CNS, Anesthetic, Relaxant, Psychiatric, and Opiod Drugs Flashcards
Mnemonics-GABA receptors effects
FREnzodiazepines: FREquency
BarbiDURATes: DURATion
What abnormal sleep pattern results from the use of benzodiazepines?
decreased REM sleep
Which benzodiazepine has the longest half-life?
CHLORDIAZEPOXIDE has the longest half-life (36-200 hours) and the longest spelling (many letters)
Which drugs are considered date-rape drugs?
Alcohol (most common)
Flunitrazepam (rohypnol)
Gamma-hydroxybutyrate
Mnemonics-Thiopental
TAYOpental=TAYO agad (shortest acting)
What enzyme is deficient in acute intermittent porphyria?
HMB synthase
What is the most catastrophic symptom of sedative-hypnotic withdrawal?
rebound suicide
Mnemonics-Zolpidem
zzZZzzZZzzZZzz (sleep)
Zolpidem, Zaleplon = Zleep disorders
Mnemonics-Buspirone
Buspirone for Busy People (Always Anxious)
BuSPirone like your BenzodiaSePine
Mnemonics-Wernicke-Korsakoff Syndrome
Weird ACO = Wernicke-Korsakoff Syndrome
-Ataxia, confusion, Ophthalmoplegia
What changes in the brain are seen in Wernicke-Korsakoff syndrome?
Hemorrhagic necrosis of the mamillary bodies
Mnemonics-Delirium Tremens
H-A-D 48 Hallucinations Autonomic instability Delirium 48-72 hours post-discontinuation
What drugs can cause disulfiram reaction?
Clara took the Pre-Medical Test in the PM Chlorpropamide Cefo Perazone Mandole Tetan Procarbazine Metronidazole
How will you distinguish whether local anesthetics are esters or amides?
ESTERS have only 1 i in their names.
Tetracaine, Procaine, Benzocaine
AMIDES have 2 i’s in their names.
Bupivacaine, Ropivacaine, Lidocaine
Which local anesthetics have the shortest and the longest half-lives?
PROCAINE = shortest half-life (1-2 mins)
A PRO finishes the race fastest.
ROPIVACAINE = longest half-life (4.2 hrs)
At the end of the long ROPe.
Mnemonics-Delirium Tremens
H-A-D 48 Hallucinations Autonomic instability Delirium 48-72 hours post-discontinuation
What drugs can cause disulfiram reaction?
Clara took the Pre-Medical Test in the PM Chlorpropamide Cefo Perazone Mandole Tetan Procarbazine Metronidazole
How will you distinguish whether local anesthetics are esters or amides?
ESTERS have only 1 i in their names.
Tetracaine, Procaine, Benzocaine
AMIDES have 2 i’s in their names.
Bupivacaine, Ropivacaine, Lidocaine
Which local anesthetics have the shortest and the longest half-lives?
PROCAINE = shortest half-life (1-2 mins)
A PRO finishes the race fastest.
ROPIVACAINE = longest half-life (4.2 hrs)
At the end of the long ROPe.
Why should you NOT inject local anesthetics into an abscess during incision and drainage?
- won’t work due to acidic environment
- (below pKa = uncharged form with no anesthetic activity predominates)
What is the toxic dose of LIDOCAINE?
toxic dose = 5 mg/kg for any drug or solution, 1% = 10 mg/mL For a 70 kg patient: 70 kg x 5 mg/kg = 350 mg toxic dose If 1% solution is used: 350 mg/10 mg/mL = 35 mL
What are the drugs used in lethal injection?
Thiopental (5g)
Pancuronium (100mg)
Potassium Chloride (100mEq)
What are the primary signs of Parkinson Disease?
PARKINSON DISEASE It's a TRAP Tremor Rigidity Akinesia Postural instability
What drugs can cause livedo reticularis?
A man reads FHM and GQ! Amantadine Hydroxyurea Minocycline Gemcitabine Quinidine
What are the features of neuroleptic malignant syndrome?
