A: 1-5 Flashcards

1
Q

How can we block the sensory transmissionfrom from a local area of the body to the CNS?

A

Inhibition of voltage dependent Na+ ch.

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2
Q

What will enhance the effect of local anesthetics?

A

Elevated extracellular K+ conc.

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3
Q

What will antag. the effect of local anes.?

A

Elevated E.c Ca2+ conc.

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4
Q

Give the properties of the best molecule to cross the lipid membrane?

A

Lipid soluble
Non-ionized
Uncharged

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5
Q

Which molecule is more effective in blocking?

Non ionizing/Ionizing

A

Ionizing

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6
Q

Nerve fiber sensitivity- What are the properties of a nerve that will get block fast?

A

Small fiber diameter
Myelinated
High firing rate
Anatomic location

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7
Q

Which fiber type is considered to be heavily myelinated?

A

Type A

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8
Q

Except _____ all local anesthetics are _____

A

Cocaine

Vasodilators

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9
Q

Local anesthetics can be devided into two groups

A

Amides

Esters

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10
Q

Local anesthestics- Amides can be devided into 2

A

Long acting: Bupivacaine, ropivacaine

Medium acting: Lidocaine, articain

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11
Q

Local anesthetics- Esters

A

Surface acting: Cocaine, benzocaine

short action: procaine

long action: tetracaine

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12
Q

Which are the short acting Amides?

A

Lidocaine

Articaine

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13
Q

Lidocaine MOA

A

Blockage of VDNaC

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14
Q

Which local anesthestic has the fastest duration of action?

A

Articaine

אתה מלקק ארטיק וזה ישר עושה לך בריין פריז

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15
Q

Lidocaine metabolism

A

CYP 450

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16
Q

Lidocaine duration of action

A

1-2 h

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17
Q

What can prolonged the duration of action of Lidocaine?

A

Epinephrine co-admin.

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18
Q

Which is the Amides long acting agent?

A

Bupivacaine

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19
Q

Bupivacaine duration of action

A

3-6 h

20
Q

Bupivacaine metabolism

A

CYP 450

21
Q

Cocaine metabolism

A

Plasma Cholinesterase

22
Q

Cocaine duration of action

A

1-2 h

23
Q

When is Cocaine used?

A

Procedures requiring high surface activity and vasoconstriction

24
Q

Cocaine side effects

A

CNS
Arrhythmias
HTN
Coronary vasospasm

25
Q

Drugs pKa

A

The pH at which the molecule is 50% ionized and 50% non ionized

26
Q

The lower the pKa the more ____ the drug

A

Acidic

27
Q

Lipid solubility of a drug is invrsley proportional to

A

Its charge

28
Q

Urine alkalization will promote excrtion of which drugs?

A

Isonizaid

Weak acids

29
Q

Urine acidification will promote excrtion of which drugs?

A

Morphine
Nicotine
Weak base

30
Q

Volume of distribution=

A

Amount of drug in the body / Plasma drug conc.

31
Q

Example for a drug which is highly bound to plasma proteins

A

Warfarin is bound to Albumin

NASID’s can displace Warfarin from Albumin

32
Q

Pharmacokinetics include

A

Absorption
Distribution
Metabolism
Elimination

33
Q

Phase I reaction possabilities

A

Oxidation
Reduction
Hydrolysis

34
Q

Types of elimination

A

First order

Zero order

35
Q

First order elimination

A

Rate of elimination is proportional to plasma conc.
Constant fraction of drug is eliminated per unit time
Higher thee conc. –> Greater the amount eliminated

36
Q

Zero order elimination

A

Rate of elimination is constant regardless of the conc.

37
Q

Receptor theory=

A

Classic receptor theory
Two state receptor theory (inactive, active)
Spare receptor theory

38
Q

Potency=

A

Amount of a drug required to produce a givven effect

39
Q

Efficiacy=

A

Maximal effect an agonist can produce if the dose is taken into the highest tolerated level

40
Q

The higher the ____________ the safer the drug

A

Theraputic index

41
Q

Example for synergistic drug interactions

Additive

A

Aspirin and Ibuprofen

42
Q

Example for synergistic drug interactions

Potentiation

A

Caffeine and NASID’s

43
Q

Pharmacokinetics is=

A

How a body processes a drug

44
Q

Process of drug developement

A

In vitro
Animal atudying
Clinical testing
Marketing

45
Q

Clinical testing phases

A

Phase 1: 20-100 subjects. is it safe?
Phase 2: 100-200 does it work?
Phase 3: 1000-6000 double blind