Drugs and the Nervous System

Question 1

Common method of administration of anaesthetics?

Answer 1

1. Epidural

2. Intradermal and topical to relieve superficial pain

Question 2

Commonly used anaesthetics?

Answer 2

1. Lidocaine - dental

2. Prilocaine - in creams

Question 3

Adverse effects of anaesthetics?

Answer 3

Abnormal heart beat
Convulsions
Cardiorespiratory arrest
Hypersentivity

Question 4

What are vasoconstrictors used for?

Answer 4

1. Prolong drug action
2. Enhance potency
3. Reduces toxicity
4. Reduces blood loss

Question 5

Examples of vasoconstrictors?

Answer 5

1. Adrenaline

2. Felypressin

Question 6

What do antidepressants do?

Answer 6

Increase excitatory neurotransmitter levels in the brain

Question 7

What do antiparkinsonians do?

Answer 7

Increases levels of dopamine

Question 8

What do anticonvulsants do?

Answer 8

Treatment for epilepsy

Via reducing conduction of excitatory nerve impulses or /and increases GABA activity

Question 9

3 Types of antidepressants?

Answer 9

1. Tricyclic (TCAs)
2. Selective Serotonin Reuptake Inhibitor (SSRIs)
3. Monoamine Oxidase Inhibitor (MAOIs)

Question 10

Tricyclic antidepressants and selective serotonin reuptake inhibitors mechanism?

Answer 10

Blocks reuptake of receptor

Question 11

What do monoamine oxidase inhibitor do?

Answer 11

Blocks enzymes from breaking down the neurotransmitters

Question 12

Use of anaesthetics is to promote?

Answer 12

Analgesia, Unconsciousness, Amnesia, loss of reflexes

Question 13

How do anaesthetics work?

Answer 13

Promote insensitivity

Via crossing the blood brain barrier

Question 14

Side effects of anaesthetics?

Answer 14

1. Nausea/vomiting
2. Shallow/rapid breathing
3. Crosses Placenta
4. Loss of temp control

Question 15

Examples of excitatory neurotransmitters?

Answer 15

Noradrenaline
Dopamine
Serotonin
Acetylcholine
Glutamate

Question 16

Examples of Inhibitory neurotransmitters?

Answer 16

GABA

Glycine

Question 17

What are the stages of anaesthetics?

Answer 17

1. Analgesia
2. Excitement
3. Surgical Anaesthesia - loss of reflexes skeletal muscle relaxation
4. Medullary Paralysis - loss of respiratory/ vasomotor control

Question 18

Inhaled Anaesthetics

Answer 18

Nitrous Oxide N20
Isoflurane
Desflurane
Sevoflurane

Question 19

Intravenous anaesthetics

Barbiturate

Answer 19

Thiopental

Question 20

Intravenous anaesthetics

Non-Barbiturate

Answer 20

Propofol

Question 21

Other intravenous anaesthetics?

Answer 21

Etomidate

Ketamine

Question 22

Anxiolytics/Hypnotics

Answer 22

Benzodiazepines
e.g
Midazolam
Diazepam
Temazepam
Lorazepam

Question 23

Midazolam

Answer 23

Conscious sedation and induction of anaesthesia
Can cause nausea
20 mins pre med
Used in children

Question 24

Diazepam

Answer 24

Used to treat anxiety

High doses may cause induced sleep, drowsiness, depression etc

Question 25

Tempazepam

Answer 25

Shorter acting - little 'hangover' | Can be given by mouth

Question 26

Lorazepam

Answer 26

Marked amnesia

Question 27

Types of drugs that mainly act on the nervous system?

Answer 27

1. anaesthetics 2. anxiolytic/ hypnotics 3. Neuromuscular blocking drugs 4. Antidepressant drugs 5. Antiparkinsonian 6. Anticonvulsants

Question 28

Types of GA

Answer 28

Barbiturates Gases Non-barbiturates Volatile Liquids

Question 29

Inhaled anaesthetics

Answer 29

Isoflurane Desflurane Sevoflurane

Question 30

Advantages of Propofol | non-barbiturate

Answer 30

Rapid action | Rapid recovery

Question 31

Disadvantages of Propofol | non-barbiturate

Answer 31

Causes convulsions

Question 32

Advantages of Thiopental | barbiturate

Answer 32

Useful for brief procedures

Question 33

Disadvantage of Thiopental | barbiturate

Answer 33

Rapid awakening

Question 34

What does increasing doses of benzodiazepines do?

Answer 34

anxiety > sedation > hypnosis

Question 35

Advantages of Hypnotic drugs

Answer 35

Causes amnesia | Does not cause excessive sedation in low doses

Question 36

Disadvantages of Hypnotic drugs

Answer 36

``` No analgesic effect Hypertension/ Constipation risk Causes respiratory depression Crosses placenta Interacts with alcohol ```

Question 37

What are neuromuscular blocking drugs?

Answer 37

Muscle relaxants

Question 38

What do neuromuscular blocking drugs do?

Answer 38

Block transmission in motor nerves Cause deep anaesthesia Relax vocal cords to allow endoscopy

Question 39

Neuromuscular drugs?

Answer 39

Prolongs muscle paralysis/pain | Causes bronchospasm due to histamine release

Question 40

What are non-depolarising drugs?

Answer 40

Acetylcholine antagonist

Question 41

What are depolarising drugs?

Answer 41

Acetylcholine agonist

Question 42

What do narcotic analgesics do?

Answer 42

Act on opioid receptors in CNS to relive pain

Question 43

Example of narcotic analgesics?

Answer 43

Fentanyl Alfentanil Remifenanil Morphine

Question 44

Narcotics

Answer 44

Causes nausea Reduces breathing rate Can be addictive

Question 45

Pain receptor located in the skin

Answer 45

Nociceptors