CNS

Question 1

Midazolam-Mech of Action

Answer 1

Benzodiazipine- Facilitates inhibitory action of GABA by Binding to GABA A receptor causing opening of chloride channel hence increase conductance through the channels leading to hyperpolarization

Question 2

Pharmacokinetics of midazolam

Answer 2

Orally active, water solubility can be given IM IN IV
broken down to metabolites in liver which are excreted in kidney
crosses BBB CNS effects terminated by redistribution to Skeletal and adipose tissue
half life 2-4 hours

Question 3

Pharmacodynamics of midazolam

Answer 3

sedation
anticonvulsant
muscle relaxant
anaesthesia

Question 4

Olanzapine

Answer 4

Antipsychotic via Dopamine Antagonism.
Olanzapine- 5HT>D2=D1+alpha1
Low Extrapyrimidal
Mod sedative

Question 5

Haloperidol

Answer 5

Antipsychotic via Dopamine Antagonism.
D2>D1>alpha>5HT
High Extrapyrimidal effect (related to high D2 Affinity)- Parkinsonism, akathisia, acute dystonic reaction, tardive dyskinesia
Low sedative
Neuroleptic malignant syndrome

Question 6

Atropine-MOA

Answer 6

Reversible block of cholinergic muscarinic receptors

Question 7

Atropine- effects

Toxicity

Answer 7

CNS- decrease tremor and ridigity in parkinsonism
EYE- Mydriasis
CVS- shorten PR opposes vagal slowing of AV and SA conduction hence tachycardia
Resp-blocks secretion
GI- decrease Motility
GUS- Slows voiding blocks bladder contraction
SKin- Decrease sweating

Agiatation delerium
Inc Temp 
Flushed Skin
Dry skin/mouth
Urinary retention
Tachycardia
Blurry vision

Question 8

Prilocaine-MOA

Adverse effect

Answer 8

amide LA -Blocks Voltage gated Na channel
reversibly block impulse conduction along axons

CNS- Convulsions, drowsiness
CVS- negative inotropic, blocks pacemaker excitability and conduction
haem-methaemoglobinemia
allergy

Question 9

Morphine-MOA

Answer 9

Binds with G protein coupled receptors in the brain and spinal cord. causes:

1. closing of voltage gated Ca channel in the presynaptic neuron-dec Ca release hence limiting transmitter release.
2. Hyperpolarizes the post synaptic neuron by increase K conductance leading to formation of IPSP

Question 10

Morphine- Metabolism

Answer 10

Metabolised to Polar metabolite via glucorinadation in the liver. Conjugated to form M3G or M6G

Question 11

Morphine receptor

Answer 11

Full agonist at Mu partial at KAPPA and Gamma

Question 12

Dantrolene-MOA

USES

Answer 12

Blocks Ca release from Sarcoplasmic reticulum of skeletal muscle

NMS
Malignant hyperthermia
spasmolysis in cerebral palsy, MS

Question 13

Thiopentone
MOA

Propofol
MOA

Ketamine
MOA

Answer 13

Binds to GABA receptor and facilitates its action

Facilitates the inhibitory action of GABA and glycine.

Blocks the Glutamic acid receptors