effects (2) :

A

MOA: [D2 Blocker] with some [5HT4 agonist]

SE: [Focal dystonia], Akathisia, [Tardive Dystonia after 3 months]

M.SE.FAT

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50
Q

Metaclopramide:
Contraindications:

A

Contraindications: long-term rx (3 months

can cause tardive dyskinesia)

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51
Q

Haloperidol

MOA:

Indications (2):

A

MOA: [D2 Blocker]

Indications:
ºacute psychosis

ºlong-term depot for poorly compliant schizophrenic
patients

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52
Q

Haloperidol

Side Effects:

A

extrapyramidal motor disturbances

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53
Q 
Trazadone
MOA (2)
A

[5-HT2A/2C BLOCKER] + SSRI

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54
Q 
Trazadone
Indications (2)
A

Anxiety/depression

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55
Q

Trazadone

SE

A

Warning of suicidality in young adults at initiation of treatment

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56
Q

Trazadone

Contraindicaitons

A

MAO inhibitors

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57
Q

Nociceptin receptor
(OP4)
Subtypes

A

ORL1

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58
Q

Nociceptin receptor location (7)

A

Brain:

  • Cortex
  • Amygdala
  • hippocampus
  • septal nuclei
  • habenula
  • hypothalamus

Spinal cord

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59
Q

Nociceptin function (3)

A
  • anxiety
  • depression
  • appetite
60
Q

Pentazocin

Receptor subtypes and action

A

m-receptor: antagonist
d-receptor: agonist
K-receptor: agonist

61
Q

Pentazocin

Indications

A

Dental extraction

62
Q

Pantazocin

Side Effects: (2)

A
  1. Hallucinations/Psychomimetic Effects

2. Cardiovascular effects

63
Q

5-HTP

Mechanism of Action

A

5-HT Precursor

64
Q

5-HTP

Rx

A

Depression

65
Q

Buspirone

Mechanism of Action

A

5-HT1A partial agonist

66
Q

Buspirone

Rx (2)

A

Anxiety/depression

67
Q

Buspirone

Side Effects

A

Early increase in anxiety

68
Q

Sumatriptan

Mechanism of Action

A

5-HT1D agonist

69
Q

Sumatriptan

Rx

70
Q

Sumatriptan

Side Effects

A

Coronary vasoconstriction

71
Q

Risperidone

Mechanism of Action

A

5-HT2A/2C BLOCKER

72
Q

Risperidone

Rx (2)

A
  • Depression

- Psychosis

73
Q

Risperidone

Side Effects (2)

A
  1. Akathisia (also occurs as Metaclopramide SE)

2. Weight Gain

74
Q

Odansetron

Mechanism of Action

75
Q

Odansetron

Rx

A

Chemotherapy-induced emisis

76
Q

Fluoxetine

Mechanism of Action

77
Q

Fluoxetine

Rx (6)

A
  1. OCD
  2. Depression
  3. Anxiety
  4. Panic Disorder
  5. PTSD
  6. Social Phobia

” You’ll need SSRI’s if you [OD on APPS] “

78
Q

Fluoxetine

Side Effects (2)

A

Sexual Dysfunction

Insomnia

79
Q

Sertraline

Mechanism of Action

80
Q

Sertraline

Rx (6)

A
  1. OCD
  2. Depression
  3. Anxiety
  4. Panic Disorder
  5. PTSD
  6. Social Phobia

” You’ll need SSRI’s if you [OD on APPS] “

81
Q

Sertraline

Side Effects (2)

A

Sexual Dysfunction

Insomnia

82
Q

L-DOPA

Mechanism of Action

A

Dopamine Precursor

83
Q

L-DOPA

Rx

A

Parkinson’s Disease

84
Q

L-DOPA

Side Effects (2)

A

Arrythmia

Dyskinesia

85
Q

Delta (OP1)

Subtypes (2)

A

Delta 1

Delta 2

86
Q

Delta (OP1)

Location (4)

A

Brain

  • Pontine Nuclei
  • Amygdala
  • Olfactory bulbs
  • Deep Cortex
87
Q

Delta (OP1)

