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Pharmacology > CNS Drugs > Flashcards

CNS Drugs Flashcards

1
Q

Define sedative.

A

A drug that calms or relaxes and may induce a sleep state.

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2
Q

Define hypnotic.

A

A drug that induces sleep. Many drugs are classified as sedative-hypnotics.

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3
Q

Define anxiolytic.

A

A drug that reduces anxiety or tension.

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4
Q

Define anesthetic.

A

A drug that depresses the CNS, creating a loss of sensation and potentially a loss of consciousness.

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5
Q

Define analgesic.

A

A drug that reduces pain or the sensation of pain.

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6
Q

Define antipsychotic.

A

A drug used to treat psychosis (altered sense of reality).

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7
Q

What order do sedatives act on the CNS in?

A
  1. Cortex (cerebral, motor, etc.)
  2. Reticular activating system in the brainstem
  3. Medulla oblongata in the lower part of the brainstem.
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8
Q

What are the stages of CNS depression?

A

Relief from anxiety, disinhibition, hypnosis (sleep), general anesthesia, coma, death.

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9
Q

What kind of receptors are GABA receptors?

A

They are the main inhibitory receptor in the CNS

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10
Q

How do GABA receptors cause inhibition?

A

Stimulation of the receptors causes ion channel opening and an influx of Cl- into the cell, making the cell hyperpolarized and more difficult to cause action potential.

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11
Q

What are the main effects of GABA receptor stimulation?

A

Drowsiness and relaxation, amnesia, and lowered anxiety.

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12
Q

How do benzodiazepines work?

A

They are GABA receptor agonists.

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13
Q

What effects do benzodiazepines have on the body?

A

Sedation, decrease in anxiety, amnesia, muscle relaxation, and seizure prevention.

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14
Q

True or false: benzodiazepines have analgesic properties.

A

False

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15
Q

What class of drug is Diazepam?

A

Benzodiazepine.

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16
Q

What is the generic name for Valium?

A

Diazepam

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17
Q

What is the administration route and length of effect of diazepam (Valium)?

A

24 hours, given PO or IV

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18
Q

What class of drug is Lorazepam?

A

Benzodiazepine

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19
Q

What is the generic name for Ativan?

A

Lorazepam

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20
Q

What is the length of effect and route of administration for Lorazepam (Ativan)?

A

10 hours, PO or IV

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21
Q

What class of drug is Midazolam?

A

Benzodiazepine

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22
Q

What is the generic name for Versed?

A

Midazolam

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23
Q

What is the length of effect and route of administration for Midazolam (Versed)?

A

1-4 hours, given PO, IV, or IM

24
Q

What is the onset time for Midazolam (Versed)?

A

Rapid onset of 1-2 minutes.

25
Q

Which benzodiazepine is used as a short term sedative?

A

Midazolam (Versed)

26
Q

What class of drug is Flumazenil (Anexate)?

A

A benzodiazepine antagonist.

27
Q

What does Flumazenil (Anexate) do?

A

It blocks the benzo-specific site on the GABA receptor to reverse the sedative and respiratory depression of benzos.

28
Q

How do barbiturates work?

A

They are GABA receptor agonsits.

29
Q

What are the main problems with barbiturates?

A

They have a narrow therapeutic index, cause respiratory depression and hypotension, and have a high risk of addiction if used in the community.

30
Q

What class of drug is Phenobarbital?

A

A barbiturate

31
Q

What is Propofol (Diprivan)?

A

A GABA receptor agonist that is used as the main IV anesthetic agent.

32
Q

What are the benefits of Propofol?

A

Fast onset (1-2 minutes), easily titrated to effect, and has significant amnesia effect.

33
Q

Where is Propofol used?

A

In the OR for induction and maintenance of anesthetic state and in the ICU or ER as procedural sedation or maintenance of sedative state.

34
Q

What is the generic name of Propofol?

A

Diprivan

35
Q

What class of drug is Ketamine?

A

It is a dissociative anesthetic (opioid).

36
Q

What are some benefits to using Ketamine?

A

Minimal to no respiratory depression, mild cardiac stimulation, mild bronchodilatory effect, anti-inflammatory, no loss of upper airway muscle tone, and some analgesic effects.

37
Q

What is Dexmedetomidine (Precedex)?

A

A sedative-hypnotic with analgesic effects.

38
Q

How does Dexmedetomidine (Precedex) work?

A

It is an agonist for adrenergic receptors in the brain.

39
Q

How is Dexmedetomidine (Precedex) given?

A

As a continuous IV infusion

40
Q

What is Dexmedetomidine (Precedex) used for?

A

It has a short effect so it is used specifically for “fast-track” surgeries. It may also be used as continuous ICU sedation and may have benefit for conscious sedations.

41
Q

What are the benefits of using Dexmedetomidine (Precedex)?

A

Patients will respond to questions and stimuli and has minimal respiratory depression.

42
Q

What kind of drug is Haloperidol (Haldol).

A

An anti-psychotic

43
Q

How does Haloperidol (Haldol) work?

A

It blocks dopamine receptors in the CNS.

44
Q

How is Haloperidol (Haldol) given?

A

IV, IM, or PO

45
Q

What kind of drug is Quetiapine (Seroquel)?

A

An antipsychotic and antidepressant.

46
Q

How does quetiapine (Seroquel) work?

A

It blocks dopamine, serotonin, and adrenergic receptors in the CNS.

47
Q

What is Quetiapine (Seroquel) used for in the community?

A

Severe depression, schizophrenia, and bipolar disorders.

48
Q

What are the pathways for opioid analgesia?

A

Elevating pain threshold, dissociating from pain perception, and decreasing the response of the body to pain

49
Q

What is Codeine used for?

A

It is a weak analgesic taken PO for minor pain management (not used for severe acute pain).

50
Q

What is Morphine used for?

A

Moderate to severe pain levels

51
Q

How long does morphine last and how is it given?

A

Lasts 3-4 hours and is given IV, IM, sub-q, orally, inhaled, or via PCA pump for post-surgical pain, significant pain events, and palliative care.

52
Q

What is Hydromorphone?

A

Dilaudid. An artificial opioid that is used similarly to morphine but has easier fine tuning.

53
Q

What is Fentanyl used for?

A

Surgical procedures and induction.

54
Q

What are some symptoms of opioid overdose?

A

Pinpoint pupils, somnolence and coma, depressed or absent ventilation, and hypotension.

55
Q

What is the only depolarizing muscle blockade used in Canada?

A

Succinylcholine (Anectine)

56
Q

How does succinylcholine work?

A

It binds to nicotinic receptors on skeletal muscle (mimics ACh) which causes depolarization and prevents them from repolarizing.

57
Q

What non-depolarizing muscle blocker is normally used?

A

Rocuronium (Zemuron).

Pharmacology (10 decks)

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