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Irm > L23: Pharmacology Of CNS And Breathing > Flashcards

L23: Pharmacology Of CNS And Breathing Flashcards

1
Q

Where can drugs act to affect breathing

A

Lungs

CNS

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2
Q

Where in the brain are drugs likely to act on to affect breathing

A

Brainstem

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3
Q

What are in the brainstem

A

A collection of automatic neurone nuclei such as DRG, VRG, PRG and botzinger complex

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4
Q

What are the functions of respiratory stimulants

A

Increase ventilation

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5
Q

What are the examples of respiratory stimulants

A

Doxapram

Aminophyllines

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6
Q

What is the mechanism of action of doxapram

A

Stimulates carbon dioxide and oxygen chemoreceptors by non specific action to increase the electrical activity of the neurones

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7
Q

What are the adverse effects of respiratory stimulants

A

They can work on any other neurones to cause

Cardiac arrhythmia

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8
Q

When is doxapram used

A

In emergencies such as:
Acute ventilator failure with COPD
Post operative respiratory depression

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9
Q

What are respiratory depressants

A

Any agent which has a generalised CNS depressant that depresses ventilation via action at the nuclei in the brainstem

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10
Q

What are the examples of respiratory depressants drugs

A 
General anaesthetic 
Alcohol
Barbiturates
Opioids
Benzodiazepines
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11
Q

Do respiratory depressants completely shut down the breathing system

A

No they decrease the activity

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12
Q

What are the 2 sorts of general anaesthetic

A

Volatile (inhaled)

Injected

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13
Q

What happens to the physiological response when patients inhale general Anaesthetics

A

Reduced response in central chemoreceptors

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14
Q

What happens as a consequence of reducing the response of central chemoreceptors

A

Paco2 increases

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15
Q

What is the mechanism of action for general anaesthetics

A

Not really sure but has an effect on the neurotransmitter of GABA

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16
Q

What type of neurotransmitter is GABA

A

Inhibitory neurotransmitter

17
Q

When are benzodiazepines used

A

Pre-anaesthetic

Management of anxiety disorders

18
Q

What is the physiological response of benzodiazepines at low dose

A

Decreases response in peripheral chemoreceptors

19
Q

What does a decrease in peripheral chemoreceptors result in

A

Hypoxia

20
Q

What is the physiological action of benzodiazepines in higher doses

A

Reduces response in central chemoreceptors

21
Q

What is the mechanism of action of benzodiazepines

A

1) GABA bound to GABAa receptors causes voltage gated chloride ion channels to cause chloride influx and give hyper polarisation occurring
2) benzodiazepines bind to a different site next to GABA and increase the effect of GABA to increase the chloride influx and result in hyperpolarisation

22
Q

Can benzodiazepines work on their own or do they require GABA

A

Require GABA to work

23
Q

What is the physiological action of barbiturates

A

Reduce the response to central chemoreceptors

24
Q

What is barbiturates rarely used

A

The anaesthetic dose is really close to its fatal respiratory depression dose

25
Q

What is the mechanism of action of barbiturates

A

Similar action to benzodiazepines

1) bind to GABAa receptors and DO NOT require GABA
2) chloride channels open so chloride influx occurs
3) hyper polarisation occurs in neurone

26
Q

Do barbiturates require GABA to take action

A

No

27
Q

What is the physiological action of alcohol

A

Reduces the response to central chemoreceptors

28
Q

What is the mechanism of action of alcohol

A

Increase GABAa transmission to give hyperpolarisation and this inhibits neurone activity
And
Decreases excitatory neurones by NMDA receptors
And
Affects voltage gated calcium channels to stop exocytosis of neurotransmitter vesicles

29
Q

What are examples of opioids

A

Morphine

Heroin

30
Q

What is the adverse effects of opioids

A

Tolerance

31
Q

What does tolerance mean

A

A dose of drug that used to work stops working and you need a higher dose to make it work again

32
Q

What is the physiological action of opioids

A

Reduce the response in central chemoreceptors

33
Q

What is the mechanism of action of opioids

A

1) Act on G protein coupled receptors
2) This opens potassium channels
3) Hyper polarisation occurs
4) neurone excitability decreases

34
Q

What are the opioid receptor antagonist called

A

Naloxone

35
Q

When can naloxone be used

A

Opioid overdose with people using heroin etc.

36
Q

Does taking different forms respiratory depressants have an additive effect

A

Yes

37
Q

Which respiratory depressants acting together make it fatal

A

Benzodiazepines
Opioid
Alcohol

38
Q

Name an benzodiazepine antagonist

A

Flumazenil

Irm (21 decks)

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