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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
Carbidopa Side Effects (2)
Same as L-Dopa since it increases L-Dopa --> arrhythmia, dyskinesia
26
Selegiline Mechanism of Action
MAO-b inhibitor
27
Selegiline Rx
Parkinson's disease
28
Talcapone Mechanism of Action
COMT inhibitor
29
Talcapone Rx
Parkinson's disease
30
Methylphenidate Mechanism of Action
Dopamine reuptake inhibitor
31
Methylphenidate Rx
ADHD
32
Methylphenidate Side effect
Tachycardia
33
Mu (OP3) Locations (6)
Brain: - cortex (lamina III-IV) - Thalamus - Striosomes - periaqueductal gray Spinal Cord - substantial gelatinosa -Intestinal tract
34
Mu - subtype 1 Function (2)
- Supraspinal analgesia | - physical dependence
35
Mu - subtype 2 Function (5)
- Respiratory depression - miosis - euphoria - reduced GI mobility - physical dependence " Mu2 was a kinda GRUMP "
36
Mu - subtype 3 Function
unknown
37
Naloxone Receptors - antagonist/agonist (3)
mu-R: antagonist Delta-R: antagonist Kappa-R:antagonist
38
Naloxone A: Used for: B: Its indication helps prevent/reduce effects such as...(3) C: Has NO _______ properties characteristic of other narcotic antagonist
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
39
Naloxone Side Effects (4)
1. Change in mood 2. Trembling 3. Change in heart rhythm 4. Block the action of pain-lowering endorphins
40
MethaDone Receptor - Antagonist/agonist (2)
mu - agonist delta- agonist * (M)etha(D)one *
41
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.
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.
42
MethaDone Function
Treats Opioid Dependence
43
Tizanidine Physiological effect:
[CENTRAL a2 agonist] that acts on pre and post-synpatic nerves of Spinal Cord ---> Inhibition
44
Tizanidine | Indication (2)
Multiple sclerosis | Spinal spasticity
45
Tizanidine | Toxicity (2)
Drowsiness | Hypotension
46
Dantrolene | Physiological Actions
Blocks calcium release from SR of skeletal muscle
47
Dantrolene | Indications (5)
- SPASMS 2º to Stroke - SPASMS 2º to Spinal Cord Injury - Malignant Hyperthermia - Cerebral Palsy - Multiple Sclerosis
48
Dantrolene | Toxicity (3)
- Muscle weakness - Sedation - Hepatitis
49
Metaclopramide MOA: Side effects (2) :
MOA: [D2 Blocker] with some [5HT4 agonist] SE: [Focal dystonia], Akathisia, [Tardive Dystonia after 3 months] M.SE.FAT
50
Metaclopramide: Contraindications:
Contraindications: long-term rx (3 months | can cause tardive dyskinesia)
51
Haloperidol MOA: Indications (2):
MOA: [D2 Blocker] Indications: ºacute psychosis ºlong-term depot for poorly compliant schizophrenic patients
52
Haloperidol | Side Effects:
extrapyramidal motor disturbances
53
``` Trazadone MOA (2) ```
[5-HT2A/2C BLOCKER] + SSRI
54
``` Trazadone Indications (2) ```
Anxiety/depression
55
Trazadone SE
Warning of suicidality in young adults at initiation of treatment
56
Trazadone Contraindicaitons
MAO inhibitors
57
Nociceptin receptor (OP4) Subtypes
ORL1
58
Nociceptin receptor location (7)
Brain: - Cortex - Amygdala - hippocampus - septal nuclei - habenula - hypothalamus Spinal cord
59
Nociceptin function (3)
- anxiety - depression - appetite
60
Pentazocin Receptor subtypes and action
m-receptor: antagonist d-receptor: agonist K-receptor: agonist
61
Pentazocin | Indications
Dental extraction
62
Pantazocin Side Effects: (2)
1. Hallucinations/Psychomimetic Effects | 2. Cardiovascular effects
63
5-HTP Mechanism of Action
5-HT Precursor
64
5-HTP Rx
Depression
65
Buspirone Mechanism of Action
5-HT1A partial agonist
66
Buspirone Rx (2)
Anxiety/depression
67
Buspirone Side Effects
Early increase in anxiety
68
Sumatriptan Mechanism of Action
5-HT1D agonist
69
Sumatriptan Rx
Migraine
70
Sumatriptan Side Effects
Coronary vasoconstriction
71
Risperidone Mechanism of Action
5-HT2A/2C BLOCKER
72
Risperidone Rx (2)
- Depression | - Psychosis
73
Risperidone Side Effects (2)
1. Akathisia (also occurs as Metaclopramide SE) | 2. Weight Gain
74
Odansetron Mechanism of Action
5-HT3
75
Odansetron Rx
Chemotherapy-induced emisis
76
Fluoxetine Mechanism of Action
SSRI
77
Fluoxetine Rx (6)
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
Fluoxetine Side Effects (2)
Sexual Dysfunction | Insomnia
79
Sertraline Mechanism of Action
SSRI
80
Sertraline Rx (6)
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
Sertraline Side Effects (2)
Sexual Dysfunction | Insomnia
82
L-DOPA Mechanism of Action
Dopamine Precursor
83
L-DOPA Rx
Parkinson's Disease
84
L-DOPA Side Effects (2)
Arrythmia | Dyskinesia
85
Delta (OP1) Subtypes (2)
Delta 1 | Delta 2
86
Delta (OP1) Location (4)
