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Pharmacology > Drugs and the nervous system > Flashcards

Drugs and the nervous system Flashcards

1
Q

Name drugs that act mainly on the nervous system

A 
Anaesthetics
Anxiolytics/hypnotic
Neuromuscular blockers
Antidepressants
Antiparkinsonians
Anticonvulsants
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2
Q

How are general anaesthetics administered?

A

By inhalation or intravenously

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3
Q

What do anaesthetics promote?

A

Analgesia
Unconsciousness
Amnesia
Loss of reflex

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4
Q

How do anaesthetics work?

A

Act on CNS to promote insensitivity. They are usually fat soluble so can cross blood-brain barrier.
Can act on membrane receptors and ion channels.

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5
Q

Side effects of anaesthetics

A
  • Nausea and vomiting
  • Decreased blood pressure & Cardiac output
  • Shallow/rapid breathing
  • Decreased kidney perfusion
  • Loss of temp control
  • Crosses the placenta
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6
Q

What drug can interact with anaesthetics and increase bleeding?

A

Aspirin and oral anticoagulants

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7
Q

What are the 4 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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8
Q

Types of general anaesthetics

A

Barbiturates
Non-Barbiturates
Gases
Volatile liquids

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9
Q

What do you know about Nitrous Oxide (N2O)

A
  • Used in maintaining anaesthesia with oxygen
  • Used in combination with other drugs
  • Potent analgesic (not potent enough to induce general anaesthesia on its own)
  • Has pain relieving properties
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10
Q

Name some inhaled anaesthetics other than Nitrous oxide

A

Isoflurane
Desflurane
Sevoflurane

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11
Q

Side effects of some inhaled anaesthetics

A

Cardiovascular depression
Hypotension
Arrhythmia
Decrease CSF pressure

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12
Q

What do you know about Propofol?

A 
Intravenous Anaesthetic
Used for day surgery 
Non-Barbiturate
Rapid action & recovery
Can cause convulsions/ anaphylaxis
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13
Q

What do you know about Thiopental/Thiopentone?

A

Intravenous Anaesthetic
Used for brief procedures
Rapid awakening/ long lasting sedation

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14
Q

What do you know about Etomidate?

A

Anaesthetic alternative to thiopental.
Less hypotension
Negative: muscle movements, suppression of adrenocortical function.

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15
Q

What do you know about Ketamine?

A

Anaesthetic rarely used. Used mostly in children
Can be used in shocked patients
Negatives: Increases HR & BP, causes bad dreams and hallucinations during recovery.

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16
Q

Who are at most risk from bronchospasm and aspiration of fluid after anaesthesia?

A

Children

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17
Q

What do you know about Benzodiazepines?

A

Anxiolytic/ hypnotic
Cause amnesia
Negatives: No analgesic affect, Hypotension and Constipation.

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18
Q

What do you know about Midazolam?

A 
Benzodiazepine/ Anxiolytic 
Pre-med (20 min before surgery)
Can be used in children 
Causes sedation and induction of anaesthesia
Can cause nausea and vomiting.
19
Q

What do you know about Diazepam?

A 
Benzodiazepine/Anxiolytic
Used to treat anxiety
Not used in children
High doses can induce sleep
Used prior to dental treatment
20
Q

What are the disadvantages of Hypnotics?

A
  • Can lead to dependence
  • Can cause respiratory depression
  • Benzodiazepines interact with alcohol
  • Can cross the placenta
21
Q

What do you know about Neuromuscular blocking drugs?

A

-Block transmission in motor nerves
-Muscle relaxants
-Reduce need for very deep anaesthetics
-Relax vocal cords
Negatives:
-Prolonged muscle paralysis/pain
-Histamine release

22
Q

What do you know about Narcotic (opioid) analgesics?

A 
Act on CNS to relieve pain
Euphoric 
Negatives:
-Nausea & vomiting
-Constipation
-Reduced breathing rate
-Risk of addiction
23
Q

Fentanyl, alfentanil, remifentanil and morphine are examples of…

A

Narcotic (opioid) analgesics

24
Q

Local anaesthetics are used for…

A

Analgesia and paralysis

25
Q

What are nociceptors?

A

Pain receptors in the skin

26
Q

Local anaesthetics mechanism of action

A

Block transmission of nerve impulses carrying pain signals from nociceptors to the brain.
Nociceptor->Spinal cord->Brain.

27
Q

What do you know about Lidocaine?

A

Local anaesthetic
Widely used
Often used in dental surgery
Used to treat premature ejaculation.

28
Q

What do you know about Prilocaine?

A

Local anaesthetic

Mixed with lidocaine in cream (EMLA) for surface anaesthesia

29
Q

Side effects of local anaesthetics

A 
Hypersensitivity
Abnormal heart beat
Restlessness 
Convulsions
Cardiorespiratory arrest
30
Q

What do you know about vasoconstrictors?

A

Enhance potency and prolong duration of action
Increase safety margin (reduce toxicity)
REDUCE LOCAL BLOOD FLOW TO REDUCE BLOOD LOSS IN SURGERY.

31
Q

Adrenaline and felypressin are examples of…

A

Vasoconstrictors

32
Q

What do antidepressants do?

A

Increase levels of excitatory neurotransmitters in the brain.

33
Q

What do Antiparkinsonian drugs do?

A

Increase the levels of neurotransmitter dopamine

34
Q

What do Anticonvulsants do?

A

Treat epilepsy by decreasing conduction of excitatory nerve impulses and/or increasing GABA activity

35
Q

What are the 3 main types of antidepressants?

A

Tricyclic antidepressants (TCA’s)
Selective serotonin re-uptake inhibitors (SSRI’s)
Monoamine oxidase inhibitors (MAOI’s)

36
Q

Imipramine, nortriptyline and doxepin are examples of…

A

Tricyclic antidepressants

37
Q

Tricyclic antidepressants side effects

A

Dry mouth
Constipation
Arrhythmias

38
Q

Fluoxetine, citalopram, sertraline and paroxetine are examples of…

A

Selective serotonin re-uptake inhibitors

39
Q

Selective serotonin re-uptake inhibitors side effects

A

Convulsions

40
Q

Phenelzine and tranylcypromine are examples of…

A

Monoamine oxidase inhibitors

41
Q

Monoamine oxidase inhibitors side effects

A

Nausea, dizziness and insomnia

42
Q

Name some excitatory neurotransmitters (speed up)

A 
Noradrenaline
Dopamine
Serotonin
Acetylcholine
Glutamate
43
Q

Name two inhibitory neurotransmitters

A

GABA

Glycine

Pharmacology (9 decks)

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