Pharm 11

Question 2

MOA of local anesthetics (LA’s)

Answer 2

Block voltage-dependent sodium channels

Question 3

This may enhance activity of local anesthetics

Answer 3

Hyperkalemia

Question 4

This may antagonize activity of local anesthetics

Answer 4

Hypercalcemia

Question 5

Almost all local anesthetics have this property and sometimes require the administration of vasoconstrictors (ex. Epinephrine) to prolong activity

Answer 5

Vasodilation

Question 6

Local anesthetic with vasoconstrictive property, favored for head, neck, and pharyngeal surgery

Answer 6

Cocaine

Question 7

Longer acting local anesthetics which are less dependent on vasoconstrictors

Answer 7

Tetracaine and bupivacaine

Question 8

These LA’s have surface activity

Answer 8

Cocaine and benzocaine

Question 9

Most important toxic effects of most local anesthetics

Answer 9

CNS toxicity

Question 10

Commonly abused LA which has cardiovascular toxicity including severe hypertension with cerebral hemorrhage, cardiac arrhythmias, and myocardial infarction

Answer 10

Cocaine

Question 11

LA causing methemoglobinemia

Answer 11

Prilocaine

Question 12

Structurally related to acetylcholine, used to produce muscle paralysis in order to facilitate surgery or artifical ventilation. Full doses lead to respiratory paralysis and require ventilation

Answer 12

Neuromuscular blocking drugs

Question 13

These drugs strongly potentiate and prolong effect of neuromuscular blockade (NMB)

Answer 13

Inhaled anesthetics, especially isoflurane, aminoglycosides, and antiarrhythmic

Question 14

These prevent the action of Ach at the skeletal muscle endplate to produce a “surmountable blockade,” effect is reversed by cholinesterase inhibitors (ex. neostigmine or pyridostigmine)

Answer 14

Nondepolarizing type antagonists

Question 15

Agent with long duration of action and is most likely to cause histamine release

Answer 15

Tubocurarine

Question 16

Non-depolarizing antagonist has short duration

Answer 16

Mivacurium

Question 17

Agent blocking muscarinic receptors

Answer 17

Pancuronium

Question 18

Agent undergoing Hofmann elimination (breaking down spontaneously)

Answer 18

Atracurium

Question 19

Depolarizing blocker –> continuous depolarization –> muscle relaxation and paralysis, also causes muscle pain postoperatively and myoglobinuria may occur

Answer 19

Succinylcholine

Question 20

During Phase I these agents worsen the paralysis by succinylcholine, but during phase II they reverse the blockade produced by succinylcholine

Answer 20

Cholinesterase inhibitors

Question 21

Agents acting in the CNS or in the skeletal muscle, used to reduce abnormally elevated tone caused by neurologic or muscle end plate disease

Answer 21

Spasmolytic drugs

Question 22

Facilitates GABA presynaptic inhibition

Answer 22

Diazepam

Question 23

GABA agonist in the spinal cord

Answer 23

Baclofen

Question 24

Similar to clonidine and may cause hypotension

Answer 24

Tizanidine

Question 25

Agent used for acute muscle spasm

Answer 25

Cyclobenzaprine

Question 26

Agent used in drug therapy of Parkinson’s instead of Dopamine which has low bioavailability and does not cross the BBB

Answer 26

L-dopa

Question 27

This is combined with L-dopa, inhibits DOPA decarboxylase (active only peripherally) which allows lower effective doses of L-dopa and allows for fewer SE’s (GI distress, postural hypotension, and dyskinesias)

Answer 27

Carbidopa

Question 28

Clinical response that may fluctuate in tx of Parkinson’s dx

Answer 28

“On-off-phenomenon”

Question 29

Anti-Parkinson’s drug which increases intraocular pressure and is contraindicated in closed angle glaucoma

Answer 29

Levodopa

Question 30

Ergot alkaloid that is a partial agonist at D2 receptors in the brain, used for patients who are refractory or cannot tolerate levodopa, causes erythromelalgia

Answer 30

Bromocriptine

Question 31

Non ergot agents used as first-line therapy in the initial management of Parkinson’s

Answer 31

Pramipexole and ropinirole

Question 32

Sedative-Hypnotics action

Answer 32

Reduce inhibition, suppress anxiety, and produce relaxation

Question 33

Additive effects when Sedative-Hypnotics used in combination with these agents

Answer 33

CNS depressants

Question 34

Common mechanism by which overdose result in death

Answer 34

Depression of medullary and cardiovascular centers

Question 35

The most important sign of withdrawal syndrome

Answer 35

Excessive CNS stimulation (seizures)