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Musculoskeletal drugs Flashcards

1
Q

Define Neuromuscular blocking drugs

A

Used to produce muscle paralysis in order to facilitate surgery or artificial ventilation ( in CNS)

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2
Q

Spasmolytic

A

A drug that reduces abnormally elevated muscle tone (spasticity) without paralysis e.g. baclofen, dantrolene, diazapem

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3
Q

major use for spasmolytic drugs

A

muscle strains (uncontrollable spasms) back pain

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4
Q

where are the GABAb receptors that Baclofen works on?

A

CNS (specifically the ventral horn of the spinal cord. specifically at the AXON TERMINAL OF THE PRESYNAPTIC AFFERENT NERVE

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5
Q

Baclofen

A

GABA agonist.

acts within the spinal cord to suppress hyperactive reflexes involved in regulation of muscle mvoement.

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6
Q

Diazepam

A

member of the benzodiazepine family. facilitating GABA mediated inhibition of motor neurons.

indicated for muscle spasm of any origin

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7
Q

Dantrolene

A

acts directly on skeletal muscle to relieve spasticity (unlike baclofen and diazepam)

blocks release of Ca form SR (decrease in SM contraction)

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8
Q

Indications for Dantrolene

A

THerapeutic uses, spasticity and malignant hyperthermia

Can relieve symptoms with MS, cerebral palsy and spinal cord injury

associated with reduction in the abillity of a skeletal muscle to contract

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9
Q

Tiazanidine

A

Alpha2 receptor agonist used for patients with brain or spinal injuries

musch less anti-hypertensive than clinidine

however causes hypetension, drosiness and drymouth

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10
Q

Spasm

A

sudden violent painful involuntary contraction of a muscle group.

involve motor neuron

(bursitis, dislocaiton, fracture, herniated disk, hypokalamia , strains)

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11
Q

Spasticity

A

Increase in passive stretch reistence of a muscle.

COnsidered permenant condition that might persis to disabling

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12
Q

causes of spasticity

A

head injurie, cerebral palsy, MS, stroke

Upper motor neuron

cerebrovascular adjacent accident
closed head injury
quadrapalegia
Spinal cord, Trauma.

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13
Q

Give a condition that baclofen is not effective in

A

relief of spasticity associated with parkinsons or in stroke

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14
Q

Give condition that Baclofen is prefered over dantrolene

A

in a patient whose spasticity is accompanied by muscle weakness

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15
Q

Explain what to do with diazepam to avoid the side effect of sedation

A

Start dose low 4mg increase to 60mg/dl

Initial therapy low dose then increase

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16
Q

Explain how dantrolene helps malignant hyperthermia

A

Malignant hyperthermia can be triggered by anesthetic and succinlycholine

Dantolene relives symptoms by blocking Ca release from SR

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17
Q

Distinguish between spasmolytic and paralytic

A

paralytic used to produce muscle paralysis to do surgery

spasmolytic used to reduce abnormally elevated muscle tone without paralysis

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18
Q

Give indications of diazempam as a spasmolytic

A

Trauma

General Muscle spasm

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19
Q

Give to therapeutic uses for dantrolene

A

spasms

malignant hyperthermia

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20
Q

Give three conditions that dantrolene can releve spasticity for

A

Cerebral palsy, MS, Spinal cord injury

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21
Q

Tetracycline mechanism of action

A

Binds reversibly to 30s subunit of bacterial ribosome and blocks the binding of a.a.-tRNA to acceptor site.

this prevents addition of a.a. to the growing peptide

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22
Q

Mechanisms of Resistence tetracycline

A

Increased efflux

Production of ribosome protection protein

enzymatic modificatio of cycline

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23
Q

Tet (AE)

A

found in gram negative bacteria

resistent to Tetra doxy mino, not tige

24
Q

Tet(K)

