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DRUGS Flashcards

1
Q

What is the mechanism of action of nitrous oxide (N₂O)?

A

NMDA receptor antagonist.

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2
Q

What is a key advantage of nitrous oxide (N₂O)?

A

Minimal cardiovascular depression, used in conscious sedation.

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3
Q

How do Sevoflurane, Desflurane, Isoflurane, and Halothane work?

A

They enhance GABA-A activity.

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4
Q

What is a major side effect of halothane?

A

Hepatotoxicity.

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5
Q

Which inhaled anesthetic is associated with nephrotoxicity?

A

Sevoflurane.

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6
Q

What are the primary concerns with Isoflurane and Desflurane?

A

Airway irritation.

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7
Q

What is the mechanism of action of propofol?

A

Potentiates GABA-A receptors.

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8
Q

What are the key properties of propofol?

A

Rapid onset, antiemetic effects, risk of hypotension.

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9
Q

What is the mechanism of action of ketamine?

A

NMDA receptor antagonist.

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10
Q

What are the effects of ketamine?

A

Causes dissociative anesthesia, increases BP & HR, and may cause hallucinations.

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11
Q

How does etomidate work?

A

It is a GABA-A agonist.

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12
Q

What is an advantage of etomidate?

A

Less cardiovascular depression.

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13
Q

What is a risk of etomidate?

A

Adrenal suppression.

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14
Q

How does methohexital work?

A

It is a barbiturate that enhances GABA-A activity.

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15
Q

What is methohexital used for?

A

Short procedures due to its rapid onset.

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16
Q

What is the function of benzodiazepines like midazolam, lorazepam, and diazepam in anesthesia?

A

They potentiate GABA-A receptors to provide sedation and amnesia.

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17
Q

What drug reverses benzodiazepine effects?

A

Flumazenil.

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18
Q

How do opioids (Fentanyl, Morphine, Remifentanil) contribute to anesthesia?

A

They act as mu-opioid receptor agonists to provide analgesia.

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19
Q

What is a major side effect of opioids in anesthesia?

A

Respiratory depression.

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20
Q

What is dexmedetomidine’s role in anesthesia?

A

It is an α₂-agonist that provides sedation and analgesia without respiratory depression.

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21
Q

How does dantrolene treat malignant hyperthermia?

A

It inhibits the ryanodine receptor, preventing calcium release.

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22
Q

How do local anesthetics work?

A

They block Na⁺ channels, preventing neuronal depolarization.

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23
Q

How are ester local anesthetics metabolized?

A

By plasma esterases.

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24
Q

Why do ester local anesthetics have a higher allergy risk?

A

Due to PABA formation.

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25
Q

How are amide local anesthetics metabolized?

A

By the liver.

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26
Q

What is the most commonly used local anesthetic?

A

Lidocaine.

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27
Q

Which local anesthetic has a risk of methemoglobinemia?

A

Benzocaine & prilocaine

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28
Q

What local anesthetic is used in topical applications and can cause vasoconstriction?

A

Cocaine.

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29
Q

What is the advantage of articaine over other local anesthetics?

A

It has a rapid onset and better tissue diffusion.

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30
Q

How do non-selective NSAIDs (Aspirin, Ibuprofen, Naproxen, Ketorolac) work?

A

They inhibit COX-1 & COX-2, decreasing prostaglandins.

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31
Q

What are the risks associated with NSAIDs?

A

GI ulcers and bleeding.

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32
Q

How does celecoxib differ from non-selective NSAIDs?

A

It selectively inhibits COX-2, lowering GI risk but increasing cardiovascular risk.

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33
Q

How does acetaminophen work?

A

It inhibits central COX, providing analgesia but weak anti-inflammatory effects.

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34
Q

What is the antidote for acetaminophen toxicity?

A

N-acetylcysteine.

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35
Q

What is the mechanism of sodium channel blockers (Phenytoin, Carbamazepine, Lamotrigine)?

A

They stabilize Na⁺ channels.

