drugs 2

Question 1

mu receptor effects?

Answer 1

CONSTIPATION, miosis, biliary colic analgesia, sedation, respiratory depression

Question 2

which two gates do opioids work on?

Answer 2

close calcium, open potassium

Question 3

what is effect of closing calcium channels

Answer 3

presnyaptic, prevents release of neurotransmitters (glutamate, NE, ACh, substance P) = prevent feeling pain

Question 4

opioid antitussive?

Answer 4

codeine, dextromethorphan

Question 5

opioid anti-diarrheals?

Answer 5

loperamide, diphenoxylate

Question 6

what are the symptoms of withdraw

Answer 6

rhinorrhea, lacrimation, yawning, hyperventilation, hyperthermia, muscle aches, vomiting, diarrhea, anxiety

Question 7

list 3 partial mu agonist opioids?

Answer 7

buprenorphine, nalbuphine, butorphanol

Question 8

whats the MOA of dextromethorphan?

Answer 8

mu agonist and NMDA r antagonist

Question 9

what are the 3 short acting benzos?

Answer 9

alprazolam, triazolam, oxazepam, midazolam

Question 10

how do benzos act?

Answer 10

bind to allosteric site of GAB-r, potentiating effect

Question 11

long-acting benzos used in delirium tremens tx?

Answer 11

chlordiazepoxide and diazepam

Question 12

3 uses of IV benzo?

Answer 12

anesthetic, seizures, alcohol withdrawal

Question 13

2 benzos used in status epilepticus?

Answer 13

lorazepam, diazepam

Question 14

3 benzos used in IV anaesthetics?

Answer 14

diazepam, lorazepam, midazolam

Question 15

what does benzo withdrawal resemble?

Answer 15

alcohol withdrawal - tremors, anxiety, dysphoria, psychosis, seizures

Question 16

concomitant use of benzos with what drugs should be avoided?

Answer 16

CNS depressants - 1st generation anti-histamines, alcohol, barbiturates, neuroleptics

Question 17

what’s the benzo antidote?

Answer 17

flumazenil - competitive antagonist of benzo R; reverse sedation and OD, but can precipitate withdrawel seizures in chronic users

Question 18

non benzo sleep aids?

Answer 18

zolpidem, zaleplon, zopiclone, melatonin, ramelteon

Question 19

how do barbs and benzos differ in their action on GABA-A Cl channels?

Answer 19

Benzos = increase frequency, bars = increase duration

Question 20

which ultra short bab is often used in induction IV anesthesia?

Answer 20

thiopental

Question 21

why do we see rapid plasma decay of thiopental?

Answer 21

quick reabsorption into fat and skeletal muscle tissues

Question 22

barb treatment for seizures and essential tremor?

Answer 22

primidone

Question 23

does chronic use of barbs and benzos lead to tolerance

Answer 23

YES

Question 24

should barbs be avoided in elderly?

Answer 24

YES

Question 25

do barbs induce CYP450?

Answer 25

YES - watchout with warfarins and statins