Drugs And Nervous System

Question 1

Name 2 inhibitory neurotransmitters?

Answer 1

GABA

Glycine

Question 2

Do general anaesthetics work on the CNS or the PNS?

Answer 2

CNS

Question 3

General anaesthetic are given by _______ and ________ and and used to promote what ??

Answer 3

Inhalation and intravenous

Analgesia, unconsciousness, amnesia, loss of reflexes

Question 4

Explain the positives and negatives of the phases of anaesthesia (maintenance and induction)

Answer 4

Induction + quick - Lack of control

Maintenance + controllable - clostrophobic

Question 5

Name the 4 stages of local anaesthesia

Answer 5

Analgesia
Excitement
Surgical anaesthesia, loss of reflexes
Medullary paralysis, Lord of respiratory control

Question 6

Nitrous oxide is used in _______ and normally in combination, it is a ______ analgesic and must be given with _______. Long term low levels may damage foetus.

Answer 6

Maintance , potent, foetus

Question 7

Other inhaled anaesthetics apart from nitrous oxide end in what ??

Answer 7

Flurone

Eg Isoflurone, desflurone, sevoflurone.

Question 8

Propofol is a ___________ ________and a ___________That has rapid ______ and _______ without hangover. May cause convulsions or anaphylaxis.

Answer 8

Intravenous anaesthetic, Non-barbiturate, action, recovery

Question 9

Thiopental is what type of general intravenous anaesthetic?

Answer 9

Barbiturate, useful for brief procedures

Question 10

Etomidate and ketamine are other intravenous drugs. Why would they be used ?

Answer 10

Etomidate has no hangover effect, less hypotension but muscle movements (not used in maintenance)
Ketamine - used for shocked patients, bad dreams and hallucinations

Question 11

Name the types of drugs used in surgery

Answer 11

Anxiolytics 
Hypnotics   - Benzodiazepines 
Neuroleptic and anti-emetic 
Analgesic 
Antihistamines 
Anticholinergics

Question 12

Benzodiazepines can be given by which routes and end in what ?

Answer 12

Oral, IV, IM, rectal and end in pam

Eg? Midazolam, temazepam, diazepam

Question 13

Benzodiazepines cause …

Answer 13

Amnesia, have no analgesic effects and may cause hypotension or constipation

Question 14

Benzodiazepines work by ?

Answer 14

Increasing GABA, which blocks receptors on post synaptic cell, therefore action potential cannot be propagated

Question 15

Name the disadvantages of hypnotics ( benzodiazepines )

Answer 15

Can lead to dependency, cause respiratory depression, benzodiazepines interact with alcohol, can cross placenta

Question 16

Neuromuscular blocking drugs work by ? And are good for ?

Answer 16

Blocking transition to motor nerves.
When don’t need deep anaesthesia and causes vocal cords to relax which allows insertion tracheal tube and requires assisted respiration

Question 17

Non depolarising blockers work by ? Examples ?

Answer 17

Competing with Ach for nicotine receptors at NMJ
Atracurium- rapid short
Pancuronium- longer lasting

Question 18

Name 5 excitatory neurotransmitters?

Answer 18

Noradrenaline 
Dopamine 
Serotonin 
Acetylcholine 
Glutamate

Question 19

Depolarising blockers work by ? And example

Answer 19

Mimicking Ach which causes sustained depolarisation of muscle, short lasting eg suxomethonium

Question 20

Narcotic (opioid) analgesic causes ?

Answer 20

Act on CNS to relieve pain, cause euphoria post opp, but may also cause nausea, reducers breathing rate, small risk of addiction

Question 21

Local anaesthesia work by blocking what ? When are they used ?

Answer 21

Sodium channels to block transmission of nerve impulses carrying pain signals to the brain. Used in minor surgery

Question 22

Name the two administration methods for local anaesthetics ?

Answer 22

Epidural- injection into the epidural space (effects nerve roots)
Intradermal - relives minor pain

Question 23

Name 2 commonly used local anaesthetics and there used ?

Answer 23

Lidocaine- dental surgery

Prilocaine- mixed with lidocaine in cream for surface anaesthesia

Question 24

Side effects of local anaesthetics

Answer 24

Abnormal HR
Restlessness
Convulsions

Question 25

Vasoconstrictor…..

Answer 25

enhance potency and prolong action, increase safety and reduce local blood flow

Question 26

What does TCA, SSRI and MAOI stand for and what are there side effects (antidepressants)

Answer 26

TCA- tricyclics eg imipramine > dry mouth, blunder vision, constipation and mental confusion
SSRI- selective serotonin re-uptake inhibitors eg fluoxetine > headache, nausea, diarrhoea and convulsions
Monaamine oxidase inhibitors eg phenelzine > nausea, dizziness and insomnia- interacts with triamine containing food eg cheese