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36
Q

What is a common side effect of phenytoin?

A

Gingival hyperplasia.

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37
Q

What is the first-line drug for absence seizures?

A

Ethosuximide.

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38
Q

What is the first-line drug for status epilepticus?

A

IV Lorazepam.

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39
Q

What is the mechanism of action of levetiracetam (Keppra)?

A

SV2A modulator affecting neurotransmitter release.

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40
Q

How do SSRIs (Fluoxetine, Sertraline, Escitalopram, Paroxetine) work?

A

They inhibit serotonin reuptake.

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41
Q

What is the most common side effect of SSRIs?

A

Sexual dysfunction.

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42
Q

What is a key advantage of bupropion?

A

It does not cause sexual dysfunction but lowers seizure threshold.

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43
Q

What is a major risk of MAOIs (Phenelzine)?

A

Hypertensive crisis with tyramine-containing foods.

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44
Q

What is the treatment for serotonin syndrome?

A

Cyproheptadine (5-HT2A antagonist).

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45
Q

What is the standard formulation for dental anesthesia?

A

2% Lidocaine + 1:100,000 Epinephrine.

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46
Q

What formulation is used for hemostasis in dental procedures?

A

2% Lidocaine + 1:50,000 Epinephrine.

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47
Q

What is an alternative for vasoconstrictor-intolerant patients?

A

3% Mepivacaine (No Epinephrine).

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48
Q

What local anesthetic is used for long-duration procedures?

A

0.5% Bupivacaine + 1:200,000 Epinephrine.

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49
Q

What is the advantage of 4% Articaine + Epinephrine (1:100,000 or 1:200,000)?

A

Rapid onset and better tissue diffusion.

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50
Q
A
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51
Q

Nitrous Oxide (N₂O)

A

NMDA receptor antagonist, minimal cardiovascular depression.

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52
Q

Sevoflurane

A

Enhances GABA-A, risk of nephrotoxicity.

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53
Q

Desflurane

A

Enhances GABA-A, airway irritation.

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54
Q

Isoflurane

A

Enhances GABA-A, airway irritation.

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55
Q

Halothane

A

Enhances GABA-A, hepatotoxicity.

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56
Q

Propofol

A

Potentiates GABA-A, rapid onset, antiemetic, risk of hypotension.

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57
Q

Ketamine

A

NMDA receptor antagonist, increases BP & HR, dissociative anesthesia.

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58
Q

Etomidate

A

GABA-A agonist, minimal cardiovascular depression, risk of adrenal suppression.

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59
Q

Methohexital

A

Barbiturate, enhances GABA-A, used in brief procedures.

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60
Q

Midazolam

A

Benzodiazepine, pre-op sedation, anterograde amnesia.

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61
Q

Lorazepam

A

Benzodiazepine, anxiolytic, sedation.

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62
Q

Diazepam

A

Benzodiazepine, muscle relaxant, seizure treatment.

63
Q

Fentanyl

A

Mu-opioid receptor agonist, strong analgesia, respiratory depression.

64
Q

Morphine

A

Mu-opioid receptor agonist, analgesia, nausea risk.

65
Q

Remifentanil

A

Mu-opioid receptor agonist, ultra-short-acting opioid.

66
Q

Dexmedetomidine

A

α₂-agonist, sedation without respiratory depression.

67
Q

Dantrolene

A

Inhibits ryanodine receptor, treats malignant hyperthermia.

68
Q

Procaine

A

Ester, short-acting, metabolized by plasma esterases.

69
Q

Chloroprocaine

A

Ester, rapid onset, low toxicity.

70
Q

Tetracaine

A

Ester, long-acting, spinal anesthesia.

71
Q

Benzocaine

A

Ester, risk of methemoglobinemia.

72
Q

Cocaine

A

Ester, local anesthetic with vasoconstriction.

73
Q

Lidocaine

A

Amide, most commonly used, intermediate duration.

74
Q

Mepivacaine

A

Amide, longer duration than lidocaine, no vasodilation.

