Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm 2 > Drugs of Abuse and General anesthetics > Flashcards

Drugs of Abuse and General anesthetics Flashcards

1
Q
  • “Herbal marijuana alternative”
  • Marketed as incense, “not for human
    consumption”
  • Structurally dissimilar to THC but acts on
    CB1 and CB2 receptors and possibly NMDA
  • 2 – 100 times more potent than THC
  • Sprayed onto herbal mixture and smoked
A

Synthetic Cannabinoids (SC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What receptors do the Synthetic cannabinoids act upon?

A

CB1 and CB2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Intake and Output
* No human evidence for ADME
* Anecdotal reports of onset and duration
* Onset within minutes
* Duration varies, average 1 hour
– May vary according to chemical type
* Available as either plant-based material to
be rolled and smoked, or as an oil to be
vaped.

A

Synthetic Cannabinoids (SC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Effects
Euphoria
Anxiolytic
Stimulant
Dream enhancement
“Benefits”
Not detected in
standard urine drug
screen
Smells like incense
Sympathomimetic effects
Paranoia
Agitation
Seizure
Renal failure
Rhabdomyolysis
Difficult to distinguish from
primary psychiatric illness

A

Synthetic Cannabinoids (SC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
  • Low dose (<10 mg)
    – Methyphenidate
  • High dose (> 10 – 15 mg)
    – Cocaine, methamphetamine
  • Onset ~ 30 minutes
  • Dose-dependent duration (0-12h)
A

Methylenedioxypyrovalerone
(MDPV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
  • Amphetamines, ecstasy, cocaine
  • Average dose 100 – 200 mg
  • Onset 30 – 45 minutes
  • Short duration (1–2h)
  • Strong desire to re-dose
A

4-Methylenemethcathinone
(Mephedrone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Mechanism of ____
* Strong inhibition of dopamine,
serotonin, and norepinephrine
reuptake
* Also increases presynaptic release

A

Cathinones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

____ effects
* Euphoria
* Heightened alertness
* Energy
* Talkativeness
* Libido increase
Agitation
Paranoia
Hallucination (audio, visual, tactile)
Sympathomimetic toxidrome
Seizures, hyperthermia,
hyponatremia, rhabdomyolysis

A

Cathinone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
  • ⍺-pyrrolidinopentiophenone (⍺-PVP)
    – AKA: Gravel, $5 Insanity
  • Synthetic cathinone, structurally similar to
    MDPV
  • Dopamine, norepinephrine reuptake
    inhibition
  • Developed in the 1960’s by Boehringer-
    Ingelheim, but never marketed
A

Flakka

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is tx for SC and cathinones?

A

BZDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
  • 100x more potent than fentanyl
  • 10,000x more potent than morphine
A

W18

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

– 8x more potent than morphine
– Fatalities reported
* Pulmonary edema
* Opioid toxidrome

A

U-47700

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

– 10,000x more potent than morphine
– 1kg = 50,000,000 fatal doses
* Grain of sand lethality
– Developed by Janssen 1970s
* Wildnil®
Who said the opioid crisis couldn’t get any worse? Gussow L. Emergency Medicine News. November 2016:29-30

A

Carfentanil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do you treat non-pharmaceutical fentanyl effects?

A

Naloxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hypnotic, no analgesia
0.1 - 0.3 mg/kg IV
Each 0.1 mg/kg = 100 sec sedation
Onset within seconds
RSI gold standard, minimal use in
procedural sedation
Won’t control pain after procedure
Neutral hemodynamic profile
Myoclonic activity
EEG activity increased
Emetogenic

A

Etomidate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Inhibits 11β-hydroxylase
Cholesterol  cortisol
Adrenal suppression

A

Etomidate

17
Q

Midazolam
Most lipid soluble
Slower, unreliable, difficult to titrate
Better suited as anxiolytic
Great amnesia, no analgesia

A

BZD

18
Q

What is the reversal agent for BZDs?

A

Flemazenil

19
Q

GABA agonist
Quick on, quick off
Lipid emulsion
No analgesia

A

Propofol

20
Q

Burns on administration
May give lidocaine (2 - 4mL of 1%)
Negative inotrope
Elderly, volume depleted, rate of
administration
Respiratory depression

A

Propofol

21
Q

Similar to PCP
Less euphoria and sensory distortion
Dissociative anesthetic
Corticothalamic and limbic dissociation
Bronchodilation, airway reflexes
maintained

A

Ketamine

22
Q

 Multiple mechanisms
GABA
μ receptor agonist
Catecholamine reuptake inhibition
Cholinergic receptor antagonism in
prefrontal cortex
NMDA receptor antagonism

A

Ketamine

23
Q

 Indications
Sedation, analgesia, anesthesia
Seizure
Depression
Excited delirium
Opioid induced hyperalgesia
Opioid sparing treatment
Delayed sequence intubation
Adverse reactions
Sympathomimetic
Can be good or bad
Psychic phenomena
Emergence vs. dysphoria
Intracranial pressure

A

Ketamine

24
Q

 Ketamine + propofol
 1:1 most common
20mL syringe; 10 mL propofol, 10 mL ketamine.
Note concentration!
 Dosing, typically 0.5 mg/kg of each
component
0.1 mL/kg

A

Ketofol

25
Q

Highly selective ᵷ -2 agonist
Same family as clonidine
Sedation, some analgesia, opioid
sparing, sympatholytic
Easily arousable, minimal respiratory
depression

A

Dexmedetomidine

26
Q

Onset 15 min
Context sensitive t ½
4 minutes after 10 min infusion
250 minutes after 8-hour infusion
May accumulate in hepatic
dysfunction

A

Dexmedetomidine

Pharm 2 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions