Pharmacology Unit 7 Flashcards
What is Parkinson’s Disease (PD)?
A chronic degenerative disease of the CNS associated with diminished dopamine synthesis, release, or binding in the substantia nigra.
What are the clinical signs of Parkinson’s Disease?
Bradykinesia, rigidity in movement, difficulty initiating movement, and loss of motor control.
What is bradykinesia?
A condition characterized by slowness of movement.
What causes rigidity in movement in Parkinson’s Disease?
A compensatory response of cholinergic activity to dopamine under secretion.
Fill in the blank: Parkinson’s Disease is associated with diminished _______ in the substantia nigra.
dopamine
What role does cholinergic activity play in Parkinson’s Disease?
It compensates for dopamine under secretion, causing rigidity in movement.
What is the primary cause of symptoms in Parkinson’s Disease?
Dysfunction of dopamine in various parts of the brain
Which area of the brain is most critical in Parkinson’s Disease and relies on dopamine?
Corpus striatum
What are the two key neurotransmitters involved in controlling balance, posture, tone, and involuntary muscle movement?
- Dopamine
- Acetylcholine (Ach)
What is the main focus of drug therapy in Parkinson’s Disease?
Dopamine and Acetylcholine (Ach)
If dopamine is absent, what effect does Acetylcholine (Ach) have in Parkinson’s Disease?
Ach has a more dramatic effect
What is the therapeutic goal when dopamine is absent in Parkinson’s Disease?
Restore dopamine and block Ach
What are some important structures mentioned in the pathophysiology of Parkinson’s Disease?
- Substantia nigra pars compacta
- Globus pallidus externus
- Ventroanterior nucleus
- Substantia nigra pars externa
- Subthalamic nucleus
- Globus pallidus interna
- Ventrolateral nucleus of the thalamus
What is the primary pharmacokinetic property of dopamine in relation to the blood-brain barrier (BBB)?
Dopamine does not cross the BBB.
What is the primary pharmacokinetic property of levodopa (dopa) in relation to the blood-brain barrier (BBB)?
Dopa crosses the BBB.
What is the method of administration for levodopa?
Oral administration.
How can dosages of levodopa be minimized?
By administering it with a companion drug that inhibits premature levodopa breakdown.
What type of drug is used to inhibit the premature breakdown of levodopa?
A peripheral de-carboxylase inhibitor, such as carbidopa.
What is the combination of levodopa and a decarboxylase inhibitor called?
Sinemet.
True or False: Levodopa is more effective when taken alone without any companion drugs.
False.
Fill in the blank: Levodopa is often administered with _______ to enhance its effectiveness.
carbidopa.
What are common gastrointestinal problems associated with Levodopa therapy?
Nausea, vomiting, constipation
These issues can significantly affect patient compliance and quality of life.
What cardiovascular problems can arise from Levodopa therapy?
Orthostatic hypotension, arrhythmias
These conditions may require monitoring and management to prevent falls and other complications.
What are dyskinesias in the context of Levodopa therapy?
Involuntary movements, often as a side effect of long-term use
Dyskinesias can severely impact motor control and daily functioning.
How can Levodopa therapy lead to behavioral changes?
Changes in mood, impulse control issues
Behavioral changes can affect social interactions and overall mental health.
What does diminished response to Levodopa mean?
Decreased effectiveness of the drug over time
This phenomenon may necessitate dosage adjustments or alternative therapies.
What are fluctuations in response to Levodopa?
Variability in symptom control, often referred to as ‘on-off’ phenomena
Patients may experience periods of good response followed by periods of poor response.
What are drug holidays in the context of Levodopa therapy?
Temporary cessation of the drug to manage side effects or diminished response
Drug holidays may help restore the drug’s effectiveness and reduce adverse effects.
What are dopamine agonists used for?
Management of Parkinson’s disease symptoms
Dopamine agonists mimic the effects of dopamine in the brain.
What is the role of cholinergic blockers in Parkinsonism?
To reduce tremors and muscle rigidity
Cholinergic blockers help balance neurotransmitters in the brain.
What is amantadine used for?
Treatment of Parkinson’s disease and to manage dyskinesia
Amantadine has both antiviral and antiparkinsonian properties.
What do catechol-O-methyltransferase inhibitors do?
Prolong the effect of levodopa by inhibiting its breakdown
These inhibitors enhance dopamine availability in the brain.
What is the function of monoamine oxidase B inhibitors in Parkinsonism?
To inhibit the enzyme that breaks down dopamine, thereby increasing its availability
This helps improve motor function in patients.
What is the first requirement for general anesthesia?
Rapid onset of anesthesia (loss of consciousness and sensation)
This ensures that the patient becomes unconscious quickly for surgical procedures.
What is required for skeletal muscle relaxation in general anesthesia?
Skeletal muscle blockers used in conjunction
These blockers help achieve adequate muscle relaxation necessary for surgical access.
