Test 2 ch 6 Flashcards

1
Q

Afferent

A

towards CNS

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2
Q

Efferent

A

away from CNS

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3
Q

CNS neurotransmitters

A

ACh, GABA, dopamine, epinephrine, norepinephrine, serotonin, glutamate.

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4
Q

Primary PNS neurotransmitters

A

ACh, norepinephrine

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5
Q

Sympathetic nervous system transmitters

A

ACh, norepinephrine, dopamine, glutamine, epinephrine

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6
Q

Parasympathetic nervous system transmitters

A

ACh

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7
Q

alpha receptors

A

vasoconstriction, raises blood pressure, decongestion

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8
Q

beta-1 receptors

A

increase heart rate and contractive force of the heart.

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9
Q

beta-2 receptors

A

influence bronchodilation

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10
Q

Anticholinergic side effects

A
decreased GI motility
decreased sweating
decreased urination
dilated pupil and blurred vision
dry eyes
dry mouth
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11
Q

Goals of anesthesia

A

amnesia
adequate muscle relaxation
adequate ventilation
pain control

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12
Q

malignant hyperthermia

A

rare but serious side effect of anesthesia that is associated with an increase in intracellular calcium levels causing a rapid rise in body temperature

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13
Q

dantrolene (Dantrium)

A

IV drug used to treat malignant hyperthermia, as well as a skeletal muscle relaxant to treat MS, stroke, cerebral palsy, and spinal cord injuries. Is thought to reduce muscle tone and metabolism. Is required to be in OR drug kits.

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14
Q

midazolam (Versed)

A

benzodiazepine that is used for induction, short procedures, and dental procedures. Has the fastest onset, greatest potency, and most rapid elimination of the benzodiazepines.

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15
Q

flumazenil (Romazicon)

A

antagonizes benzodiazepines by competing for receptor sites. it is used for complete or partial reversal of anesthesia.

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16
Q

naloxone (Narcan)

A

antagonizes benzodiazepines by competing for the opiate receptor sites. It has a greater affinity for the receptor than the narcotic, but its action is much shorter. Therefore this drug has to be administered repeated to obtain the desired effect.

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17
Q

nitrous oxide

A

Inhalant anesthetic, but not a very potent anesthetic. It is usually used with other agents. It reduces blood pressure and provides only analgesia. Is typically used in dental procedures

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18
Q

enflurane (Ethrane)

A

Inhalant anesthetic that has rapid induction and recovery Causes uterine relaxation so it cannot be used during labor.

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19
Q

propofol (Diprivan)

A

Injectable anesthetic, used for the maintenance of anesthesia, sedation, or treatment of agitation of patients.
changes urine color pink, green, or brown
its a white emulsion

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20
Q

fentanyl (Sublimaze)

A

Injectable anesthetic that is used extensively for open-heart surgery. Lozenge is used extensively with children and IV form in the OR. Has greater potency than morphine. Can also be administered as a patch which releases the drug into the bodies fat where it is slowly released.

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21
Q

alfentanil (Alfenta)

A

fentanyl derivative that is ultrashort acting (5-10 mins)

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22
Q

sufentanil (Sufenta)

A

fentanyl derivative five to ten times more potent than fentanyl

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23
Q

remifentanil (Ultiva)

A

fentanyl derivative that is the shortest acting opioid with a rapid offset.

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24
Q

ester anesthetics

A

type of anesthetic that is short acting and easily broken down

25
Q

amide anesthetics

A

type of anesthetic that is difficult to break down so they are longer acting and eventually metabolized by liver enzymes.

26
Q

anesthetic order of function loss

A
  1. pain perception
  2. temperature sensation
  3. touch sensation
  4. proprioception
  5. skeletal muscle tone
27
Q

lidocaine (Lidoderm)

A

local anesthetic that can be administered as a patch or adhesive strip. Should only be applied to intact skin so when applying do not place on irritated red skin.

28
Q

acute pain

A

pain associated with trauma or surgery, usually easier to manage and disappears as the body heals

29
Q

chronic nonmalignant pain

A

pain that may have a diagnosed or undiagnosed cause. The pain lasts for more than three months and may respond poorly to treatment.

30
Q

chronic malignant pain

A

pain that accompanies a malignant disease and often increases in severity as disease progresses

31
Q

what system to do all narcotics suppress?

