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Pharmacology Block 3 > Week 15, 16 Drugs > Flashcards

Week 15, 16 Drugs Flashcards

1
Q

Sodium Thiopental

A 
Parenteral General Anesthetic
Barbiturate--> GABA.A-R
(X) induction> 10 min
(-) t 1/2= 12 hrs> hangover 
(-) CNS depression, reduce blood flow/intracranial P
(-) CV- HYPOtension 
(-) Respiratory depression
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2
Q

Propofol

A

Parenteral General Anesthetic
–> GABA.A-R
(X) induce, maintain
(+) anti-emetic, less hangover, sensual dreams
(-) pain on injection, excitation on induction
(-) LARGE BP Drop: vasodilation, depress myocardial contractility, blunts baro-R
(-) ^^Resp depression

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3
Q

Etomidate

A

Parenteral General Anesthetic
(X) induce for pt @ risk for HYPOtension (no bp effect)
(-) pain on injection, myoclonus
(-) nausea, vomit
(-) suppression of adrenocortical response
(-) CNS, CV, Respiratory depression

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4
Q

Ketamine

A

Parenteral General Anesthetic
“dissociative anesthesia”
NMDA-R antagonist
analgesia, unresponsive, amnesia, (+)broncodilator*
(X) iv, im, oral> pt with bronchospasm, children for short, painful procedures
(-) nystagmus, salivation, lacrimation, spontaneous mvmnt
(-) ^ ICP
(-) emergence delirium- disturbing hallucinations
(-) HTN (sympathomimetic)

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5
Q

Midazolam

A 
Parenteral General Anesthetic
short-acting BZD
--->+ GABA.A-R
(X) conscious sedation, anxiolysis, amnesia
(X) induction or pre-op anxiolytic
- slow induction, long duration
(-) respiratory depression, HYPOtension
(O) neuromuscular disease
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6
Q

Isoflurane

A 
Inhaled General Anesthetic
*mod blood:gas
(X) maintain or induce(*irritant)
\+NO for reduced dose 
(-) airway irritant, resp depressant, 
(-)HYPOtension, arrythmias
(-) ^ ICP
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7
Q

Desflurane

A 
Inhaled General Anesthetic
-LOW blood:gas= rapid
*special admin equip
(X) out-pt surgery, maintain 
(+) skeletal muscle relax
(-) HYPOtension, arrhythmia, ^ICP
(-) resp depression, cough
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8
Q

Sevoflurane

A 
Inhaled General Anesthetic
*metab to Fl in liver/ cmpd A-nephrotoxic
(X) in/out pt
(X) induce, maintain
(X) children, adults 
(-) HYPOtension, arrhythmia, ^ ICP
(-) resp depression, less irritant
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9
Q

Nitrous Oxide

A

Inhaled General Anesthetic
- insoluble, ^ concent of other anesthetics
(X) enhance induction
(X) sedation and analgesia @ 50%
(-) dilute O2> use 100% O2
(O) pneumothorax, dissolve in gas pocket , abuse liability

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10
Q

Cocaine

A

Local Anesthetic- Ester
—/NERT on adrenergic N
(X) topical anesthetic of URT
(+) vasoconstrict–/bleed

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11
Q

Procaine

A

Local Anesthetic- Ester
(X) infiltration anesthesia
- low potency, slow onset, short duration

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12
Q

Tetracaine

A

Local Anesthetic- Ester
-potent, long duration
(X) spinal anesthesia, topical and opthalmic

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13
Q

Benzocaine

A

Local Anesthetic- Ester
- SLOW absorption= LONG duration
(X) topical application to wounds/ulcerated surfaces

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14
Q

Lidocaine

A

Local Anesthetic- Amide
-fast, intense, long lasting
+ vasoconstrictor (epi)
(X) local of intmed duration

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15
Q

Bupivacaine

A

Local Anesthetic- Amide
(X) sensory>motor LONG lasting
(X) epidural childbirth**
(-) cardiotoxicity

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16
Q

Ropivacaine

A

Local Anesthetic- Amide
(X) similar to bupivacaine + less cardiotoxic
(X) epidural childbirth**
(+) sensory»»»>motor