What does inhibition of sensory and autonomic reflexes refer to in general anesthesia?
The suppression of reflex actions during surgery
This is important to prevent involuntary movements that could complicate surgical procedures.
Why is easy adjustment of the anesthetic dosage important during a procedure?
To tailor the anesthesia level to the patient’s needs
This flexibility allows anesthesiologists to ensure patient safety and comfort.
What is a key safety requirement for general anesthesia?
A minimum of toxic side effects (i.e., be relatively safe)
Anesthesia should not cause harmful effects to the patient.
What is expected regarding recovery after administration of general anesthesia?
Rapid, uneventful recovery after administration is terminated
Quick recovery is essential for patient turnover and safety.
What is the purpose of amnesia in general anesthesia?
No recollection of what occurred during the surgery
This helps reduce psychological distress associated with surgical experiences.
What is Stage I of general anesthesia?
Analgesia
This stage involves the loss of pain sensation while the patient remains conscious.
What characterizes Stage II of general anesthesia?
Excitement (Delirium)
Patients may exhibit agitation and confusion during this stage.
What is the primary focus during Stage III of general anesthesia?
Surgical Anesthesia
This is the stage where the patient is adequately anesthetized for surgical procedures.
What is Stage IV of general anesthesia?
Medullary Paralysis
This stage is characterized by respiratory and cardiovascular failure.
What is the goal of the anesthesia provider during the induction of general anesthesia?
To bring the patient to Stage III as rapidly as possible and maintain that stage for the duration of the surgical procedure
This ensures optimal conditions for surgery while minimizing risks.
What are inhalation anesthetics?
Gases or volatile liquids used for anesthesia
Commonly used in surgical procedures for induction and maintenance of anesthesia.
What are intravenous anesthetics?
Anesthetics administered through the bloodstream
Used for rapid induction of anesthesia.
What are the two primary methods of administration for anesthesia?
Inhalation or IV
How is anesthesia distributed in the body?
Uniformly throughout the body
What effect can temporary storage of anesthesia in adipose tissue have on a patient?
Confusion, disorientation and lethargy
How does the dosage of anesthesia vary?
By age
What are the primary routes of elimination for anesthesia?
Lungs, biotransformation in the liver or a combination
Fill in the blank: Anesthesia may be temporarily stored in _______.
adipose
True or False: Anesthesia is only eliminated through the lungs.
False
What are adjuvants in anesthesia?
Drugs used to balance the effects of general anesthetics
Adjuvants are necessary because general anesthetics cannot always provide all desired effects.
Name two types of adjuvants used in anesthesia.
- Preoperative medications
- Neuromuscular blockers
These adjuvants help enhance the overall anesthetic experience.
What is a common characteristic of most local anesthetics?
They share a common chemical strategy
This commonality allows for similar mechanisms of action in blocking nerve signals.
How are local anesthetics chosen for use?
Based on the site and nature of the procedure
Different anesthetics may be more effective depending on the specific requirements of the surgical or medical procedure.
What suffix is commonly associated with local anesthetics?
‘caine’
Examples include lidocaine, bupivacaine, and procaine.
What are the methods of administration for local anesthetics?
Topical, transdermal, injection
Local anesthetics can be administered in various ways to achieve the desired effect.
What is crucial for the effectiveness of local anesthetics at the site of administration?
Drug should remain at the site
Ensuring that the anesthetic remains localized is key to its effectiveness.
How are local anesthetics eliminated from the body?
By hydrolyzing (breaking apart of the molecule) of hepatic enzymes
This process involves the liver breaking down the anesthetic compounds.
What organ is primarily responsible for the excretion of local anesthetics?
Kidney
The kidneys play a vital role in filtering and excreting waste products, including anesthetics.
What is a clinical use of local anesthetics that involves applying the anesthetic directly to the skin or mucous membranes?
Topical
Topical anesthetics are often used for minor procedures or to relieve pain in specific areas.
What method of local anesthesia involves delivering the anesthetic through the skin using a patch?
Transdermal
Transdermal delivery is useful for providing continuous pain relief.
What technique of local anesthesia involves injecting the anesthetic directly into the tissue?
Infiltration
Infiltration is commonly used for surgeries and dental procedures.
What type of local anesthesia targets specific nerves to block sensation in a particular area?
Peripheral Nerve block
This technique is often used for limb surgeries.
What is the term for the technique that involves injecting anesthetics into the spinal canal?
Central Neural Blockade
This includes spinal and epidural anesthesia.
What method of anesthesia is used to block the sympathetic nervous system?
Sympathetic
Sympathetic blocks can be used for pain management in certain conditions.
What is the term for the regional anesthesia technique that involves injecting anesthetic into a limb via a vein?
Intravenous Regional Anesthesia (Beir Block)
Beir Block is commonly used for procedures on the upper or lower extremities.
