Pharmacology 2 Flashcards
Directly proportional to the potency of inhalation anesthetics
Lipid solubility
Inversely proportional to the potency of inhalation anesthetics
Minimal alveolar concentration (MAC)
Inversely proportional to the rate of induction and recovery of inhalation anesthetics
Blood:gas partition coefficient
Mechanism of action of inhalation anesthetics
Potentiation of GABA at GABAA receptors; also reduce Na and Ca influx
Currently the only non-halogenated inhalation anesthetic
Nitrous oxide
Inhalation anesthetic with the most analgesic activity
Nitrous oxide
Inhalation anesthetic with the least respiratory and cardiovascular depression and therefore is used frequently as a component of balanced anesthesia
Nitrous oxide
Inhalation anesthetic that can cause fatal hepatotoxicity and cardiac arrhythmia and is no longer used in the US
Halothane
Inhalation anesthetic that is withdrawn from the market due to fatal nephrotoxicity
Methoxyflurane
Inhalation anesthetic that at high concentrations can produce CNS excitation, leading to seizures
Enflurane
Rare, but fatal side effect associated with combination of halogenated inhalation anesthetic and depolarizing blocker
Malignant Hyperthermia
Close to ideal inhalation anesthetic that exhibits rapid and smooth induction and recovery, with little organ system toxicity
Sevoflurane
Barbiturate used for the induction of anesthesia
Thiopental
A short-acting benzodiazepine commonly used adjunctively with inhalation anesthetics and opioid analgesics for a balanced anesthesia
Midazolam
Opioid safe for use of analgesia and anesthesia during cardiac surgery
Fentanyl
Produces both rapid anesthesia and recovery, has antiemetic activity, but may cause marked hypotension
Propofol
Produces dissociative anesthesia but has significant analgesic activity
Ketamine
Mechanism of action of the intravenous anesthetic that causes dissociative anesthesia
Block NMDA receptor
Side effects of dissociative anesthetic
Cardiovascular stimulation, increased cerebral blood flow, vivid dreams, hallucinations
Neuroleptanesthesia can be produced by a combination of these two agents
Fentanyl and droperidol
Mechanism of action of local anesthetics
Block voltage-gated sodium channels
This condition may necessitate larger doses of local anesthetics because the drugs become ionized and cannot penetrate the neuronal membranes
Low pH
Almost all local anesthetics have this property and sometimes require the administration of vasoconstrictors to prolong activity
Vasodilation
The only local anesthetic with vasoconstrictive property, but due to abuse potential, only occasionally used for nasal surgery
Cocaine
This type of local anesthetic is more likely to cause hypersensitivy reactions
Ester-type (local anesthetic with one “I” in name)
Local anesthetic most widely used for obstetric anesthesia but causes the most cardiac depression
Bupivacaine
Side effect of most local anesthetics
CNS excitation
Common side effect of antipsychotics, MPTP (contaminant in illicit meperidine analog), and cholinergic excess
Drug-induced Parkinsonism
Precursor of dopamine that can cross the blood-brain-barrier and used to alleviate motor dysfunction in Parkinson’s disease
Levodopa (L-dopa)
Inhibits peripheral DOPA decarboxylase, reduces peripheral side effects of dopamine precursor and enhances its delivery to the brain
Carbidopa
Two fluctuations in clinical response associated with long-term use of dopamine precursor
“Wearing off” and “on-off-phenomenon”
Inhibits monoamine oxidase type B (MAO-B), used as monotherapy for early or mild Parkinson’s disease or adjunct to improve motor function in patients with fluctuations in clinical response
Selegiline
Inhibits of catechol-O-methyltransferase (COMT), used as adjunct to improve motor function in Parkinson’s patients with fluctuations in clinical response
Entacapone, tolcapone
Ergot type 2 dopamine receptor (D2) agonist, used as adjunct to improve motor function in Parkinson’s patients with fluctuations in clinical response
Bromocriptine
Non ergot type 2 dopamine receptors (D2) agonist, used for Parkinson’s and restless legs syndrome
Pramipexole and ropinirole
An antiviral that enhances dopamine release from nigrostriatal neurons
Amantadine
Two centrally-acting anticholinergics useful for tremor and rigidity but have little effect on bradykinesia in patients with Parkinson’s
Benztropine, Trihexylphenidyl
Drug of choice indicated for familial or essential tremors
Propranolol
Two drugs that inhibit vesicle monoamine transporter used for Huntington’s
Tetrabenazine, reserpine
An antipsychotic with dopamine receptor antagonist activity used for Huntington’s
Haloperidol
Three centrally-acting cholinesterase inhibitors used for Alzheimer’s
Donepezil, rivastigmine, galantamine
Noncompetitive antagonist of NMDA receptors used for Alzheimer’s
Memantine
Three main classes of CNS depressant drugs of abuse
Alcohol, opioid, barbiturate/benzodiazepine
Agent that is metabolized by alcohol dehydrogenase or microsomal ethanol-oxidizing system (MEOS) to acetaldehyde; displays zero-order kinetics of elimination
Ethanol
Enzyme that is induced through chronic exposure to alcohol, may contribute to tolerance
Microsomal ethanol oxidizing system (MEOS)
Complications of the gastrointestinal system associated with chronic alcohol use
Mallory-Weiss syndrome, hepatitis, cirrhosis, pancreatitis
Neurological abnormality caused by chronic alcohol use and thiamine deficiency
Wernicke-Korsakoff syndrome
The most common neurologic abnormality in chronic alcoholics
Neurologic deficits (Peripheral neuropathy)
Life-threatening alcohol withdrawal syndrome that peaks at 5 days after the last drink
Delirium tremens
Inhibits aldehyde dehydrogenase and used as deterrent for alcohol use
Disulfiram
Opioid receptor antagonist used to prevent alcohol abuse
naltrexone
Competes for alcohol dehydrogenase and is used in methanol or ethylene glycol poisoning
Fomepizole, Ethanol
Most commonly abused opioids
Heroin, morphine, oxycodone
Respiratory and CNS depression, pinpoint pupils, seizures, and needle track marks are symptoms of this intoxication
Opioid
Opioid receptor antagonist that is used to treat opioid intoxication, may cause more rapid and intense symptoms of withdrawal
Naloxone
Sweating, dilated pupils, piloerection, and flu-like symptoms are symptoms of withdrawal from this class of drugs
Opioid
Opioids used for long-term maintenance from opioid withdrawal
Methadone, Buprenorphine
Most widely abused sedative hypnotics
Short-acting barbiturates (pentobarbital)
Two date rape drugs that work through enhancement of GABA receptors in the brain
Flunitrazepam, GHB (γ-hydroxybutyrate)
Benzodiazepine antagonist used to treat benzodiazepine intoxication
Flumazenil
