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Pharmacology > Exam #4 > Flashcards

Exam #4 Flashcards

1
Q

4 stages of anesthetics?

A
  1. Analgesia
  2. Excitement
  3. Surgical Anesthesia
  4. Medullary paralysis
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2
Q

Define Induction

A

Time from administration of anesthetic to reach stage 3 dependent upon uptake from lungs and distribution to CNS

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3
Q

Minimum Alveoli Concentration

A

Concentration of inhaled anesthetic that results in 50% of patients failing to move in response to surgical incision

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4
Q

Greater the MAC =?

A

Lower the POTENCY

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5
Q

LOW MAC=?

A

High Potency like Halothane

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6
Q

name a low potent anesthetic

A

Nitrous Oxide

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7
Q

Define Recovery

A

Reverse of induction, dependent upon export of inhalation anesthetic in the expired breath

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8
Q

MOA of inhalation anesthetics?

A

Enhance effects of GABA, while suppressing actions of Glutamate

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9
Q

Adverse effects of Inhalation Anesthetics?

A 
↬ Respiratory depression
↬ Cardiac Depression
↬ Sensitization of heart to catecholamines
↬ Malignant hyperthermia
↬ Aspiration of gastric contents
↬ Hepatotoxicity
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10
Q

Types of inhalation anesthetics?

A
  1. Volatile Liquids

2. Gases

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11
Q

Volatile liquid anesthetics

A

↬ Halothane

↬ Isoflurane

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12
Q

name a gas anesthetic

A

↬ Nitrous Oxide

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13
Q

Pre-anesthetic drugs you can give

A

↬ Benzodiazepines
↬ Opioids for pre-op pain
↬ Anti-cholinergic drugs - atropine (decreases secretions) and maintains HR up
↬ Neuromuscular blockers

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14
Q

Post-anesthetic meds you give?

A

↬ Anelgesics
↬ Anti-emetic
↬ Muscurinic Agonists (bethanecol - increases GI, urinary motility)

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15
Q

How are intravenous anesthetics used?

A

Either alone or to supplement the effects of inhalation anesthetics

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16
Q

Two potential benefits of IV agents when combined with inhaled anesthetics?

A
  1. Permit dosage of inhaled agents to be reduced

2. Produced effects that cannot be achieved with an inhaled agent alone

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17
Q

Types of IV anesthetics

A
  1. Barbiturates
  2. Benzodiazepines
  3. Miscellaneous
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18
Q

Name a Barbiturates

A

Thiopental

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19
Q

Name a Benzodiazepine

A

Midazolam

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20
Q

What is Ketamine

A

A tasteless, odorless, amnesia inducing drug. Date rape drug. Distorts sounds and sensations and makes patients feel detached from reality.

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21
Q

Action of Propofol

A

Induces and maintains anesthesia, sedates during mechanical ventilation and during non-invasive procedures.

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22
Q

Adverse effects of Propofol

A

↬ Resp. depression
↬ Hypotension
↬ Bacterial infection

23
Q

Use of local anesthetics

A

To get rid of pain prior to procedures and also found in OTC meds.

24
Q

MOA of local anesthetics

A

Inhibits sensory neurons that carry painful stimuli to CNS, by blocking influx of NA+ in nerve cell

25
Q

Classes of local anesthetics

A
  1. Esters - Short duration of action, metabolized by enzyme esterase’s present in blood & skin
  2. Amide - Long duration of action, metabolized in liver
26
Q

Ester local anesthetics

A
  1. Procaine
  2. Cocaine
  3. Benzocaine
  4. Tetracaine
27
Q

Amide local anesthetics

A
  1. Lidocaine
  2. Mepivacaine
  3. Bupivacaine
  4. Prilocaine
28
Q

Local Anesthetics ROA?

A

Topically and Injection

29
Q

Local Anesthetics adverse effects?

A 
↬ Systemic effects when given frequently & at high does  or in areas of open injury
↬ Cardiovascular& CNS disturbances 
↬ If patient has hypersensitivity switch class of anesthetic
30
Q

Define Opioids

A

Drug produces same pharmacological effects as opium same pharmacological effects as endogenous neuropeptides (ENKEPHALINS, ENDORPHINS, DYNORPHINS) → work on 3 receptors MU, KAPPA, DELTA

31
Q

What receptors do Opioids work on?

A

MU, KAPPA

32
Q

Classifications of Opioids

A
  1. Opioid agonist
  2. Opioid antagonist
  3. Opioid agonist/antagonist (morphine)
33
Q

Physiological actions of Morphine?

A

Histamine release
Emesis
Contraction of smooth muscle in biliary & urinary tract
Cardiovascular changes (orthostatic hypotension)
Decreases cough reflex, GI motility, Uterine tone, Mental fx
Respiratory depression
Euphoria
Analgesia
Myosis

34
Q

Indications for Morphine

A
  • Pain
  • Diarrhea
  • Relief of cough
  • Relief of acute pulmonary edema
35
Q

Adverse effects of Morphine

A

↬ N&V
↬ Respiratory depression
↬ Constipation
↬ Urinary retention
↬ Elevation of intracranial pressure caused by rep. depression
↬ Tolerance to analgesic, sedative & euphoria effects needing an increased dosage
↬ Tolerance also develops to resp. depression
↬ No tolerance to myosis or constipation
↬ Physical dependency rarely a problem if its taken for less than 2 weeks, if taken longer physical and psychological dependency increases.
↬ No cross tolerance w/ CNS depressants
↬ Cross tolerance w/ other opioids
↬ Cross placenta & cause resp. depression in newborn

36
Q

Morphine drug-drug interaction

A 
↬ CNS depressants
↬ Anticholinergics
↬ Hypotensive drugs
↬ MAO inhibitors
↬ Agonist/Antagonist drugs like Pentazocine
37
Q

Codeine action

A

similar to morphine, but milder

38
Q

Indication of Codeine

A

Anti-tussive & treatment of mild to moderate pain

39
Q

Pentazocine classification

A

partial agonist, antagonist. Works @ Kappa as agonist and @ MU as antagonist

40
Q

What happens if Pentazocine is given with morphine?

A

If given for a long period of time withdrawal syndrome can occur.

41
Q

Pure Opioid Antagonists

A

Narcan & Naltrexone

42
Q

Narcan MOA

A

Competitive antagonist

43
Q

Narcan Indications

A

Reverses opioid OD, and post-op opioid effect

44
Q

Narcan onset of action & duration

A

Within 30 secs of admin & brief

45
Q

Narcan adverse effects

A

Tachycardia
Cardiac Dysrhythmias
Withdrawal

46
Q

Naltrexone MOA

A

Competitive antagonist

47
Q

Naltrexone Indication

A

Benefit to patients with opioid dependency because it can be given orally & has a longer duration of action 48hrs

48
Q

Adverse effects of Naltrexone

A

Similar to Narcan but also Hepatotoxicity

49
Q

Strong opioid agonists list

A

▸ Morphine
▸ Meperidine
▸ Methadone
▸ Fentanyl

50
Q

Moderate to strong opioid agonists list

A

▸ Codeine
▸ Oxycodone
▸ Hydrocodone

51
Q

Combination Opioid Agonists list

A

▸ Hydrocodone + Acetaminophen = Vicodin
▸ Oxycodone + Aspirin = Perocodan
▸ Oxycodone + Acetaminophen = Percocet

52
Q

Agonist/Antagonist opioids list

A

▸ Pentazocine

53
Q

Opioid antagonist list

A

▸ Narcan

▸ Naltrexone

Pharmacology (8 decks)

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