CNS stimulants- COMP

Question 1

What agents are considered to be CNS stimulants?

Answer 1

Drugs that stimulate nervous system (CNS) as their primary action are classified as analeptics or convulsants.

Question 2

Analeptics can increase excitability by either blocking

Answer 2

inhibition or enhancing excitation.

Question 3

Doxapram is a

Action of ventilation?

Answer 3

centrally acting analeptic that selectively increases minute ventilation by activating the carotid bodies.

Question 4

Stimulus produced by 1mg/kg of doxapram is

Answer 4

equivalent to that produced by a PaO2 of 38mm Hg acting on the carotid bodies.

Question 5

What is responsible for increase in minute ventilation associated with doxapram.

Answer 5

An increase in tidal volume, more than an increase in breathing frequency

Question 6

Which drugs has a large margin of safety

Answer 6

Doxapram

Question 7

_______is useful in the treatment of ADHD in children.

Answer 7

Methylphenidate

Question 8

The best-characterized cellular action of methylxanthines is

Answer 8

antagonism of adenosine

Question 9

Methylxanthines are metabolized

Answer 9

primarily in the liver.

Question 10

Premature infants and theophylline

Answer 10

Premature infants metabolize theophylline in part to caffeine, and therefore theophylline can be used to
stimulate respirations in neonates with primary apnea of prematurity.

Question 11

The prominent effect of caffeine is

Answer 11

CNS stimulation.

Question 12

Caffeine also causes cerebral vasoconstriction and cause

Answer 12

secretion of gastric fluid.

Question 13

Postdural puncture headache may respond to

Answer 13

300mg of caffeine.

Question 14

The primary effects of nicotine is

Answer 14

initial stimulation followed by persistent depression

of autonomic ganglia.

Question 15

CV nicotine

Answer 15

Nicotine also increases heart rate and SBP and evokes peripheral vasoconstriction.

Question 16

Ingestion of nicotine

Answer 16

Ingestion of cigarette

ENOUGH nicotine in one cigarette can kill a child

Question 17

Nicotine GI largely due to _____stimulation

Leading to _____and_____

Answer 17

Largely due to parasympathetic stimulation.
Leading to vomiting and diarrhea.
Increase in salivary and bronchial secretions followed by inhibit

Question 18

Fatal dose of nicotine in adults

Answer 18

Fatal overdose of nicotine in adults is about 60mg.

Question 19

A GABA analogue that is often administered for treatment of spasticity, due to diseases or injury to the spinal
cord.

Answer 19

Baclofen

Question 20

KNow DANDROLENE MOA

Answer 20

Produces skeletal muscle relaxation by a direct action
on excitation-contraction coupling, presumably by
decreasing the amount of calcium released from
sarcoplasmic reticulum.

Question 21

Dandrolene NM

Answer 21

Neuromuscular transmission and electrical properties

of the skeletal muscle cell membranes are not altered

Question 22

Unlike neuromuscular blocking agents, Dantrolene

cannot

Answer 22

decrease contractile activity by 80%.

Question 23

Dantrolene in therapeutic doses has little effect on

Answer 23

cardiac and smooth muscle.

Question 24

Does Dantrolene impair polysynaptic reflexes like

centrally acting agents?

Answer 24

does not impair polysynaptic reflexes like

centrally acting agents.

Question 25

Absorption from the GI tract and IV injection provides

sustained

Answer 25

dose related concentration in the plasma.

Question 26

Dandrolene: The IV preparation can cause

Answer 26

phlebitis due to high pH (9.5).

Question 27

Extravasation of dantrolene can cause

Answer 27

tissue necrosis.

Question 28

Less than 1% of dantrolene is excreted

Answer 28

unchanged in urine

Question 29

Elimination half time of dantrolene is.

Answer 29

5-8 hours

Question 30

Diuresis can also follow dantrolene use, therefore_______ is recommended.

Answer 30

urinary catheter

Question 31

Dantrolene is useful in the management of patients with

Answer 31

skeletal muscle spasticity due to upper motor neuron lesions.

Question 32

The maximum oral dose of Dandrolene is

Answer 32

400mg administered in four divided doses.

Question 33

Dantrolene induced skeletal muscle weakness

often

Answer 33

negates any significant improvement.

Question 34

__________is effective in the prevention and

treatment of malignant hyperthermia.

Answer 34

Dantrolene is effective in the prevention and

treatment of malignant hyperthermia.

Question 35

Prophylaxis in malignant hyperthemia-susceptible
patients can be done with
This regimen results in plasma levels

Answer 35

dantrolene 5mg/kg PO in 3 or 4 divided doses every 6 hours, with the last dose 4 hours preoperatively.
>2.8ug/ml at the time of induction.

Question 36

Alternatively 2.4mg/kg of dantrolene can be given

over 10-30 minutes as

Answer 36

prophylaxis just prior to induction, and for continued protection, one half the dose is repeated in 6 hours.

Question 37

Dantrolene ________is repeated until symptoms subside or a __________is reached.

Answer 37

2mg/kg IV; cumulative dose of 10mg/Kg

Question 38

MH first sign

Answer 38

Masseter rigidity (not responsding to NMB)

Question 39

Therefore triggering drugs must be avoided even when

Answer 39

dantrolene prophylaxis is used.

Question 40

Most common side effect is

Answer 40

skeletal muscle weakness that may be sufficient to interfere with adequate ventilation of the lungs or prevent
aspiration.

Question 41

Class of methylxanthines

Answer 41

Caffeine
Theophylline
Theobromine

Question 42

Apnea of prematurity treated with

Answer 42

Caffeine

Question 43

Structurally related to TCA is

Answer 43

Cyclobenzaprine (flexeril)

Should not be given with MAOI

Question 44

Dandrolene can lead to

Answer 44

Uterine Atony