Anesthetics, Narcotic Pain Relievers, Psychiatric Drugs & Drugs for CNS Disorders Flashcards

1
Q

anesthetics

A

induces reverseable loss of sensation and/or consciousness

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2
Q

analgesics

A

work to relieve pain without loss of sensation and/or consciousness

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3
Q

general anesthetics

A

cause reverseable loss of consciousness

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4
Q

local anesthetics

A

cause reverseable loss of sensation for a limited region of the body while maintaining consciousness

-caine

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5
Q

Narcotics

A
  • opiates
  • act on specific receptors in the CNS and work to reduce the perception of pain
    • mu (this is the major target)
    • kappa
    • and delta receptors
  • four groups
    • agonists
    • weak agonists
    • antagonists
    • mixed agonist-antagonists
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6
Q

agonist

A

narcotic drug that binds to opoid receptors, activating them, resulting in full opoid effect

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7
Q

morphine

A
  • the best-known agonist
  • acts primarily in the CNS
  • reduces awareness of pain and produces drowsiness and sedation
  • at certain concentrations, acts in the medulla as a cough suppressant
  • also produces
    • pupillary constriction
    • respiratory depression
    • decreases movement of material in GI tract
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8
Q

dextromethorphan

A
  • chemically similar to morphine
  • does not have the same pain-reduction properties
  • does have antitussive properties
    • found in may OTC cough medications
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9
Q

codeine

A
  • less potent than morphine
  • also used for pain management
  • also used for cough suppressant
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10
Q

meperidine

A
  • less potent than morphine
  • no antitussive qualities
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11
Q

heroin

A
  • more fat-soluble than morphine and rapidly crosses the blood-brain barrier
  • converted to morphine in the brain
  • more rapid acting than morphine
  • very strong analgesic
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12
Q

fentanyl

A
  • 80 x more potent than morphine
  • short duration of action
  • primarily used by anesthesiologists
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13
Q

methadone

A
  • effective oral analgesic
  • longer duration than morphine
  • anti-addictive use for opiates
  • is also addicting
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14
Q

weak agonists

A

produce weaker analgesic effects than agonists

ex. tramadol

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15
Q

antagonists

A

in contrast to agonists: antagonists bind to opiod receptors to deactivate it

  • no effect when given alone (as opiods must first activate the receptor)
  • used as narcotic “antidote”
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16
Q

mixed agonist-antagonists

A
  • this contradictory concept presents as an agonist to the kappa receptor in the brain which gives them analgesic activity, but appear as antagonists to the mu receptor (the one agonists work on)
  • produces a similar effect to morphine
17
Q

psychiatric drugs

A
  • treat psychiatric disorders by exerting an effect on the chemical makeup of the brain and the CNS
  • work by a variety of mechanisms
  • usedin psychiatric settings
  • two major classes:
    • antipsychotics
    • mood disorder drugs
18
Q

antipsychotic drugs

A
  • also referred to as:
    • neuroleptic drugs
    • antischizophrenic drugs
  • categorized as:
    • alpha-blockers
    • muscarinic antagonists
    • histamine antagonists
  • organized by:
    • 1st generation
    • 2nd generation (newer meds)
19
Q

first-generation antipsychotics

A
  • typical antipsychotics
  • used to treat psychoses
    • schizophrenia
    • acute mania
    • agitation
  • work by blocking dopamine receptors in the brain
  • side effect:
    • extrapyramidal motor control disabilities - Parkinson’s like movements (unsteadiness)
20
Q

second-generation antipsychotics

A
  • atypical antipsychotics
  • reduce the positive (hallucinations, dellusions, disordered thought) and negative (withdrawal, catatonia) symptoms of schizophrenia
  • work at a combination of receptors to accomplish both effects
    • dopamine receptors
    • 5-HT2A receptors
  • used to treat:
    • schizophrenia
    • bipolar disorder
    • autism
21
Q

mood disorder drugs

A
  • antidepressant drugs
  • work by increasing the concentration of norepinepherine or serotonin
    • both of which are neurotransmitters in the synaptic cleft
  • main classifications:
    • SSRIs
    • SNRIs
    • hetrocyclics
    • MAO inhibitors
  • names of mood disorder drugs are not similar
    • do not share a common stem
22
Q

SSRI

A
  • selective serotonin reuptake inhibitors
  • increase the concentration of serotonin
  • takes several weeks to achieve full effect
  • no evidence supports one SSRI being any more effective than another
  • abruptly stopping medication may cause withdrawal symptoms
23
Q

SNRI

A
  • serotonin-norepinephrine reuptake inhibitors
  • increase concentration of serotonin and norepinephrine
  • can cause dose-dependent increase in BP
24
Q

heteocyclics

A
  • named after chemical structure of this class
  • block the reuptake of biogenic amines, including serotonin and norepinephrine
  • however, they have no idea how
  • several weeks for full therapeutic effect
  • little to no effect on non-depressed individuals
25
Q

MAO inhibitors

A
  • monoamine oxidase inhibitors
  • works by increaseing concentration of norepinephrins, serotonin, and dopamine in the blood by inhibiting the degredation of these chemicals
  • are not used much any longer, though they are still an effective antidepressant
  • can cause a fatal hypertensive crisis
  • precautions;
    • do not take with SSRIs
    • do not eat food rich in tyramine (includes cheese, beer, & red wine)
26
Q

Other Mood Disorder Drugs

A
  • bupropion
    • antidepressant that’s also used for smoking cessation
  • mirtazapine
    • antidepressant that works through a different mechanism of action than most others
  • sibutramine
    • also increases norepinephrine but is more often prescribed for weight loss
27
Q

Bipolar Drugs

A
  • falls somewhat into mood-disorder category since the goal of treatment is to reduce the frequency and severity of mood fluctuations
  • Primary drug of treatment:
    • lithium
  • other drugs now used:
    • carbamazepine
    • valproate
  • mechanism of action for these drugs is - who the hell knows?
28
Q

CNS disorders

A
  • includes treatment of:
    • dementia
    • anxiety
    • Parkinson’s disease
    • epilepsy
29
Q

Dementia Medications

A
  • includes Alzheimer’s disease
  • these drugs produce only marginal improvements in symptoms and do not alter the underlying pathology
  • these drugs primarily increase the amount of acetylcholine by inhibiting its breakdown
  • also known as:
    • cholinesterase inhibitors
30
Q

Anxiety Medications

A
  • anxiolytics & hypnotics
  • these drugs are used for a variety of purposes including anxiety and epilepsy
    • also used for:
      • induction of sleep
      • induction of anesthesia
  • categorized by their chemical structure
  • 2 largest groups:
    • barbiturates (-tal or -barbital)
    • benzodiazepines (-pam or -lam)
  • at low doses, all of these drugs work to reduce anxiety
  • at higher doses, they produce a more pronounced sedation
31
Q

Parkinson’s Disease Medications

A
  • dopamine replacement drugs
    • levodopa
    • carbidopa
  • dopamine-agonist therapy
    • bromocriptine
  • anticholinergic therapy (less commonly used)
    • trihexyphenidyl
32
Q

Epilepsy Drugs

A
  • valproate
    • used for generalized convulsive seizures
    • can cause fatal hepatic failure
  • carbamazepine
    • used for partial seizure types
    • taken up to 4 times a day
    • commonly causes nausea and drowsiness
  • ethosuximide
    • used for absence seizures
  • phenytoin
    • used for epilepsy
    • has been replaced by newer drugs in U.S.