Function (3)

A
  • Analgesia
  • Antidepressant effects
  • Physical dependence
88
Q

Kappa (OP2)

Subtypes (3)

A

Kappa 1
Kappa 2
Kappa 3

89
Q

Kappa (OP2)

Location (4)

A

Brain:

  • Hypothalamus
  • Periaqueductal Gray
  • Claustrum

Spinal Cord:
-Substantia Gelatinosa

90
Q

Kappa (OP2)

Function (5)

A
  • Miosis (and MEPERIDINE uses this receptor)
  • Inhibits ADH release
  • Sedation
  • Spinal Analgesia

-Dysphoria

” [MISS D] loved her some Kappas”

91
Q

Morphine

receptor type

92
Q

Morphine

Indication

A

severe pain

93
Q

Morphine

Side Effects (3)

A

(x) Constipation
(x) Addiction
(x) Tolerance

94
Q

Morphine

Antidote

95
Q

Meperidine

Receptor type

A

Kappa receptor

96
Q

Meperidine

Indication

A

Severe pain

97
Q

Meperidine

Side Effects (4)

A
  • Seizure
  • Dysphoria
  • Tremor
  • Respiratory Depression
98
Q

Meperidine

Other Notes (2)

A

1) Also binds: K+ channels, Muscarinic receptors, Dopamine transporter
2) Do not use Naloxone as andtidote

99
Q

Hydrocodone

Receptor types (2)

100
Q

Hydrocodone

Indication (2)

A
  1. Moderate pain

2. Coughing (anti-tussive)

101
Q

Hydrocodone

Side Effects (3)

A
  • Constipation
  • Respiratory Depression
  • Nausea
102
Q

Hydrocodone

Other note

A

Recreational Drug

103
Q

Codeine

Receptor type

A

Mu receptor

104
Q

Codeine (4)

Indications

A
  • Irritable Bowel Syndrome
  • Narcolepsy
  • Diarrhea
  • Cough

“Why would I need Codeine [IN DC] ? “

105
Q

Codeine

Side Effects (5)

A
  • Euphoria
  • Itching
  • Urinary Retention
  • Depression
  • Constipation
106
Q

Codeine

Other Note

A

Active metabolite is morphine

107
Q

Procaine (HCl)

Potency

108
Q

Procaine (HCl)

Onset of Analgesia

109
Q

Procaine (HCl)

Duration of Action

A

Short (30 - 45 min)

110
Q

Procaine (HCl)

Anesthetic Use

A

Infiltrative Nerve Block: Subarachnoid

111
Q

Cocaine (HCl)

Potency

112
Q

Cocaine (HCl)

Onset of Analgesia

A

Rapid (1 min)

113
Q

Cocaine (HCl)

Duration of Action

A

Medium (1 hr)

114
Q

Cocaine (HCl)

Anesthetic Use

A

Topical

Easily absorbed through mucous membrane

115
Q

Tetracaine (HCl)

Potency

116
Q

Tetracaine (HCl)

Onset of Analgesia

A

Slow for Spinal (15 - 20 min)

117
Q

Tetracaine (HCl)

Duration of Action

A

Long (2-5 hr)

118
Q

Tetracaine (HCl)

Anesthetic Use

A

Subarachnoid

119
Q

Benzocaine

Potency

A

(Topical use only)
poorly water soluble
dusting powder/ointment for wounds without concerns for systemic toxicity

120
Q

Benzocaine

Onset of Analgesia

A

Dependent upon pharmaceutical formulation

121
Q

Benzocaine

Duration of Action

A

Dependent upon pharmaceutical formulation

122
Q

Benzocaine

Anesthetic Use

123
Q

Lidocaine (HCl)
(Xylocaine)

Potency

124
Q

Lidocaine (HCl)
(Xylocaine)

Onset of Analgesic

125
Q

Lidocaine (HCl)
(Xylocaine)

Duration of Action

A

Medium (1.25 hr)

126
Q

Lidocaine (HCl)
(Xylocaine)

