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DRUGS PHARMACOLOGY > CNS > Flashcards

CNS Flashcards

1
Q

N2O

A 
MAC -105%
quick, smooth induction 
good analgesia
minimal skeletal muscle relaxation
stimulate sympathetic tone- maintain cvs function

elevate intracranial pressure, pneumothorax, depress bone marrow, neuropathy

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2
Q

Diethyl ether

A 
inflammable, irritant
giod analgesia
marked skeletal muscle relaxation
prolonged induction
N, V, retching, eye congeetiin, sore tracheq, burns on face
reflex stimulation of respiration
sympathetic tone- maintain cvs function
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3
Q

halothane

A

potent (2-4/0.5-1)
relax uterus, intestine somewhat
reduce intracellular Ca, vagal stimulation- cvs functions decreased; no baroreceptor reflex- no reflex stimulation of heart
sensitize heart to Adr - arrhythmia
vasodilation (CO2)- brain; alveoli dilate - v:p mismatch
dilate bronchi - given to ASTHMA ppl

decreased urine
hepatitis
malignant hyperthermia (ryr1 )
29% METABOLISM

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4
Q

isoflurane

A 
irritant
less potent
quicker action
direct vasodilation (Coronary: steal)
sympathetic stimulation
uterine/sk muscle relaxation
NO pupil dilation, light reflex loss
no seizure - neurosurgery
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5
Q

desflurane

A 
with N2O and O2
irritant
low solubility- short action
steeper dose response
sympathetic stimulation
direct vasodilation
uterine, skeletal muscle relaxation
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6
Q

sevoflurane

A

I>S>D (pk, pd)
3% metabolised

quick induction/recovery
direct vd
no sympathetic stimulation- fall in bp

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7
Q

enflurane

A

seizure

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8
Q

thiopentone sodium iv - common induction

given with atropin, ms relaxant

A

ultra short acting
high lipid solubility (undissociated form)
alkaline solution - irritant- lrynx spasm
wide distribution
accumulates
redsitribution elimination 3 min, hepatic metabolism 8-12 hours
vasodilation - cvs collapse
reflex changes
vc in brain

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9
Q

arrhythmogenic

A

halothane

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10
Q

sympathetic stimulation

A

N2O, ether, isoflurane, desflurane

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11
Q

atropine and thiopentene

A

react chemically - not in same syringe

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12
Q

acute intermittent porphyria

A

thiopentone

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13
Q

naroanalysis

A

thiopentone

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14
Q

methohexitone sod.

A

more potent, quicker briefer action, EXCITEMENT common during recovery and induction

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15
Q

propofol i.v

A

unconsciousness in 15-45 secs, last for 5-10 min

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16
Q

propofol (with fentanyl) IV + lidocine

A

no airway irritation - used in asthmatics

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17
Q

asthmatics - general anesthetics

A

propofol, sevoflurane, halothane, ketamine

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18
Q

propofol adr

A

induction apnea, vasodilation, cvs normal and depression, barorelfex suppression, respiratory

acidosis, lipemia, heart failure

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19
Q

sympathetic stimulation

A

manage cvs function

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20
Q

etomidate

A

less potent anesthetic, relaxant tc

4 min action

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21
Q

BZD as general anesthetic

A

conscious sedation

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22
Q

diazepam iv

A

sedation, amnesia, unconsciousness in 5-10 min

redistribution in 15 mins - amnesia for 2 hours

23
Q

diazepam running iv drip

A

poor analgesic

(poor) central muscle relaxant

24
Q

BZD anesthesia antagonised by

A

flumazenil 2mg i.v

25
Q

lroazepam

A

more potent, less irritant than diazepam - SLOW ACTING

26
Q

midazolam

A

faster, shorter acting
more potent, less irritant

use -critical care anesthesia

27
Q

ketamine

A

dissociative anesthesia
site of action - cortex, subcortex
SYMPATHETIC stimulation
no respiratory depression

28
Q

ketamine - action duration

A

effect within min, recoveryin 15 min and amnesia for 2 hours

29
Q

ketamine - adr

A

emergence delirium, hallucination, involuntary movements (increased muscle tone)

30
Q

ketamine side effects

A

increase cerebral ((((oxygen consumption)))) and heart work

31
Q

rape drug

A

ketamine

32
Q

fentanyl

A 
lipohilic
short acting
opioid analgesic (pethidine related)
anesthetic awareness
parasympathetic stimulation - heart rate decrease
33
Q

fentanyl antagonist

A

naloxone

34
Q

dexmedetomidine

A

centrally active alpha 2A agonist - sedation

downregulate sympathetic response

35
Q

side effect dexmedetomidine and clonidine (alpha agonists)

A

dry mouth, hypotension ,bradycardia

36
Q

conscious sedation

A

diazepam (for 1 hour), midazolam (1 hour before surgery), propofol (iv infusion), N2O, fentanyl

37
Q

anesthetic and antihypertensives

A

BP falls

38
Q

opioids, neuroleptics, MAO I, clonidine

A

potentiate anesthetics

39
Q

halothane

A

sensitises heart to Adr

40
Q

corticosteroids + anesthetics

A

cvs collapse, adrenal insuffiency

41
Q

Diabetic on anesthesia

A

need more insulin

42
Q

pre anesthetic medication

A

antianxiety, amnesiacs, analgesics, anticholinergics, antiemetics, acid deceaser

43
Q

sedative antianxiety +fentanyl

A

diazepams, lorazepams, promethazine, pethidine, morphine, chlorpromazine, triflupromazine, haloperidol

44
Q

amnesiac

A

midazolam, hyoscine

45
Q

antihistaminic

A

promethazine

46
Q

antiemetic (increase stomach emptying and LES tone)

A

Metoclopromide, domperidone, promethazine, hyoscine, chlorpromazine, triflupromazine, haloperidol

47
Q

anticholinergic - reduce secretions, prevent bradycardia, hypotension,

A

atropine, hyoscine, glycopyrrolate (MAIN- antisecretory), promethazine

48
Q

analgesia

A

morphine, pethidine, FENTANYL,

49
Q

emergence delirium

A

ketamine, hyoscine,

50
Q

antimuscarnics

A

bronchodilation, pupil dilation, relax LES, DRY MOUTH

51
Q

neuroleptics

A

chlorpromazine, triflupromazine, haloperidol

52
Q

PPI/H2 blockers

A

ranitidine, famotidine, omeprazole

53
Q

antiemetics - increase stomach emptying and LES tone

A

metoclopromide - EPS

domperidone (no EPS side effects)

54
Q

antimetics - serotonin 3 blocker

A

ondansetron

DRUGS PHARMACOLOGY (5 decks)

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