A

respiratory system

32
Q

natural opiods

A

endorphines, enkephalins and dynorphins

33
Q

patient-controlled analgesia (PCA)

A

means of controlling pain in hospitalized patients where the patient regulates, within limits, the amount of drug received by pushing a button.

34
Q

gold standard drug when comparing narcotics

A

morphine

35
Q

Buprenorphine (Buprenex, Subutex)

A

drug used for pain management and prevention of opioid withdrawal. Patients should start with this. Tablet is placed under the tongue until it dissolves.

36
Q

Buprenorphine-naloxone (Suboxone, Butrans)

A

Given after patient has completed a course of buprenorphine. Only approved for opioid dependence. Prescribers must have two DEA numbers to write for this drug.

37
Q

morphine (MS contin, MSIR, Kadian, Avinza)

A

Principal alkaloid obtained from opium. Strong analgesic used for relief of severe and chronic pain, preoperative sedation, and supplement to anesthesia. Drug of choice for pain of heart attacks

38
Q

Codeine

A

opioid analgesic that is primarily an antitussive or antidiarrheal. Converted to morphine in the liver.

39
Q

Fentora

A

buccal pellet form of Fentanyl that is effervescent and absorbed in the mouth. Because it is absorbed quicker it has to be in lower doses.

40
Q

Components of a migrane

A
prodrome
aura
headache
headache relief
postdrome
41
Q

propranolol (Inderal)

A

drug of choice for prophylaxis of migraines.

42
Q

rizatriptan (Maxalt, Maxalt-MLT)

A

triptan, oral tablets that are quickly absorbed and have most rapid onset of all oral migraine therapies. Tablet is dissolved under the tongue.

43
Q

sumatriptan (Imitrex)

A

triptan that when injected is effective in 15 minutes. It has little or no activity on dopamine, beta-adrenergic, and alpha-adrenergic receptors. Comes in autoinjectors.

44
Q

zolmitriptan (Zolmig)

A

triptan that is simiplar to sumatriaptan. It constricts cerebral blood vessels and reduces inflammation of sensory nerves.

45
Q

Ergot Derivatives

A

derived from fungi that help in the treatment of migranes
effectiveness is due to its vasoconstriction activity
side effects are nausea and vomiting

46
Q

metoclopramide (Reglan)

A

antiemetic that reduces nausea and vomiting and enhances the absorption of other antimigraine products.

47
Q

chlorpromazine (Thorazine)

A

antiemetic that is effective in some migraines that are unresponsive to ergotamines.

48
Q

Tramadol (Ultram)

A

when given with Tylenol it has a high success rate in treating pain. Has a slow onset so it was promoted as nonaddictive, but recent evidence suggests that there is some potential for addiction.
Control schedule 5

49
Q

Inhalant Anesthetics

A

all reduce blood pressure so fluids are often given before surgery to help counter this.

50
Q

Analgesic ladder

A

pain - non-opiod like aspirin, acetaminophen or NSAID
pain persists - opiod for mild-moderate pain like codeine
pain still persists - stronger opiod like morphine, oxycodone, fentanyl

51
Q

C-II laws

A

locked away in the pharmacy, prescription must have DEA of doctor, has to be given to pharmacy within 1 month, cannot be refilled.

52
Q

addiciton

A

compulsive disorder that leads to continued use of a drug despite harm it causes

53
Q

dependence

A

physical and emotional reliance on a drug that will lead to a withdrawal period when patients stop taking it.

54
Q

meperidine (Demerol)

A

drug that changes the way the body senses pain. Used to combat mild to moderate pain. Shouldn’t be used long term because of a metabolite than can cause serious problems can accumulate

55
Q

Oxycodone (OxyContin, OxyIR, Roxicodone)

A

used to relieve mild to severe pain. Most commonly combined with other analgesics like APAP or aspirin. Causes CNS depression. It is very commonly abused. OxyContin is extended release form.

56
Q

Fiorcet

A

combination drug used to treat migraines, tension, and muscle contraction headaches

57
Q

Effects of narcotics

A

Analgesia
Sedation
Euphoria and Dysphoria

58
Q

Fentanyl

A

administered as patch and as a lozeenge
should not be used for acute pain
releases into body fats and is stored and slowly released into the bloodstream

59
Q

Hydrocodone

A

sold only in combination with other drugs
most abused prescription drug
is habit-forming and can lead to addiction