Week 4 Flashcards
Non-depolarizing neuro-muscular blockers x3
rocuronium bromide-newer drug short half life few minutes
Pancuronium bromide-intermediate half life 30 minutes
vecuronium -intermediate acting
Tubocurarune
Tubocurarine is historical because
original neuro blocker in curare used on arrow tips of South Africa natives. It has a long half-life of 60 minutes. unsafe for surgery
nicotine stimulates both the ____ and ___ systems. high doses of nicotine in insects can produce an ____ of conflicting signals that can produce death and nicotine has been used as an ____. High concentrations are found on nicotine leaves to ____ consumption of the leaf
sympathetic and parasympathetic
overload
insecticide
discourage
Nicotine is available in gum as ____
nicorettes
trade name for nicotine patches x3
habitrol-slow
prostep-fast
nicoderm-fast
nicotine patches results in patients having a ____ reaction (50%) it is placed on the upper back where the skin is ____. The success rate is about ___%
skin
thicker
10
______ is a partial nicotine agonist: it gives effects similar to nicotine but lesser in degree. it prevents nicotine from binding to the receptors. well publicized cases of ____ and ____ behavior have reduced the number of descriptions.
chantix
suicidal
erratic
______ chewing is very common in Southeast Asia. this drug consists of a piece of the ___ ___ ____ wrapped inside a leaf of ____ paper. its structure is close to nicotine which probably stimulate nicotinic receptors. one side effect is copious salivation and regular spitting of dark ___ saliva from pigment in the drug
betel
betel palm seed
betel
red
This drug seemed to show through the use of it it relieved asthma symptoms but it actually increases the risk of asthma related death
salmeterol
inhaled steroids act to inhibit influx of inflammatory cells, block synthesis of ____ and reduce formation of inflammatory ____. Primary choice when taken with B2 agonists.taking the steroid by inhalation reduces the effects of weight gain water retention and hypertension. adverse side effects of inhaled steroids include more throat and oral infection with candida albicans, a common yeast infection.
prostaglandins
cytokines
_____ is a newer drug given qd. it has a rapid ____. this is the same drug at dosages appropriate for nasal allergies applied with nasal inhaler and this drug is a s_____
fluticazone
onset
steroid
______ is one of the earliest inhalation steroids. short half life and most be give more frequently
azmacort
______ is a teriod anti-inflammatory. it is available as a DPI inhaler for use in asthma, as a ____ inhaler for allergies and as a cream for skin conditions such as ____
Monetasone
nasal
eczema
_____ is a long acting combination of fluticazone and Servent
advair
______ is a new and expensive combination if budesonide and formoterol fumarate
symbicort
____ is the most commonly prescribed antileukotriene and it inhibits the synthesis of the specific _____ ____. it is a non steriod
singulair
leukotriene D4
_____ a blocker of leukotriene receptor is also prescribed occasionally
Accolate
_______ is an adjunct prophylactic drug used when other drugs B2 and steroids are not sufficient to control asthma. it is a relative of caffeine with a ___ therapeutic index. it is taken ___. this drug has serious interactions with ___ and ____ with if which inhibit the excretion of theophylline.
theophylline
narrow
orally
erythromycin and hydrocortisone
______ is an ionic form of theophylline given ___ for acute asthma attacks when patients can’t inhale. thigh high for removing cellulite
aminophylline
____is used as a prophylatic treatment for asthma. it stabilizes the membrane of mast cells to prevent the release of histamine. used in combo with albuterol. requires QID inhalation for several weeks to reach optimal efficacy. this drug is more commonly used to treat _____
intal
allergies
parkinson disease is a progressive disease that affects ____ people in the US. it produces a variety of movement disorders called ____.
1.2 million
dyskinesias
at the molecular level parkinson disease is due to the lack of ____ levels in the striatum of the brain, the extra pyramidal system that controls movement. this drug acts as an i______. This compound is produced by the ___ ___ cells in the striatum
dopamine
inhibitor
substantia nigra
parkinsons cause is still unknown but in most cases it is probably due to environmental. two causes in very unique situations are
contamination of methyl fentanyl, a heroin-like street drug
cycad seed flour traditionally eaten on guam contains potent brain neurotoxin
Dopamine itself cannot be given to treat parkinson, because it does not cross the ___ ___ ___ and it metabolized by __ and ____ in the go tract and liver. It is also an ____ ______ in the body causing tachycardia and hypertension
blood brain barrier
MAO and COMT
adrenergic agonist
Dopamine can either help to increase the levels of it in the striatum or block the break of dopamine. this can be accomplished by the following methods
- give dopamine as a ___
- give dopamine as a ____ agonist.