75
Q

Bupivacaine

A

Amide, long-acting, risk of cardiotoxicity.

76
Q

Ropivacaine

A

Amide, less cardiotoxic than bupivacaine.

77
Q

Articaine

A

Amide, rapid onset, better tissue penetration.

78
Q

Prilocaine

A

Amide, risk of methemoglobinemia.

79
Q

Pramoxine

A

Topical anesthetic, used in skin preparations.

80
Q

Phenacaine

A

Used in ophthalmic anesthesia.

81
Q

Dyclonine

A

Topical anesthetic, found in lozenges.

82
Q

Aspirin

A

Irreversible COX-1 & COX-2 inhibitor, risk of Reye’s syndrome.

83
Q

Ibuprofen

A

Reversible COX-1 & COX-2 inhibitor, mild GI toxicity.

84
Q

Naproxen

A

Longer half-life than ibuprofen, used for inflammation.

85
Q

Ketorolac

A

Strong NSAID, high risk of GI bleeding.

86
Q

Piroxicam

A

Long half-life, increased GI ulcer risk.

87
Q

Celecoxib

A

Selective COX-2 inhibitor, lower GI risk, higher CV risk.

88
Q

Acetaminophen

A

Central COX inhibition, hepatotoxic in overdose.

89
Q

Methotrexate

A

Inhibits dihydrofolate reductase, hepatotoxicity risk.

90
Q

Infliximab

A

TNF-α inhibitor, risk of infections.

91
Q

Etanercept

A

TNF-α inhibitor, subcutaneous injection.

92
Q

Adalimumab

A

TNF-α inhibitor, used in RA and psoriasis.

93
Q

Phenytoin

A

Na⁺ channel blocker, causes gingival hyperplasia.

94
Q

Carbamazepine

A

Na⁺ channel blocker, risk of SIADH.

95
Q

Lamotrigine

A

Na⁺ channel blocker, risk of Stevens-Johnson syndrome.

96
Q

Valproate

A

Na⁺ & Ca²⁺ blocker, hepatotoxicity, teratogenic.

97
Q

Ethosuximide

A

T-type Ca²⁺ blocker, first-line for absence seizures.

98
Q

Levetiracetam

A

SV2A modulator, mood changes.

99
Q

Gabapentin

A

N-type Ca²⁺ blocker, used for neuropathic pain.

100
Q

Topiramate

A

Enhances GABA, causes weight loss.

101
Q

Lorazepam (AED)

A

Enhances GABA-A, first-line for status epilepticus.

102
Q

Fosphenytoin

A

Na⁺ channel blocker, used for status epilepticus.

103
Q

Phenobarbital

A

Enhances GABA, used for refractory seizures.

104
Q

Fluoxetine

A

SSRI, longest half-life, risk of sexual dysfunction.

105
Q

Sertraline

A

SSRI, commonly used for depression and anxiety.

106
Q

Escitalopram

A

SSRI, fewer drug interactions.

107
Q

Paroxetine

A

SSRI, short half-life, withdrawal risk.

108
Q

Venlafaxine

A

SNRI, hypertension risk at high doses.

109
Q

Duloxetine

A

SNRI, used for neuropathic pain.

110
Q

Bupropion

A

Dopamine reuptake inhibitor, no sexual dysfunction.

111
Q

Mirtazapine

A

α₂ antagonist, causes weight gain and sedation.

112
Q

Trazodone

A

Serotonin modulator, causes priapism.

113
Q

Amitriptyline

A

TCA, anticholinergic side effects.

114
Q

Nortriptyline

A

TCA, less sedating than amitriptyline.

115
Q

Phenelzine

A

MAOI, risk of hypertensive crisis with tyramine.

116
Q

Cyproheptadine

A

5-HT2A antagonist, treats serotonin syndrome.

117
Q

2% Lidocaine + 1:100,000 Epinephrine

A

Standard for dental procedures.

