Week 4 Flashcards
Skeletal muscle Relaxants
Neuromuscular blockers are?
Nicotinc (muscle) antagonist; used in majory surgery to induce temporary muscle paralysis.
Tubocurainin- duration of procedure
Succinylcholine- during intubation
Adverse effects- respiratory paralysis, cardiac dysfunction, muscle pain after use in surgery, and muscle damage may occur.
What does baclofen do and where is its action take place?
Is a antispasticity drug. Takes place in CNS
What are the adverse effects for skeletal muscle relaxants?
Sedation, confusion, headache, nausea, vomiting
What drug is used for skeletal muscle spasms of a local pathology- trama (SCI) inflammation, reduces spasticity caused by upper motor neuron lesion?
Gaba -a agonist-inhibition
Diazepam (Valium)
What is baclofen (liorseal)
- inhibition of monosynaptic and polysynaptic reflexes
- oral baclofen use has been established for multiple sclerosis, spinal cord injury, and intrathecal baclofen has been established for MS, SCI, and stroke.
- patients with stroke do not tolerate baclofen well.
This drug reinforces both presynaptic and postsynaptic inhibition of the spinal cord. Also inhibits nocioceptor transmission in the spinal dorsal.
Tizanidine, (Zanaflex, alpha 1 receptor agonist)
Patient reports getting a local injection of the toxin to reduce contraction associated with spastic disorders. Toxin blocs transmission at neuromuscular junction, last weeks- months?
Botulinum toxin- botox
What is the difference between sedative and hypnotic drugs?
Sedative- reduce anxiety and exert a calming effect
Hypnotic - produce drowsiness and sleepiness.
Take pill->become sedative->increase dosage->become hypnotic
A physical therapy student keeps having increased anxiety before test. He decides to go see a physician. What do you think the physician will prescribe?
Benzodiazepines
Agonist- diazepam, lorazxepam, triazolam, alprazolam, chlordizaepoxide===look for ams
Where does the benxodiazepine potenitate Gabaergic inhibition?
The BZ does not directly activate the GABA receptor but enhances the effect of the GABA binding.
What are the adverse effects of BZ
lead to day time drowsiness, impaired judgement, diminished motor skills, significantly impaired ability to learn new information.
Higher doses = date rape.
most common drug overdose to commit sucicide.
What is epilepsy?
Chronic disorder of various causes with recurrent seizures. Seizures are a sudden, unprovoked attacks of subjective experiential phenomena involuntary movements or convulsions.
The patient mentioned there was a unknown cause for his epilepsy? Is this a primary or secondary epilepsy?
Primary-unknown cause
Secondary =related to particular event (tbi, Stroke)
The patient Lost consciousnes and the seizures originated in a localized area of one cerebral hemisphere. What type of siezure if this?
Parital complex seizure
Complex=consciousness is lost
The patient had a seizure that originated in the localized area of one cerebral hemisphere but her consciousness remained inatack. What kind of seizure is this?
Simple Partial seizure
Simple-consciousness remains intack
A type of seizure that takes place when a neuronal discharge involves both cerebral hemisphere.
Generalized seizures
This seizure involves unilateral involvement, **no impaired Consciousness, jerking of the face, contralateral flexion and elevation of the arm, contralateral turning of the head, hallunications of sight, **
Simple partial seizures
This seizure is localized onset that progresses bilateral involvement, impaired consciousness , amensic about the event, clumsy perserveration of ongoing motor events, chewing, drawing, walking.
Complex partial seizures
Your working with a patient and all of sudden they have a sudden loss of consciousness, Sudden rigid extensor spasm (10-30 seconds) Rhythemic flexor spasm, respiration ceases, defacation, micturation,
Generalized
(Tonic -clonic seizure) grand mal
Your working witha child when all of sudden he/she stares blanky for a few mintues. Mild chronic movements-eye blinking along with abrupt brief loss of consciousness.
Generalized seizures
Absence Seizures
Your working with a patient when off a sudden your patient has brief contractions confied to the face, trunk, and extremites lasting only seconds.
Generalized Seizures
Myoclonic Seizures.
Generalized seizures
Atonic seizures vs status epilepticus
atonic occur in children, drop attacks 10-30 secs, may involve entire body resulting in potential injury,
Status epilepticus- seizures are prolonged or prepeated that recovery does not occur between attacks, medical emergency
OMG your patient is having a seziure. What do you do?
Ease the patient to the floor, put something soft under their head, turn patient gently onto their side.Dont put anything in their mouth and do not restrain their movements.
Basically dont let them fucking die
What is the primary drug for seizure control? This drug alters conductance of potassium and calcium channels and blocks sodium channels.
Anti-epileptic drug
Phenytonin (dilatin)- most common
What is the second most common Seizure drug?
Carbamazepine (tegretol)
What are common side effects for phenytonin, carbamazepine, valproic drugs?
Anti-epileptic side effects
Atazia, nystagmus, drowsiness, sedation, confusion, visual disturbances, cardiac dysrhythmias
What are the stages of anesthesia?
Analgesia(conscious), disinhibition(delirous), surgical anthesia (unconscious, no pain), medullary depression-severe respiratory or cardio supression
What is the most common type of inhaled anesthetics?
Nitrous oxide - lacks sufficient potency to produce surgical anesthesia alone.
What is an adverse effect from inhaled anesthetics and association with succinylcholine?
malignant hyperthermia
Morphine and fentanyl are used in blanced anesthesia especially in high risk patients. What drug is this?
Opiods
This is a intravenous anesthetic. Most commonly used and see rapid anesthesia and rapid patient recovery. What drug is this?
Propofol (diprivan)
Creates a “dissociative anesthesia” where the patient is conscious but exhibits catatonia (unresponsive), WHat drug is This?
Ketamine (ketalar)