- ihibit rate of dopamine metabolism
precursor
analog
an enzyme calle ____ _____ converts L-dopa into dopamine before it would be able to pass the blood brain barrier. Thus L-dopa is combined with ______ which inhibits the ____ ____ which does not cross the blood brain barrier. This combination of the true drugs is marketed as _____
DOPA decarboxylase
carbidopa
DOPA decarboxylase
sinemet.
maximal L-dopa efficacy takes several weeks to months to develop. in addition progressive loss of substantial nigra cells leads to loss of efficay. Efficacy of the drug usually deteriorates slowly after __-__ years of use
2-5
dopamine agonist are…..
molecules which mite the action of dopamine.
three common dopamine agonists are ….
mirapex
requip
parlodel
these two drugs are approved for restless leg syndrome
mirapex requip
this drug is used if the mother is not going to breast feed to dry her up
parlodel
what is an inhibitor of dopamine metabolism`
selegiline
Selegiline is an inhibitor of type ___ m_____ o_____ which metabolizes and inactivates dopamine only in the brain. this drug is used by itself and can be used with ____. common side effects are nausea and xerostomia. it has been approved in a patch form (——) for treating ____
B monoamine oxidase
sinemet
emsam
depression
_______ promotes the release of dopamine from the striatum however it was only effective for a ____ or two. it was formerly commonly used to reduce ___ symptoms
Symmetrel
month
flu
what are the three families of sedatives
(GHB) gamma hydroxybutyric acid
barbiturates
benzodiaepines
all three families work by activating the chloride ion channel in neural membranes. they do so by activating ____ modulated chloride receptors. when GABA binds to a GABA receptor it opens a CL- specific ion channel in neural membranes allowing more chloride ion into the cell, which increases the negative potential on th inside of the membrane causing ____ in the post-synaptic membrane and inhibiting post-synaptic neuron firing
GABA
hyperpolarization
GABA stimulation in the limbic system of the brain reduces ____; GABA stimulation in the cortical areas of the brain promotes ____; GABA in the hippocampus and cereal cortex induces _____. Often the same drug will relieve anxiety at low dosages and promote sleep at high dosages.
anxiety
sleep
amnesia
_____ has a structure very similar to GABA and can bind to GABA recptors. Large does of this drug result in ___. This drug is legally prescribed for narcolepsy, its primary use is as an illegal date rape drug
GHB
sedation
barbiturates were commonly used from ___ to ____ for anxeity and insomnia but their ____ therapeutic index due to respiratory depression has caused them to be replaced. Current uses include the treatment of seizures, induction of anesthesia and treatment of pain. Barbiturates work by directly stimulatlating the inhibitory GABA type ___ ___ as well as inhibiting certain types of ___ receptors. both actions cause a reduction in CNS activity
1912 to 1960
low
type chloride
glutamate
___ is still used for treatment of seizures and it is a barbiturate
phenobarbital
___ ____ is used for induction of anesthesia but has been replaced by proposal and this is what killed MJ
sodium pentothal
______ and ____ are prescribed for headaches. the ____ can cause dependence and intoxication similar to alcohol consumption.
Fiorinal and Fioricet
butalbital
benzodiazepines are ____ phillic therefore they pass through the Blood brain Barrier. They are used to treat ___ and ____
lipo
anxiety
insomnia
Diazepam and lorazepam are also used for treating DT ____ _____ during alcohol withdraw and ____ ____ (continuous seizures). Versed is used for producing for producing amnesia during surgical procedures
delirium tremens
status epilepticus
____ is used to treat anxiety and panic attacks. it is very habit forming and is #9 most commonly prescribed drug in the us
alprazolam or xanax
______ is one of the most commonly used benzodiazepine. it is used for anxiety, alleviating the withdraw of alcoholics. it is also a common drug for treating status epileptics and nausea associated with chemo.
lorazepam or ativan
_____ is commonly used in treatment of absence seizures, and has unlabelled use for schizophrenia, neuralgias and depression
clonazepam
______ is commonly used to treat insomnia
temazepam
_____ is occasionally used to treat anxiety before surgical or dental procedures, muscle spasticity. it can also be used IV for status epilepticus
Diazepam
______was one of the first benzodiazepines on the market. It has rapid action but short duration, due to rapid absorption and metabolism. It is used for inducing sleep. Amnesia can be a problem. It is rarely prescribed anymore.
triazolam
______is given IV before surgery or unpleasant medical procedures (colonoscopy, radiographic procedures) to produce sedation and amnesia.
versed or midazolam
_____ is ten times as strong as Valium. It has been used to treat insomnia outside of the U.S. (It is not legal in the U.S.). “Roofies” are notorious as a “date-rape” drug.
Flunitrazepam
