Section 3 - Last minute things that aren't sticking! (everythin until the illegal drug section.)

Question 1

Local Anesthetics - the balance between rate of ____ and rate of ____ is of clinical significance.

Answer 1

Absorption/Metabolism.

Question 2

If absorption rate is lower than metabolic rate, then plasma levels will be ___ and so will be ___.

Answer 2

Lower/toxicity.

Question 3

Balanced anesthesia - def

Answer 3

refers to use of combinations of drugs to accomplish what inhalation anesthetic can not do alone.

Question 4

What are some of the drugs used for balanced anesthesia?

Answer 4

Short acting barbiturates, neuromuscular blockers, opioids and Nitrous Oxide, etc.

Question 5

Procaine is an Ester or Amide?

Answer 5

Ester.

Question 6

Drugs not recommended for Treating Cancer Patients - Pure Opioid Agonists - Meperidine -

Answer 6

toxic metabolite accumulates with prolonged use.

Question 7

Drugs not recommended for Treating Cancer Patients - Opioid Agonist-Antagonists - Buprenorphine, Butorphanol, Nalbuphine, Pentazocine -

Answer 7

Ceiling to analgesic effects; can precipitate withdrawal in opioid-dependent patients; causes psychomimetic reactions.

Question 8

Drugs not recommended for Treating Cancer Patients - Opioid Antagonists - Naloxone/Naltrexone

Answer 8

Can precipitate withdrawal in opioid-dependent patients - limit use to reversing life-threatening respiratory depression caused by opioid overdose.

Question 9

Drugs not recommended for Treating Cancer Patients - Benzodiazepines - Diazepam, Lorazepam, and others.

Answer 9

Sedation from Benzos limits opioid dosage; no demonstrated analgesic action.

Question 10

Drugs not recommended for Treating Cancer Patients - Barbiturates - Amobarbital, Secobarbital, and others.

Answer 10

Sedation from barbiturates limits opioid dosage; no demonstrated analgesic action.

Question 11

Drugs not recommended for Treating Cancer Patients - Misc - Cocaine -

Answer 11

no analgesic efficacy, either alone or in combination with an opioid.

Question 12

Drugs not recommended for Treating Cancer Patients - Misc - Marijuana

Answer 12

Side effects (dysphoria, drowsiness, hypotension, bradycardia) preclude routine use as an analgesic.

Question 13

Drugs not recommended for Treating Cancer Patients - Misc - Brompton’s Cocktail

Answer 13

analgesic efficacy is no better than that of a single opioid.

Question 14

WHO Analgesic Ladder - what are the 3 steps?

Answer 14

Step 1 - Mild to Moderate Pain (Non-opioid Analgesic)
Step 2 - More severe pain - add opioid analgesic.
Step 3 - Severe pain - substitute opioid - MORPHINE.

Question 15

Non-drug treatment for pain management (5)

Answer 15

Heat, cold, massage, exercise, acupuncture.

Question 16

Migraine - drugs to abort an attack -

Answer 16

opioid analgesics (aspirin like analgesics - motrin - or opioid analgesics, like Demerol), ergot alkaloids (Ergotamine) and Serotonin Receptor Agonist (Sumaptriptan)

Question 17

Drugs for migraine prevention -

Answer 17

Beta blockers (atenolol), Calcium Channel Blockers (verapamil), Tricyclic Antidepressant (amitriptyline), Methysergide (sansert), Sodium Divalproex (depakote.)

Question 18

Conventional Antipsychotic Agents - Classifications (3) and drugs!

Answer 18

Low - Chlorpromazine (Thorazine)
Medium - Loxatine
High Potency - Haloperidol (Haldol.)

Question 19

Conventional Antipsychotic Agents - MOA -

Answer 19

block receptors within and outside the CNS - block Dopamine, ACH, Histamine, ETC.

Question 20

Therapeutic Uses - Conventional Antipsychotics -

Answer 20

Schizophrenia, Bipolar Disorder, Tourette’s Syndrome, Prevention of emesis.

Question 21

Conventional Antipsychotic Agents - Blocking… D2 Dopamingergic receptor

Answer 21

EPS, Prolactin Release

Question 22

Conventional Antipsychotic Agents - Blocking… H1 Histamine -

Answer 22

Sedation

Question 23

Conventional Antipsychotic Agents - Blocking… - Muscarinic Cholinergic -

Answer 23

Dry mouth, blurred vision, urinary retention, constipation, tachycardia.

Question 24

Conventional Antipsychotic Agents - Blocking… - Alpha-1 Adrenergic -

Answer 24

Orthostatic Hypotension, Relfex Tachycardia.

Question 25

Conventional Antipsychotic Agents - Blocking... - 5-Ht2 -Serotoninergic -

Answer 25

Weight Gain.

Question 26

Tricyclic Antidepressants - toxicity.

Answer 26

Avoid lethal dose, only dispense one-week supply..

Question 27

What is the antidote for Tricyclic Antidepressant Toxicity?

Answer 27

Cholinesterase inhibitor (physostigmine)

Question 28

Bubroprion (Wellbutrin) Basic info, MOA, Adverse Effects -

Answer 28

Similar structure to amphetamines, Response 1-3 weeks, MOA - Unknown, Adverse - agitation, headache, constipation, dry mouth.

Question 29

What are some treatments for benzodiazepine toxicity?

Answer 29

Gastric Lavage, Activated Charcoal, Flumazenil (Romazicon) - a benzodiazepine receptor antagonist , dialysis, IV fluids.

Question 30

Barbiturates - for ___ depression of the CNS.

Answer 30

Non-specific.

Question 31

Barbiturates - classification (3.) - and drugs for the categories.

Answer 31

Ultra-short acting - Thiopental. Short to intermediate acting - Secobarbital. Long-acting - Phenobarbital.

Question 32

Barbiturates - MOA -

Answer 32

Bind to gaba receptor-chloride channel complex to..enhance inhibitor action of gaba, directly mimic actions of gaba, etc...

Question 33

Since barbiturates can act as agonists, there is no end to how much they can suppress. T/F?

Answer 33

True!

Question 34

OCD - Treatment - Drug Therapy -

Answer 34

Clomipramine (Anafranil)

Question 35

Clomipramine - Anafranil - only ___ effective in treatment of OCD, Takes ____ to ____ weeks to see maximal improvements. It blocks uptake of __ in addition to ___.

Answer 35

TCA/4-12 weeks/NE, Serotonin

Question 36

SSRI Drugs for OCD Treatment - 3

Answer 36

Prozac, Luvox, Zoloft

Question 37

What are the drug choices in treating ADHD? (2)

Answer 37

Wellbutrin (bupropion) and Inderal (propanolol)

Question 38

CNS Stimulations - used for...and also increase activity of...

Answer 38

ADHD, narcolepsy, obesity..... and increase activity of the CNS.

Question 39

Amphetamine - CNS Stimulant - releases....

Answer 39

NE, Dopamine, Serotonin...

Question 40

Amphetamine - uses?

Answer 40

Arouse mood, increase self confidence, suppress appetite and pain perception.