anesthetics, analgesics, and sedatives

Question 1

opioids moa

Answer 1

presynaptic block of Ca2+ influx in response to an action potential; post-synaptic increase in K+ efflux causing hyperpolarization

Question 2

opoid toxicity

Answer 2

respiratory depression, constipation, miosis

Question 3

opioid toxicity treatment

Answer 3

naltrexone or naloxone

Question 4

butorphanol moa

Answer 4

mu opioid partial agonist and kappa opioid receptor agonist

Question 5

tramadol moa

Answer 5

very weak opioid agonist; also inhibits serotonin and norepinephrine repute

Question 6

barbiturate moa

Answer 6

facilitates GABA action by increasing the duration of Cl channel opening

Question 7

barbiturate adverse effects

Answer 7

respiratory and CV depression (can be fatal); CNS depression exacerbated by EtOH use; induces CYPs

Question 8

benzodiazepine moa

Answer 8

facilitates GABA action by increases the frequency of Cl channel opening

Question 9

benzodiazepine affect on sleep cycle

Answer 9

decreases REM sleep

Question 10

short acting benzos

Answer 10

triazolam, oxazepam, and midazolam

Question 11

treatment of benzodiazepine OD

Answer 11

flumazenil

Question 12

zolpidem, zaleplon, and eszopiclone

Answer 12

act via the BZ1 subtype of the GABA receptor; lower risk of dependence

Question 13

inhaled anesthetics

Answer 13

halothane, the “fluranes” and nitrous oxide

Question 14

inhaled anesthetic effect

Answer 14

myocaridal depression, respiratory depression, nausea, increased cerebral blood flow

Question 15

treatment of malignant hyperthermia

Answer 15

dantrolene

Question 16

causes anesthetic that causes hepatotoxicity

Answer 16

halothane

Question 17

anesthetic that causes nephrotoxicity

Answer 17

methoxyflurane

Question 18

anesthetic that is pro-convulsant

Answer 18

enflurane

Question 19

causes malignant hyperthermia

Answer 19

inhaled anesthetics and succinylcholine

Question 20

ketamine moa

Answer 20

blocks NMDA receptors, produces dissociative anesthesia;

Question 21

ketamine effects

Answer 21

increases cerebral blood flow; stimulates the CV system;

Question 22

anesthetic that causes hallucinations

Answer 22

ketamine

Question 23

propofol moa

Answer 23

potentiates GABA

Question 24

propofol use

Answer 24

rapid anesthesia induction and short procedures

Question 25

local anesthetics moa

Answer 25

block Na channels by binding to a specific inner portion of the channel; preferentially bind to activated Na channels so must effective in rapidly firing neurons;

Question 26

order of loss with local anesthetics

Answer 26

pain , temp, touch, pressure;

Question 27

amide local anesthetics

Answer 27

have 2 I’s in the name

Question 28

ester local anesthetics

Answer 28

have only 1 I in the name

Question 29

depolarizing NM blocking drug moa

Answer 29

succinylcholine - strong ACh receptor agonist; produces sustained depolarization and prevents muscle contraction

Question 30

succinylcholine moa

Answer 30

strong ACh receptor agonist; produces sustained depolarization and prevents muscle contraction
phase I: prolonged depolairzation (no antidone; block potentiated by cholinesterase inhibitors)
phase II: repolarized but blocked; ACh receptors are available, but desensitized (antidote - cholinesterase inhibitors)

Question 31

nondepolarizing NM blockers

Answer 31

tubcurarine, atracurium, mivacurium, pancuronium, vecuronium, rocuronium

Question 32

nondepolarizing NM blockers moa

Answer 32

competitive antagonists at the ACh receptors

Question 33

reversal of NM block

Answer 33

cholinesterase inhibitors