Exam 1 (Part 1) Flashcards by Andrew Glover

ED50?

Effective Dose 50% (People)

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LD50?

Lethal Dose 50% (Animals)

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TD50?

Toxic Dose 50% (People)

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Want ____ TD50 and ____ ED50?

-High TD50
-Low ED50

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Therapeutic Index?

(LD50/ED50) = (TD50/ED50)

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Tachyphylaxis?

Pharmacodynamic Tolerance

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Continuous exposure with Agonists may?

Decrease number of receptors

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Continuous exposure with Antagonists may?

Increase number of receptors

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Agonist?

Drug or ligand that produces same signal from same site

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Partial Agonist?

Agonist that is unable to induce maximal activation

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Antagonist?

Drug that binds to site and blocks/dimishes signal (Does not initiate response on own)

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Competitive Antagonist?

Reversible (can overcome)

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Non-Competitive Antagonist?

Irreversible (cannot overcome)

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General Anesthesia is made up of?

-Inhaled Drugs (Volatile Liquid and Gas)
-Intravenous Drugs

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(General Anesthesia)
(Inhaled Drugs)
Volatile Liquid?

(HIDES)
-Halothane
-Isoflurane
-Desflurane
-Enflurane
-Sevoflurane

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(General Anesthesia)
(Inhaled Drugs)
Gas?

(NO)
Nitric Oxide

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(General Anesthesia)
Intravenous Drugs?

(“Too Many People Miss IV”)
-Thiopental
-Midazolam
-Propofol
-Morphine

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Local Anesthesia?

(CAINE)
(2 I’s = Amide)
-Cocaine
-Procaine
-Tetracaine
-Lidocaine
-Bupivacaine

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With General Anesthesia you lose which sensations?

-Unconsciousness (Asleep)
-Analgesia (No Pain)
-Amnesia (No Memory)
-Loss of Reflexes (Don’t move)

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General Anesthesia is administered via?

1) Intravenous (very quick to put a patient asleep)
2) Inhalation (Maintain

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(General Anesthesia)
(Inhaled)
Volatile Liquid ___ at room temperature?

Volatile Liquid evaporates at room temperature

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Analgesic?

No Pain

(General Anesthesia)
Intravenous?

-Barbiturates (thiopental) Hypnotic
-Benzodiazepines (midazolam) Amnesic
-Phenols (propofol) Very short half life
-Opioids (morphine) Analgesic

(General Anesthesia)
(Intravenous)
Barbiturates?

(Thiopental)
-Short acting for loss of consciousness
-Poor analgesic (may increase pain)
-Decreases circulation and respiration
-Hypnotic

(General Anesthesia) (Intravenous) Benzodiazepines?

(Midazolam, Diazepam) -Amnesic (don't remember) -Cause sedation, a reduction in anxiety and amnesia -NOT analgesic (no pain relief) -Alone cause decrease in circulation and respiration -Prolong post-recovery

(General Anesthesia) (Intravenous) Phenols?

Propofol (Very Short Half Life)

(General Anesthesia) (Intravenous) Opioids?

(Morphine, Fentanyl) -Analgesic -Pain Relief -Decrease in BP, Ventilation, Respiratory -Increase chest wall rigidity -Nausea and vomiting

Intravenous Drugs tend to ____ blood pressure?

Reduce Blood Pressure

Most dangerous drugs approved for general use?

Inhalational Anesthetics (Therapeutic Indices ranges from 2-4)

Elimination of Inhalational Anesthetics occurs in?

Lungs

MAC?

(Minimum Alveolar Concentration) Concentration that results in immobility in 50% of patients

Drug is more Lipophilic?

Less drug needed to produce Anesthesia

Prime Target for most General Anesthesia?

GABAa receptors (ion channels)

Anesthetics work by influencing?

Synaptic Transmission (Ion-Gated)

Dantrolene?

Muscle Relaxer, used for Malignant Hyperthermia

Nitrous Oxide?

Analgesic (NO pain) (Very low potency) (Always combine with something else)

Propofol?

-Oil at room temperature -Fast -Short Half-Life -Decrease arterial pressure (vasodilation) -Apnea and pain at site -"Day Surgery" -Lipid Soluble

Flumazenil?

(Antagonist) Reverses action of Benzodiazepines, so you wake up

Naloxone?

(Antagonist) Used for opioid overdoses

Reversibly block impulse conduction along nerve axons, that use sodium channels?

Local Anesthetics (block pain sensation)

Esters?

(CPT) (Not intended for Systemic Circulation) -Cocaine (vasoconstrictor) -Procaine (vasodilator) -Tetracaine (vasodilator)

Amide?

(2 I's Amides) -Lidocaine (vasodilator) -Bupivacaine (vasodilator)

Local Anesthetics are ____ Bases?

Weak Bases

CPT has a ____ half-life?

Short Half-Life (Esters)

Histamines are made by _______, metabolized by _______?

-L-histidine decarboxylase -N-methyltransferase

Increase Histamine, Increase?

cGMP

Increase Histamine, Decrease?

cAMP

H1?

(Smooth muscle, neurons) 1) Vasodilation (edema) 2) Itching and Cough Reflex 3) Bronchoconstriction

H2?

(Gastric mucosa, heart, mast cells, neurons) 1) Increases gastric acid secretion 2) Allergic reaction 3) Increases HR and contractility

Antihistamines are?

Inverse Agonists of H1 (G protein-coupled receptors) (Block production of cGMP)

Antihistamines are more effective?

Before onset of allergy

First Generation of Antihistamines?

(Hi Drowsy Children) (CROSS BBB) -Chlorpheniramine -Diphenhydramine (most sedative) -Hydroxyzine (Cause sedation and block muscarinic receptors causing dry mouth, tachycardia, blurred vision)

Second Generation of Antihistamines?

(CALF) (DO NOT CROSS BBB) -Cetirizine -Azelastine (intranasal) -Loratadine -Fexofenadine (ONLY for Allergies) (GPCR)