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

Question 1

anesthetics

Answer 1

induces reverseable loss of sensation and/or consciousness

Question 2

analgesics

Answer 2

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

Question 3

general anesthetics

Answer 3

cause reverseable loss of consciousness

Question 4

local anesthetics

Answer 4

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

-caine

Question 5

Narcotics

Answer 5

• 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

Question 6

agonist

Answer 6

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

Question 7

morphine

Answer 7

• 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

Question 8

dextromethorphan

Answer 8

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

Question 9

codeine

Answer 9

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

Question 10

meperidine

Answer 10

• less potent than morphine
• no antitussive qualities

Question 11

heroin

Answer 11

• 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

Question 12

fentanyl

Answer 12

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

Question 13

methadone

Answer 13

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

Question 14

weak agonists

Answer 14

produce weaker analgesic effects than agonists

ex. tramadol

Question 15

antagonists

Answer 15

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”

Question 16

mixed agonist-antagonists

Answer 16

• 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

Question 17

psychiatric drugs

Answer 17

• 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

Question 18

antipsychotic drugs

Answer 18

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

Question 19

first-generation antipsychotics

Answer 19

• 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)

Question 20

second-generation antipsychotics

Answer 20

• 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-HT_2A receptors
• used to treat:
  
  • schizophrenia
  • bipolar disorder
  • autism

Question 21

mood disorder drugs

Answer 21

• 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

Question 22

SSRI

Answer 22

• 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

Question 23

SNRI

Answer 23

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

Question 24

heteocyclics

Answer 24

• 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

Question 25

MAO inhibitors

Answer 25

• 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)

Question 26

Other Mood Disorder Drugs

Answer 26

• 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

Question 27

Bipolar Drugs

Answer 27

• 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?

Question 28

CNS disorders

Answer 28

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

Question 29

Dementia Medications

Answer 29

• 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

Question 30

Anxiety Medications

Answer 30

• 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

Question 31

Parkinson’s Disease Medications

Answer 31

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

Question 32

Epilepsy Drugs

Answer 32

• 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.