pharmacology based on question responses Flashcards
heparin acts by…
accelerating the activity of antithrombin III which inactivates thrombin
does heparin lyse existing clots or just prevent others from forming
it doesn’t lyse existing clots
if there is bleeding caused by heparin, what can you do to stop it?
take protamine sulfate, a postively charged basic protein that inactivates the negatively charged heparin by forming a salt compound.
what does protamine sulfate do and what are side effects of protamine sulfate?
- inactivates heparin if there’s ever a bleed
side effects: hypotension, pulmonary edema and anaphylaxis
aminacaproic acid blocks…
plasminogen activation and is therefore used to treat bleeding disorders induced by fibrinolytic agents
what’s Enaxaparin?
a low molecular weight heparin that potentiates antithromib III– it can cause bleeding and thrombocytopenia like heparin
what does urokinase do?
it’s a fibrinolytic drug that converts plasminogen to plasmin —> degrades the fibrin clot
Fentanyl
an opiod analgesic used along with other benzos such as midazolam during general anesthesia– (analgesia and resp. depression so you can easily respirate a pt)
naloxone
an opioid antagonist– can be given after an opioid (like fentanyl) post-operatively to counteract respiratory depression so that pt can be axtubabted. BUT it also wears off the analgesic effect of opioids
midazolam- what type of drug? what does it do? what can it be reversed by?
a benzodiazapene- IV aneshetics -a good amnesic; causes respiratory depression. Can be used as anesthesia
- can be reversed with flumazenil
Flumazenil
a benzodiazapine antagonist– stops resp. depression brought on by benzos post-operatively
Buprenorphine
partial agonist at mu receptors. It can cause some respiratory depression.
A partial opioid agonist (like Buprenorphine) added to a full agonist (like fentanyl) will…
decrease the effects of the full agonist (but not as much as a full antagonist (like naloxone))
naloxone and flumazenil
antidotes used to counteract the effects of opioids and benzos respectively
2 examples of barbituates
thiopental, methohexital
thiopental and methohexital are what drug type? what are their unique properties?
Barbituates.- IV anesthetics
Redistribution from brain terminates effects, but hepatic metab. is required for elimination; used mainly for induction or short term procedures; hyperalgesic; decreases respiration, cardiac function and cerebral blood flow
ketamine- what type of drug? unique properties?
dissociative drug - IV anesthetic-
-pt remains conscious but has amnesia, catatonia, and analgesia; related to phencyclidine (PCP)- causes emergence reactions (hallucinations, excitation, disorientation); CV stimulant
Fentanyl, alfentanil, remifentanil, morphine- what type of drugs? unique properties?
opioids - IV anesthetics
chest wall rigidity, resp depression (can rev. naloxone); neuroleptanesthia; fentanyl + droperidol + nitrous oxide
Propofol- what is it? unique properties?
IV anesthetic
rapid induction, antiemetic
etomidate- what is it? unique properties?
IV anesthetic, rapid induction; minimal CV or resp effects; pain and myoclonus on injection; nausea
amitriptyline, nortriptyline, desipramine and doxepin are all what type of drug?
tricyclic antidepressents
tricyclic antidepressents (such as amitriptyline, nortriptyline, desipramine and doxepin) posses what 3 primary pharm actions?
1) inhibit biogenic amine reuptake at presynaptic neuron (serotonin and NE)
2) induce sedation
3) anticholinergic
the antidepressant effects of tricyclic antidepressents (such as amitriptyline, nortriptyline, desipramine and doxepin) stem from
inhibiting biogenic amine reuptake at presynaptic neuron (serotonin and NE)
tricyclic antidepressants are indicated for the txt of…
clinical depression with or without anxiety and/or sleep disturbances
agonists of dopamine receptors is used in which disease?
parkinsons
how do amphetamines act?
by increasing the release of NE from central noradrenergic neurons and promoting the release of dopamine
amphetamines are indicated for the txt of…
narcolepsy, ADD, ADHD and exogenous obesity
benzos like lorazepam, alprazolam, and diazepam potentiate the effects of…
GABA (gamma-aminobutyrate)—> antianxiety effect
is chloroprocaine an ester or an amide local anesthetic?
ester
is benzocaine an ester or an amide local anesthetic?
ester
is mepivacaine an ester or an amide local anesthetic?
amide
is tetracaine an ester or an amide anesthetic?
ester
is lidocaine an ester or an amide anesthetic?
amide
is bupivacaine an ester or an amide anesthetic?
amide
is etidocaine an ester or an amide anesthetic?
amide
is prilocaine an ester or an amide anesthetic?
amide
is ropivacaine an ester or an amide anesthetic?
amide
what is the easy way to determine an amide vs an ester local anesthetic?
amides have 2 “i’s” in there names (ie lidocaine, buivacaine, etidocaine… etc), esters have one or none! (chloroprocaine, tetracaine, etc.)
if you are allergic to one ester local anesthetic what should you do?
switch to amide local anesthetic bc you’re probably allergic to all ester anesthetics– the other class of local anesthesia, and vice versa!
alcohol withdrawals are characterized by
anxiety, tremor, insomnia, seizures, arrhythmias, nausea/vomiting, diarrhea, delirium tremens (acute delirium with confusion, disorientation, and agitation)
anxiety, tremor, insomnia, seizures, arrhythmias, nausea/vomiting, diarrhea, delirium tremens (acute delirium with confusion, disorientation, and agitation) is characteristic of withdrawals from what substance?
ETOH
hallucinations, agitation and tremor point to withdrawal from
ETOH
treatment of ETOH withdrawal
thiamine, sedative-hypnotics (benzos) with gradual tapering, clonidine and propranolol to correct the hyperadrenergic state
past lsd use can lead to
flashback visual hallucinations
chronic etoh use that leads to disorientation, walking unsteadily, inability to adduct the rt eye or abduct the left eye (opthalmaplegia), confabulation is a result of what disorder?
wernicke-korsakoff syndrome
wernicke-korsakoff syndrome, caused by chronic etoh use, is caused by what deficiency?
thiamine (vitamin B1)
dry beriberi
thiamine deficiency that damages peripheral nerves (wernicke-korasakoff syndrome - from chronic etoh)
wet beriberi
heart damage from thiamine deficiency (wernicke-korsakoff syndrome from chronic etoh)
as a result of thiamine deficiency, what enzyme stops working?
Pyruvate dehydrogenase- a mito enz that catalyzes conversion of pyruvate —> acetyl Co-A.