118
Q

2% Lidocaine + 1:50,000 Epinephrine

A

Used for hemostasis.

119
Q

3% Mepivacaine (No Epinephrine)

A

Alternative for vasoconstrictor-intolerant patients.

120
Q

2% Mepivacaine + 1:20,000 Levonordefrin

A

Alternative vasoconstrictor.

121
Q

0.5% Bupivacaine + 1:200,000 Epinephrine

A

Long-duration anesthesia.

122
Q

4% Articaine + Epinephrine (1:100,000 or 1:200,000)

A

Rapid onset, better diffusion.

124
Q

What is the mechanism of action (MOA) of inhaled anesthetics?

A

Enhance GABA-A receptor activity, inhibit NMDA receptors (some), and hyperpolarize neurons via potassium channels.

125
Q

What are the side effects of inhaled anesthetics?

A

Respiratory depression, hypotension, malignant hyperthermia (except N₂O).

126
Q

What is the mechanism of action of nitrous oxide (N₂O)?

A

NMDA receptor antagonist.

127
Q

What are key characteristics of nitrous oxide (N₂O)?

A

Minimal cardiovascular depression, used in conscious sedation.

128
Q

What is a key adverse effect of halothane?

A

Hepatotoxicity.

129
Q

What anesthetic is associated with airway irritation?

A

Isoflurane/Desflurane.

130
Q

What is the mechanism of action of propofol?

A

Potentiates GABA-A receptors.

131
Q

What are the key effects of ketamine?

A

Dissociative anesthesia, increases BP & HR, causes hallucinations.

132
Q

What is the treatment for malignant hyperthermia?

A

Dantrolene (inhibits ryanodine receptor, preventing Ca²⁺ release).

133
Q

What is the MOA of local anesthetics?

A

Block Na⁺ channels, preventing depolarization.

134
Q

How are ester local anesthetics metabolized?

A

By plasma esterases.

135
Q

Why do esters have a higher allergy risk?

A

Due to PABA formation.

136
Q

How are amide local anesthetics metabolized?

A

By the liver.

137
Q

What is the most commonly used local anesthetic?

A

Lidocaine.

138
Q

What is the MOA of non-selective NSAIDs?

A

Inhibit COX-1 & COX-2 → ↓ prostaglandins.

139
Q

What are the risks of NSAIDs?

A

GI ulcers, bleeding.

140
Q

What is a key feature of selective COX-2 inhibitors like celecoxib?

A

Lower GI risk, higher cardiovascular risk.

141
Q

What is the MOA of acetaminophen?

A

Inhibits central COX, weak anti-inflammatory.

142
Q

What is the antidote for acetaminophen toxicity?

A

N-acetylcysteine.

143
Q

What is the MOA of sodium channel blockers like phenytoin and carbamazepine?

A

Stabilize Na⁺ channels.

144
Q

What is a notable side effect of phenytoin?

A

Gingival hyperplasia.

145
Q

What is the first-line drug for absence seizures?

A

Ethosuximide.

146
Q

What is the first-line drug for status epilepticus?

A

IV Lorazepam.

147
Q

What is the MOA of SSRIs?

A

Inhibit serotonin reuptake.

148
Q

What is the risk of SSRIs?

A

Sexual dysfunction.

149
Q

What is a key benefit of bupropion?

A

No sexual side effects but lowers seizure threshold.

150
Q

What is a major risk of MAOIs?

A

Hypertensive crisis with tyramine-containing foods.

151
Q

What is the treatment for serotonin syndrome?

A

Cyproheptadine (5-HT2A antagonist).

152
Q

What is the standard formulation for dental anesthesia?

A

2% Lidocaine + 1:100,000 Epinephrine.

153
Q

What is an alternative for vasoconstrictor-intolerant patients?

A

3% Mepivacaine (No Epinephrine).

154
Q

What anesthetic is used for long-duration procedures?

A

0.5% Bupivacaine + 1:200,000 Epinephrine.

Nsp Exam 3 (13 decks)

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