CNS, Anesthetic, Relaxant, Psychiatric, and Opiod Drugs Flashcards by Gerald Libranda

Mnemonics-GABA receptors effects

FREnzodiazepines: FREquency
BarbiDURATes: DURATion

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What abnormal sleep pattern results from the use of benzodiazepines?

decreased REM sleep

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Which benzodiazepine has the longest half-life?

CHLORDIAZEPOXIDE has the longest half-life (36-200 hours) and the longest spelling (many letters)

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Which drugs are considered date-rape drugs?

Alcohol (most common)
Flunitrazepam (rohypnol)
Gamma-hydroxybutyrate

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Mnemonics-Thiopental

TAYOpental=TAYO agad (shortest acting)

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What enzyme is deficient in acute intermittent porphyria?

HMB synthase

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What is the most catastrophic symptom of sedative-hypnotic withdrawal?

rebound suicide

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Mnemonics-Zolpidem

zzZZzzZZzzZZzz (sleep)

Zolpidem, Zaleplon = Zleep disorders

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Mnemonics-Buspirone

Buspirone for Busy People (Always Anxious)

BuSPirone like your BenzodiaSePine

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Mnemonics-Wernicke-Korsakoff Syndrome

Weird ACO = Wernicke-Korsakoff Syndrome

-Ataxia, confusion, Ophthalmoplegia

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What changes in the brain are seen in Wernicke-Korsakoff syndrome?

Hemorrhagic necrosis of the mamillary bodies

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Mnemonics-Delirium Tremens

H-A-D 48
Hallucinations 
Autonomic instability
Delirium
48-72 hours post-discontinuation

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What drugs can cause disulfiram reaction?

Clara took the Pre-Medical Test in the PM
Chlorpropamide
Cefo Perazone
       Mandole
       Tetan
Procarbazine
Metronidazole

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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

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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.

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Mnemonics-Delirium Tremens

H-A-D 48
Hallucinations 
Autonomic instability
Delirium
48-72 hours post-discontinuation

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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