A

gram (+) Tetra, but not doxy mino or tige

25
Tet (M)
gram (+) protein that renders them resistant to tetra, doxy, mino but not Tige bulky tbutylglycylamido stops steric hindrance.
26
Enzymatic inactivation
not important for tetracycline.
27
Foods that impair Tetracycline absorption
Dairy antacids with multivalent cations No effect on doxy and mino impaired by alkaline pH because its HCl
28
Places that Minocycline is very high concentration
Tears and salica indicated for prophylaxis of menigococcal infections, but not 1st line
29
Elimination of tetracycline
excreted mainly in bile and urine intestine reabsorption may contribute to maintence of serum levels
30
elimination of demeclocycline
excreted mainly in bile and urine intestine reabsorption may contribute to maintence of serum levels
31
elimination of doxycycline
90% in GI in inactive form dose adjustment for renalfailure not required
32
elimination of minocycline
Mostly metabolized in liver to inactive form dose adjustment for renal insufficiency not required
33
elmination of Tige-cycline
primarily excreted in bile and eliminated in feces in unchanged form dose adjustment for renal insufficiency not required
34
Tetracylcine sensitive pathogens
RIckettsia species Mycoplasma pneumoniae Chlamydophylia and chlamydia
35
Special Tige-cycline indications
active against vancoresistant enterococci and MRSA indicated for VRE and MRSA.
36
Indications for doxycycline
even in children less than 8 years old chlamydial infection including STD mycoplasma pneumonia early lyme disease
37
Tetracycline class used for S. aureus
Mino and tige
38
Tetracycline effects on teeth and bone
Causes permenat gray-brown discoloration of teeth and enamel hypoplasia due to chelation and sequestion and UV-absorbing Also impairs skeletal bone growth in the fetus and children. contraindicated in pregnant or lactating women
39
Most common side effect of tetracycline
Hypersensitivity to tetracycline classes photosensitivity includes red-rashes and blistering. most common with demeclocycline.
40
how should you take Tetracycline to avoid esophogeal ulceration
way before bedtime and with ltos of water.
41
tetracycline with most hepatotoxicity
tetra and mino not really doxycycline. preggers get toxic better
42
List side effects of tetracycline
``` Teeth and bone allergic skin GI Liver Renal mortality vertigo ```
43
Renal adverse effects of tetracycline
inhibit protein synthesis and exacerbate renal failure by increasing azotemia from a.a. metabolism Demeclocycline can cause nehrogenic diabetes insipidus (used for SIADH)
44
Major side effect tigecycline
death
45
What tetracycline is associated with reverisble vertigo
Minocycline more with women
46
Mechanism of action of clindamycin
Binds to 50S subunit interferes with transpeptidation reaction at A and P site
47
Clindamycin effectiveness against certain bacteria
Bacteria static anerobic infections. Gram(-) are resistant because drug cannot permeate the bacterial outer membrane
48
bioavailabillities of tetracyclines
``` Tetra 60-70 demcro 60-70 doxy 95 mino 95 tige poor ```
49
True or false clindamycin penetrates into an abcess
True
50
Mechanisms of resistance cliindamycin
mutation of ribosomal binding site modification of ribosomal binding site by methylase (constituitively active) Enzymatic inactivation.
51
Clindamycin adverse effects
kills off normal flora: allowing for superinfection of C. difficile. cytotoxin can cause coltiis with lifethreatening mucosal ulcerations, fever diarrhea.
52
Inidcations for clindamycin
treament of skin and soft tissue infections caused by streptococci and staphylococci. anaerobic infections
53
Mechanism of chloramphenicol resistence
inactivation by acetyltransferase
54
Chloramphenicol pharmokinetics
metabolized in liver to inactive form. must dose compensate for liver failure
55
Cloramphenicol adverse effects
suppression of RBC production. leads to irreversible aplastic anemia. gray baby syndrome
56
Gray baby syndrome
serious consequence of chloramphenicol baby don't glucoronidate and get vomiting flaccidity. hypothermia gray color respiratory distress and metabolic acidosis
57
Chloramphenicol
only indicated for lifethreatening infections in people who cannot take safer alternatives because of resistence of allergies

Pharmacology Drugs (2 decks)

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