on the day Flashcards
What are symptoms, signs, causes of cerebellar disease
- incoordinated movement (limbs, clumsness, problems sitting, gait unsteadiness)
- Dyarthria - slurred speech
- Dysphagia - difficulty swallowing
Signs
- abnormal eye movements - nystagmus
- Dysarthria - slurr
Ataxia - incordination
-intention tremour (neocerebellum)
No differnece in tone, reflexes, sensation
Cause
- metabolic disorders e.g alcohol
- tumours, infection ect.
NO
- Rapid onset, low potency
- adverse effects
Dont use it very often but can be used in combination with other drugs
Entonox - 50% oxygen - maternity, for wound dressings - euphoric effect - laughing gas
-non addicctifvae
How does ketamine work differently from other IV anaesthetics?
What are the properties of IV anaesthetics?
Ketamine - works in a different way - binds to excitatory receptors (NMDA receptor - blocks PCP site - normally glutamate) in spinal cord (blocks excitatory synapses)
-Enhanced action of GABA receptor in brain, leads to enhanced action of inhibitory neurons (so enhanced inhibition of excitatory neurons)
Highly lipid soluble
- crosess BBB easily
- redistributes to many places in body
Inhalation aesthetics - CVS, CNS, RS
CNS - hypnosis, immobility, amnesia
CVS - lower BP, HR unchanged
RS - impaired ventilation (respiratory depresant)
Rucuronium
- low potency, rapid onset of action, longer duration
- suggamdaex - go back to normal muscle functioning fast
What does gastric epithelium produce?
gastric cycloprotective prostanoid
What factor is invovled with aspirin asthma
- decrease PGE2 formation - this is a bronchodilator
- activation of lipoxygenases, which increase inflammatory mediators - leukotrines –> bronchospasm
- so NSAIDS may precipitate broncho-constriciton in any asthmatic patient
Definition of schizophrenia and depression
Schizophrenia - disorder where there is abnormal thought, mood, perception and behaviour and attention
Depression - episodic, recurrent illness with periods of spontaneous remission
Drug treatment for bipolar drug treatment
Lithium carbonate
-stabalises manic and depressive phases - overdose tremour, seizures
How
-dampens phosphoionsitide mediated neurotransmission
Antidepressant drugs - unipolar depression
First gen - amitriptyline, imipramine
-block noradrenaline and serotonin re-uptake
Phenelzien - is a monoamine oxidase inhibitor (the enzyme that breaks down monoamides) - irreversible
Moclobemide - reversible monoamine oxidase inhibitor
Fluoxetine - potent selective serotonin reuptake inhibitor
Protoplasmic and fibrous astrocytes
Protoplasic - do not overlap , organised - regulate blood flow due to increased synaptic transmission
Fibrous - support role rather, respond to brain injury
Amyotrophic lateral sclerosis
What is it?
Why?
Progressive wasting, weakness, and atrophy of muscles leading to paralysis
- difficulty with speech and swallowing, impairment of respiration
- muscle stretch reflex exaggerated and muscle tone increased (spasticity)
- fasculations, fibrilations
Why?
-can be due to progressive degeneration of motorneurons in spinal cord, brain stem and upper motor neurons
-autoimmune hypothesis - presence of antibodies against ca2+ channels in some patients
-oxidative stress hypothesis -
free radical damage
-excitotoxic hypothesis - increase glutamate due to a number of different reasons
No effective method yet
which fibers are involved in wind up theory
c fibers
Drugs to treat epilepsy
Na+ blockers e.g carbamazapine
homonoyus hamianopia
loss of vision in one eye
