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YEAR 1 Pharmacolgy > Drugs and the Nervous System > Flashcards

Drugs and the Nervous System Flashcards

1
Q

What constitutes the nervous system?

A

The brain, spinal cord and the nerves.

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2
Q

What are the excitatory neurotransmitters?

A 
Noradrenaline
Dopamine
Serotonin (5-HT)
Acetylcholine
Glutamate
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3
Q

What are the inhibitory neurotransmitters?

A

GABA

glycine

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4
Q

What are the drugs that act on the nervous system?

A 
Anaesthetics (local and general)
Anxiolytic/ hypnotic drugs
Neuromuscular blocking drugs
Antidepressant drugs
Antiparkinsonian drugs
Anticonvulsants
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5
Q

Where do general anaesthetics act?

A

In the central nervous system.

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6
Q

How are general anaesthetics administered?

A

By inhalation or intravenously.

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7
Q

Why use anaesthetics?

A 
To promote:
Analgesia
Unconsciousness
Amnesia
Loss of reflexes
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8
Q

How do general anaesthetics work?

A
  1. act on CNS to promote insensitivity
  2. usually fat soluble – can cross blood-brain barrier
  3. may act on membrane receptors to reduce excitability of neurones
  4. may affect ion channels
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9
Q

What are some common side-effects of general anaesthetics?

A
  1. Nausea/ Vomitting,
  2. Breathing difficulties ( Shallow/rapid)
  3. Low blood pressure,
  4. Low kidney perfusion,
  5. Loss of temperature control.
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10
Q

What are the stages of anaesthesia?

A

Stage 1 – analgesia
Stage 2 – excitement
Stage 3 – surgical anaesthesia → skeletal muscle relaxation/ loss of reflexes
Stage 4 – medullary paralysis → loss of respiratory/ vasomotor control

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11
Q

What are the 4 types of general anaesthetics?

A
  1. Barbiturates,
  2. Gases,
  3. Non-barbiturates,
  4. Volatile liquids.
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12
Q

Why is nitrous oxide used?

A

To maintain anaesthesia and as a potent analgesic.

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13
Q

Three types of inhaled anaesthetics?

A

Isoflurane, desflurane, sevoflurane.

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14
Q

How is the depth of anaesthesia controlled?

A

By varying the concentration of the vapour.

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15
Q

What type of general anaesthetic is Propofol?

A

An intravenous, non-barbiturate.

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16
Q

Advantages of Propofol?

A
  1. Rapid action,

2. Rapid recovery without ‘hangover’.

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17
Q

Disadvantage of Propofol?

A

May cause convulsions or anaphylaxis.

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18
Q

What type of general anaesthetic is Thiopental (Thiopentone)?

A

An intravenous, barbiturate.

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19
Q

Advantage of Thiopental?

A

Useful for brief procedures.

20
Q

Disadvantage of Thiopental?

A

Can cause rapid awakening or long lasting sedation which may cause problems.

21
Q

What are benzodiazepines?

A

Anxiolytics or hypnotics.

22
Q

Examples of benzodiazepines…

A

Midazolam, Temazepam, Diazepam. All end in ‘am’.

23
Q

How are benzodiazepines administered?

A

Orally, intravenously. intramuscularly and rectally.

24
Q

Side effects of benzodiazepines?

A
  1. Hypotension,
  2. Constipation,
  3. No analgesic effect.
25
Q

Disadvantages of Hypnotics?

A
  1. May lead to dependence
  2. May cause respiratory depression
  3. Benzodiazepines interact with alcohol
  4. Will cross the placenta in a pregnant woman.
26
Q

How do neuromuscular blocking drugs work?

A
  1. They block transmission in motor nerves.

2. Relax vocal cords, to allow insertion of tracheal tube.

27
Q

Disadvantages of neuromuscular blocking drugs?

A
  1. Patients require assisted respiration.
  2. Prolonged muscle paralysis or pain.
  3. May cause the release of histamine which may cause a bronchospasm.
28
Q

How do Narcotic analgesics (opioid) work?

A

Act on opioid receptors in the central nervous system to relieve pain.

29
Q

What effect do narcotic analgesics have?

A

Euphoric effect. (to escape from reality).

30
Q

Examples of Narcotic analgesics…

A

Fentanyl, Alfentanil, Remifentanil. All end in the sound ‘nil’.

31
Q

Disadvantages of Narcotic analgesics?

A
  1. May cause nausea/vomiting.
  2. Reduced breathing rate.
  3. Small risk of addiction.
32
Q

What are local anaesthetics used for?

A
  1. Analgesia,

2. Paralysis.

33
Q

How do local anaesthetics work?

A

They act on specific nerve pathways.

34
Q

What is the mechanism of action for a local anaesthetic?

A

They block transmission of nerve impulses carrying pain signals from nociceptors to the brain.

35
Q

What is the cellular mechanism of action in a local anaesthetic?

A

Inhibition of Na+ entry through very sensitive Na+ channels, this blocks transmission of nerve impulses.

36
Q

Common methods of administration of local anaesthetics?

A
  1. Epidural - injection into epidural space which affects nerve roots.
  2. Intradermal/topical - relieves minor irritation/superficial pain.
37
Q

Commonly used local anaesthetics…

A

Lidocaine, Prilocaine, Bupivacaine, ropivacaine and proxymetacaine. (all end in ‘caine’)

38
Q

What is Lidocaine used for?

A
  1. Dental surgery.

2. To treat premature ejaculation.

39
Q

What is Prilocaine used for?

A

It is mixed with Lidocaine and used for surface anaesthesia.

40
Q

Side effects of local anaesthetics?

A
  1. Abnormal heart beat.
  2. Restlessness.
  3. Convulsions.
  4. In severe cases, cardiorespiratory arrest.
41
Q

How do vasoconstrictors work?

A

They enhance potency and prolong duration of action of anaesthetics. They also reduce blow flow meaning that lesson blood is lost in surgery.

42
Q

Examples of vasoconstrictors?

A

Adrenaline and felypressin.

43
Q

Other drugs that work on the nervous system…

A
  1. Antidepressants,
  2. Antiparkinsonian drugs,
  3. Anticonvulsants.
44
Q

How do antidepressants work?

A

Increase levels of excitatory neurotransmitters in the brain.

45
Q

How do antiparkinsonian drugs work?

A

Increase levels of the neurotransmitter dopamine.

46
Q

How do anticonvulsants work?

A

Treat epilepsy by reducing the conduction of excitatory nerve impulses and/or increasing GABA activity.

47
Q

What are the 3 types of Antidepressants?

A
  1. Tricyclic antidepressants.
  2. Selective serotonin re-uptake inhibitors.
  3. Monoamine oxidase inhibitors.

YEAR 1 Pharmacolgy (5 decks)

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