17
Q

Amitryptiline

A

Tri-Cyclic Antidepressant
-LONG t 1/2
(X) MDD (2nd to SSRI), chronic pain
(-) 2-3 weeks for effect, reduce REM, anti-cholinergic
(/) overdose toxicity: seizure, coma, cardiac conduction deficit

18
Q

Clomipramine

A

Tri-Cyclic Antidepressant
(X) MDD (2nd to SSRI), OCD
(-) 2-3 weeks for effect, reduce REM, anti-cholinergic
(/) overdose toxicity: seizure, coma, cardiac conduction deficit

19
Q

Fluoxetine

A

SSRI
-LONG t 1/2 (for weening off)
(X) MDD, OCD, panic, PTSD, anxiety, PMDD, ween off
(-) SSRI discontinuation syndrome (1-7 days after)- dizziness/light-head, vertigo, anxiety, fatigue, headache, tremor, visual disturbance
(-) nausea, insomnia, sex dysfunction
(O) MAOIs- serotonin reaction

20
Q

Sertraline

A 
SSRI
-shorter t 1/2 
(X) MDD, OCD, panic, PTSD, anxiety
(-) SSRI discontinuation syndrome (1-7 days after)- dizziness/light-head, vertigo, anxiety, fatigue, headache, tremor, visual disturbance
(-) nausea, insomnia, sex dysfunction
(O) MAOIs- serotonin reaction
21
Q

Buproprion

A

Atypical Anti-depressant
–/DA and NE reuptake
(X) MDD, nicotine withdrawal, SAD

22
Q

Mirtazapine

A

Atypical Anti-depressant
—/a2 NEauto-R in brain
(X) MDD
(-) ^^ appetite

23
Q

Duloxetine

A

SNRI
(X) MDD, fibromyalgia, back pain
(-) sleep disturb, GI, sex dysf
(O) liver disease

24
Q

Phenelzine

A

MAOI
irreversible—/MAO deamination of NE, DA, 5HT, tyramine
(X) MDD (2nd choice to SSRI), narcolepsy
(O) tyramine in diet
(-) toxicity; agitation, hallucination, convulsions
–> stimulation in normals, correct sleep in depressed

25
Q

Chlorpromazine

A

Typical Anti-psychotic
low/med potency
(X) anti-psychotic +
(-) sedation, anti-cholinergic

26
Q

Thioridazine

A

Typical Anti-psychotic
low potency> less extra-pyramidal effects
(X) anti-psychotic +
(-) sedative, anti-cholinergic

27
Q

Fluphenazine

A

Typical Anti-psychotic
HIGH potency> ^ extra-pyramidal
(X) anti-psychotic +
(-) less sedative, less anticholinergic

28
Q

Haloperidol

A

Typical Anti-psychotic
HIGH potency> ^ extrapyramidal
(X) Tourette’s Syndrome, anti-psychotic +
(-) less sedative, less anticholinergic

29
Q

Clozapine

A 
Atypical Anti-psychotic
--/D4 and 5HT2 R
*WORST side-effect profile 
(X) anti-psychotic NEG sxs 
(-) agranulocytosis, lower seizure threshold
30
Q

Olanzapine

A

Atypical Anti-psychotic
–/D1,2,4 and 5HT2
(X) anti-psychotic NEG sxs, adjuct to MDD
(-) diabetes risk

31
Q

Risperidone

A 
Atypical Anti-psychotic
--/5HT2 and D2
**BEST Side effect profile**
(X) anti-psychotic NEG sxs
*IM preparation (1/week)
32
Q

Quetiapine

A

Atypical Anti-psychotic
–/5HT2 and D2
(X) augment anti-psychotic NEG sxs with MDD (short t 1/2)

33
Q

Aripiprazole

A

Atypical Anti-psychotic
–/5HT2
*Partial agonist of D2 (–>+ @ low, –/ at high)
(X) anti-psychotic NEG sxs, adjunct in MDD

Pharmacology Block 3 (9 decks)

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