Anesthetic Use (4 Locations of Administration)

A 
Infiltrative Nerve Block:
Intravenous-
Epidural
Subarachnoid
Regional
127
Q

Mepivacaine (HCl)
(Carbocaine)

Potency

128
Q

Mepivacaine (HCl)
(Carbocaine)

Onset of Analgesia

A

Rapid (3-5 min)

129
Q

Mepivacaine (HCl)
(Carbocaine)

Duration of Action

130
Q

Mepivacaine (HCl)
(Carbocaine)

Anesthetic Use (2)

A

Infiltrative Nerve Block:

Epidural

131
Q

Ketamine

MOA

A

[NMDA RECEPTOR BLOCKER]

132
Q

Ketamine

Description of anesthesia

A

Dissociative anesthesia

133
Q

Ketamine

Physiological effects (6)

A

INCREASES in:

  • CMR O2 (Cerebral Metabolic Rate)
  • HR
  • Intra Cranial Pressure (ICP)
  • Cerebral Blood Flow
  • BP
  • BronchoDilation

” Ketamine INC that [C.H.I.C. BP] “

134
Q

A: List the 4 Systemic Effects of Propofol?

B: How is Propofol administered?

A

A:
1) DEC Intracranial Pressure

2) DEC CMRO2 of the brain
3) Vaso/venoDILATES –> Reduces both preload AND Afterload
4) Respiratory Depression

B: Propofol Route of Administration: INTRAVENOUS

135
Q

A: Ketamine is very strongly used as a ___Dilator

B: What does it do to these factors?

  • CMRO2
  • Cerebral blood flow
  • Intracranial Pressure
  • Blood Pressure
  • HR

C: MOA for Ketamine?

D: What are its 2 indications?

A

A: Ketamine is very strongly used as a BRONCHODILATOR

B: What does it do to these factors?

  • CMRO2 = INC
  • Cerebral blood flow = INC
  • Intracranial Pressure = INC
  • Blood Pressure = INC
  • HR = INC

C: MOA for Ketamine?
[NMDA Receptor BLOCKER]

D: ºShort Procedures ºAnesthetic Inducer

136
Q

3 Side Effects of Ketamine

A

1) Bad Dreams
2) Salivation
3) Twitching

137
Q

A: What’s the most dangerous side effect of [Intravenous Thiopental]?

B: Does Thiopental INC or DEC CMRO2?

A

A: Thiopental is a vasoCONSTRICTOR —> LIMB ISCHEMIA!

B: Thiopental still DEC CMRO2 in the brain

138
Q

A: Which IV Anesthetic has the least cardiovascular side effects?

B: What is the primary SIDE EFFECT for this [IV Anesthetic]?

C: This [IV Anesthetic] is a _______ [vasoDilator/vasoCONSTRICTOR] and will ______[INC/DEC] CMRO2

A

A: ETOMIDATE

B: Adrenal Suppression: Pt will not produce [Adrenal NorEpi] and thus be UNABLE TO MAINTAIN THEIR OWN BP

C: This [IV Anesthetic] is a vasoconstrictor and will DEC CMRO2 {like Thiopental}

139
Q

Pancuronium

Duration of Action

A

30 - 60 min

140
Q

Pancuronium

Mechanism of Action

A

Non-depolarizing blockade of muscle

Nicotinic receptors

141
Q

Pancuronium

Elimination

A

Primarily renal excretion

142
Q

Pancuronium

Rx (2)

A

Adjuvant in Surgical Anesthesia for:
1) Abdominal Wall Relaxation

2) Orthopedic Procedures

(same as Vecuronium)

143
Q

D-Tubocurarine

Duration of Action

144
Q

D-Tubocurarine

Mechanism of Action

A

[Non-Depolarizing Muscular Nicotinic Blocker]

145
Q

D-Tubocurarine

Elimination

A

Liver clearance and renal elimination

146
Q

D-Tubocurarine

Rx

A

Prototype

only used in lethal injection

🄼💊 M2 Adrenergic/Cholinergics (5 decks)

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