NEUROLEPTIC MALIGNANT SYNDROME Fever Encephalopathy Vitals unstable Elevated CPK Rigidity
Differentiate Malignant Hyperthermia (MH), Serotonin Syndrome (SS), and Neuroleptic Malignant Syndrome (NMS) based on ONSET
MH: Within minutes
SS: Within hours
NMS: 1-3 days
What drugs can cause erectile dysfunction?
ERECTILE DYSFUNCTIONS A SORE PEniS can't Fuck Hard! SSRIs Opiates Risperidone Ethanol Propranolol Estrogens Spironolactone Finasteride Hydrochlorothiazide
What drugs can cause priapism?
PRIAPISM Tigas PeniS Co, AyaW Bumaba! Trazodone Papaverine Sildenafil Quetiapine Alprostadil Warfarin Bupropion
Differentiate Malignant Hyperthermia (MH), Serotonin Syndrome (SS), and Neuroleptic Malignant Syndrome (NMS) based on CLINICAL FEATURES
MH: Fever, Acidosis, Rhabdomyolysis, Trismus, Clonus, Hypertension
SS: Fever, Agitation, Tremor, Clonus, Hyperreflexia, Diaphoresis
NMS: Fever, Encephalophaty, Vitals unstable, Elevated CPK, Rigidity
Differentiate Malignant Hyperthermia (MH), Serotonin Syndrome (SS), and Neuroleptic Malignant Syndrome (NMS) based on FIRST-LINE TREATMENT
MH: Dantrolene
SS: Sedation, paralysis, intubation and ventilation, cyproheptadine
NMS: Dantolene + support
Differentiate Malignant Hyperthermia (MH), Serotonin Syndrome (SS), and Neuroleptic Malignant Syndrome (NMS) based on PRECIPITATING DRUG
MH: Volatile anesthetics (halothane), succinylcholine
SS: SSRIs, MAOIs, TCAs, meperidine, MDMA, St. John wort
NMS: Antipsychotics
Differentiate Malignant Hyperthermia (MH), Serotonin Syndrome (SS), and Neuroleptic Malignant Syndrome (NMS) based on MECHANISM
MH: Massive Calcium release from SR
SS: Excess serotonin
NMS: Dopamine antagonism
Differentiate Malignant Hyperthermia (MH), Serotonin Syndrome (SS), and Neuroleptic Malignant Syndrome (NMS) based on CLINICAL FEATURES
MH: Fever, Acidosis, Rhabdomyolysis, Trismus, Clonus, Hypertension
SS: Fever, Agitation, Tremor, Clonus, Hyper
Differentiate Malignant Hyperthermia (MH), Serotonin Syndrome (SS), and Neuroleptic Malignant Syndrome (NMS) based on FIRST-LINE TREATMENT
MH: Dantrolene
SS: Sedation, paralysis, intubation and ventilation
NMS: Dantolene + support
Differentiate Malignant Hyperthermia (MH), Serotonin Syndrome (SS), and Neuroleptic Malignant Syndrome (NMS) based on OTHER TREATMENT
MH: Cooling
SS: Cooling, cyproheptadine, chlorpromazine
NMS: Cooling, dantrolene, bromocriptine, amantadine, diazepam
Which opioids have the shortest and longest half-lives?
REMIFENTANIL = shortest half-life (3-4 mins) BUPRENORPHINE = longest half-life (4-8 hrs)
How do you remember the opioid receptors?
- (MU) receptor = Mabagal hUminga
- (delTa) receptor = Tolerance
- (Kappa) receptor = Konstipation
Morphine Effects
Miosis Orthostatic hypotential Pulmonary depression Histamine release Increased ICP Nausea Euphoria
What is the triad of opioid overdose?
OPIOID OVERDOSE P-C-R Pupillary constriction Comatose state Respiratory depression
Mnemonics- Cocaine Intoxication
Nakakita ka ng ice-cold coke. Na-excite ka. Nanlaki ang mata mo.
COCAINE = mydriasis
Mnemonics-Marijuana Intoxication
BLOODY MARY
MARIJUANA = red conjunctiva