Brain - Pontine Nuclei - Amygdala - Olfactory bulbs - Deep Cortex
87
Delta (OP1) Function (3)
- Analgesia - Antidepressant effects - Physical dependence
88
Kappa (OP2) Subtypes (3)
Kappa 1 Kappa 2 Kappa 3
89
Kappa (OP2) Location (4)
Brain: - Hypothalamus - Periaqueductal Gray - Claustrum Spinal Cord: -Substantia Gelatinosa
90
Kappa (OP2) Function (5)
- Miosis (and MEPERIDINE uses this receptor) - Inhibits ADH release - Sedation - Spinal Analgesia -Dysphoria " [MISS D] loved her some Kappas"
91
Morphine receptor type
Mu
92
Morphine Indication
severe pain
93
Morphine Side Effects (3)
(x) Constipation (x) Addiction (x) Tolerance
94
Morphine Antidote
Naloxone
95
Meperidine Receptor type
Kappa receptor
96
Meperidine Indication
Severe pain
97
Meperidine Side Effects (4)
- Seizure - Dysphoria - Tremor - Respiratory Depression
98
Meperidine Other Notes (2)
1) Also binds: K+ channels, Muscarinic receptors, Dopamine transporter 2) Do not use Naloxone as andtidote
99
Hydrocodone Receptor types (2)
Mu | Delta
100
Hydrocodone Indication (2)
1. Moderate pain | 2. Coughing (anti-tussive)
101
Hydrocodone Side Effects (3)
- Constipation - Respiratory Depression - Nausea
102
Hydrocodone Other note
Recreational Drug
103
Codeine Receptor type
Mu receptor
104
Codeine (4) Indications
- Irritable Bowel Syndrome - Narcolepsy - Diarrhea - Cough "Why would I need Codeine [IN DC] ? "
105
Codeine Side Effects (5)
- Euphoria - Itching - Urinary Retention - Depression - Constipation
106
Codeine Other Note
Active metabolite is morphine
107
Procaine (HCl) Potency
1
108
Procaine (HCl) Onset of Analgesia
Slow
109
Procaine (HCl) Duration of Action
Short (30 - 45 min)
110
Procaine (HCl) Anesthetic Use
Infiltrative Nerve Block: Subarachnoid
111
Cocaine (HCl) Potency
2
112
Cocaine (HCl) Onset of Analgesia
Rapid (1 min)
113
Cocaine (HCl) Duration of Action
Medium (1 hr)
114
Cocaine (HCl) Anesthetic Use
Topical Easily absorbed through mucous membrane
115
Tetracaine (HCl) Potency
16
116
Tetracaine (HCl) Onset of Analgesia
Slow for Spinal (15 - 20 min)
117
Tetracaine (HCl) Duration of Action
Long (2-5 hr)
118
Tetracaine (HCl) Anesthetic Use
Subarachnoid
119
Benzocaine Potency
(Topical use only) poorly water soluble dusting powder/ointment for wounds without concerns for systemic toxicity
120
Benzocaine Onset of Analgesia
Dependent upon pharmaceutical formulation
121
Benzocaine Duration of Action
Dependent upon pharmaceutical formulation
122
Benzocaine Anesthetic Use
Topical
123
Lidocaine (HCl) (Xylocaine) Potency
4
124
Lidocaine (HCl) (Xylocaine) Onset of Analgesic
Rapid
125
Lidocaine (HCl) (Xylocaine) Duration of Action
Medium (1.25 hr)
126
Lidocaine (HCl) (Xylocaine) Anesthetic Use (4 Locations of Administration)
``` Infiltrative Nerve Block: Intravenous- Epidural Subarachnoid Regional ```
127
Mepivacaine (HCl) (Carbocaine) Potency
2
128
Mepivacaine (HCl) (Carbocaine) Onset of Analgesia
Rapid (3-5 min)
129
Mepivacaine (HCl) (Carbocaine) Duration of Action
Medium
130
Mepivacaine (HCl) (Carbocaine) Anesthetic Use (2)
Infiltrative Nerve Block: | Epidural
131
Ketamine MOA
[NMDA RECEPTOR BLOCKER]
132
Ketamine Description of anesthesia
Dissociative anesthesia
133
Ketamine Physiological effects (6)
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
A: List the 4 Systemic Effects of Propofol? B: How is Propofol administered?
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
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: 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
3 Side Effects of Ketamine
1) Bad Dreams 2) Salivation 3) Twitching
137
A: What's the most dangerous side effect of [Intravenous Thiopental]? B: Does Thiopental INC or DEC CMRO2?
A: Thiopental is a vasoCONSTRICTOR ---> LIMB ISCHEMIA! B: Thiopental still DEC CMRO2 in the brain
138
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: 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
Pancuronium Duration of Action
30 - 60 min
140
Pancuronium Mechanism of Action
Non-depolarizing blockade of muscle | Nicotinic receptors
141
Pancuronium Elimination
Primarily renal excretion
142
Pancuronium Rx (2)
Adjuvant in Surgical Anesthesia for: 1) Abdominal Wall Relaxation 2) Orthopedic Procedures (same as Vecuronium)
143
D-Tubocurarine Duration of Action
>60 min
144
D-Tubocurarine Mechanism of Action
[Non-Depolarizing Muscular Nicotinic Blocker]
145
D-Tubocurarine Elimination
Liver clearance and renal elimination
146
D-Tubocurarine Rx
Prototype | only used in lethal injection

🄼💊 M2 Adrenergic/Cholinergics (5 decks)

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