Exam 2 part 1 ethanol- anti anxiety

Question 1

mechanism of ethanol

Answer 1

inhibits (excitatory) glutamine pathway
excites GABAergic pathway
may activate DA pathway

Question 2

inhibits aldehyde dehydrogenase

Answer 2

disulfiram

Question 3

decreases craving for ethanol

Answer 3

acomprosate

Question 4

specific inhibitor of alcohol dehydrogenase

Answer 4

fomepizole- used to treat methanol poisoning

Question 5

gas at room temp; MAC>100; rapid induction/recovery

Answer 5

nitrous oxide- complications include megaloblastic leukemia and leukopenia

Question 6

halogenated hydrocarbon inhaled anesthetics

Answer 6

“fluranes”- isoflurane, desflurane, sevoflurane

-can result in malignant hyperthermia

Question 7

barbituates; bind to and activate GABAergic neurons; action is terminated by redistribution from brain

Answer 7

methohexital

Question 8

most commonly used parenteral anesthetic; increases GABAergic activity
rapid onset; short duration
antiemetic

Answer 8

propofol

Question 9

analog of phencyclidine; dissociative anesthesia; inhibits glutamate neuron; short induction/duration

Answer 9

ketamine

Question 10

very rapid- non analgesic; conscious sedation; high TI; activates GABA receptors

Answer 10

etomidate

Question 11

benzodiazepine that enhances activity of GABAergic neurons; IV general anesthetic

Answer 11

midazolam

Question 12

functional group that gets local anesthetic into membrane

Answer 12

aromatic group

Question 13

functional group that gets ionized once local anesthetic gets into membrane

Answer 13

amino group

Question 14

repeated use of an epidural anesthetic can lower pH and cause _____?

Answer 14

tachyphylaxis

Question 15

ester linked local anesthetic that is used in ophthalmic and nasal surgery; inhibits NE reuptake in CNS

Answer 15

cocaine- strong vasoconstrictor

Question 16

low solubility local anesthetic used topically

Answer 16

benzocaine

Question 17

short half life local anesthetic that doesn’t readily pass through mucous membranes so is not used topically

Answer 17

procaine

Question 18

local anesthetic used IV for cardiac arrhythmia; lupus-like syndrome in slow acetylators;

Answer 18

procainamide- amide linkage LA

Question 19

amide linked LA also used IV for arrhythmias; CNS side effects of tremors, slurred speech, drowsiness

Answer 19

lidocaine

Question 20

other amino amide linkage Local anesthetics

Answer 20

articaine
mepivacaine
bupivacaine
prilocaine
ropivacaine
etidocaine

Question 21

irreversible Na+ channel blocker; muscle weakness, respiratory paralysis; local anesthetic

Answer 21

Tetrodotoxin

Question 22

muscle weakness, respiratory paralysis; “red tide”

local anesthetic

Answer 22

saxitoxin

Question 23

antispastic drug; GABA agonist; increased activity of inhibitory neurons

Answer 23

Baclofen

Question 24

increase GABA; antispastic

Answer 24

Diazepam

Question 25

alpha 2 agonist; may inhibit motor neurons; antispastic drug

Answer 25

Tizanidine

Question 26

blocks ACh release; antispastic uses

Answer 26

botulinumtoxin

Question 27

can be used to treat malignant hyperthermia; inhibits release of Ca2+ for muscle;

Answer 27

Dantrolene- SE: muscle weakness and hepatitis

Question 28

anxiolytics; benzodiazepines primarily used to treat anxiety (longer duration)

Answer 28

``` chlordiazepoxide ("pam"s and "lam"s) diazepam alprazolam clonazepam clorazepate oxazepam lorazepam ```

Question 29

benzodiazepines used primarily to treat insomnia (shorter duration)

Answer 29

``` flurazepam temazepam estazolam quazepam triazolam ```

Question 30

anxiolytic given IV used in general anesthesia

Answer 30

midazolam

Question 31

benzodiazepine receptor blocker; given IV because of first pass metabolism. can be used to quickly reverse effects

Answer 31

flumazenil

Question 32

non benzodiazepine hypnotics; act by binding to subunits of the benzodiazepine receptor

Answer 32

zolpidem zaleplon eszopiclone

Question 33

alpha 2 agonist; induces sleep | sedation without respiratory depression

Answer 33

dexmedetomidine | SE: hypotension, bradycardia

Question 34

anxiety partial 5HT agonist no sedative or hypnotic effects slow onset no interactions with benzodiazepines and ethanol

Answer 34

buspirone- a non benzodiazepine hypnotic

Question 35

barbituates with 3-4 hour duration

Answer 35

pentobarbital | secobarbital

Question 36

barbituates wtih 6-8 hour duration

Answer 36

butabarbital | amobarbital

Question 37

barbituate with 10-16 hour duration

Answer 37

phenobarbital

Question 38

barbituates vs benzodiazepines

Answer 38

barbituates have 10x more efficacy than benzodiazepines but lower potency; much greater efficacy at enhancing GABA action

Question 39

melatonin receptor agonist; no effect on GABA; helps maintain normal circadian sleep rhythms

Answer 39

ramelteon- SE: somnolance and fatigue; long term use leads to testosterone synthesis; synergistic with ethanol

Question 40

antihistamine sleep inducer?

Answer 40

dipheuhydramine- don't use heavy machinery