Nervous System

Question 1

Names of the neurotransmitters

Answer 1

GABA GLYCINE - slow down

Glutamate, Norodrenaline, dopamine, serotonin, acetycholine speed up (excitory)

Question 2

General Anaesthetics - nervous system.

Answer 2

Propofol (short acting) Given via IV- non barbituate

Etomidate - IV - barbituate - no hangover effect
Sodium Theopental - short acting, fast, barbituate GA. Rapid awakening. acts on GABA.

Barbituates, Alcohol and Benzodiazapines all bind to GABA receptors.

Ketamine - analgesic - for induction and maintenance. receptor antagonist. Binds to opioid receptors at full dose. used to treat shock in children and adults

Act mainly on CNS. 
Given intravenously or inhalation
Promote insensitivity 
usually fat soluble
act on membrane receptors and ion channels 

Side effects - nausea, breathing (shallow/rapid)

Question 3

Local anaesthetics

Answer 3

Action: Block transmission of nerve signals from nociceptors to the brain. Act on Na+ entry through sodium channels. Block nerve impulses. cannot be given via IV.

Given by epidural and topically/transdermal.

Lidocaone - dentist - widely used. Also premature ejaculation.
Prilocaine - mixed with lidocaine to form a cream.
Side effects - abnormal heart rate and restlessness/ convulsions.

Question 4

What do nociceptors do?

Answer 4

They detect thermal, chemical and mechanical stimulants and send the signals to the brain via the dorsal horn / spinothalmic tract/ventral posterior lateral nucleus (thalmus) and to the sensory cortex

Question 5

NSAIDS (non steroidal anti inflammatory drug)

NON - SPECIFIC

Answer 5

reduce pain and inflammation. Used for inflammation and mild pain relief. Reduce prostaglandin production.

COX 1 and 2. important in gastric protection. NSAIDS cause bleeding, gastric problems. kidney problems

stop prostaglandin production. Stop arachadonic acid acting on COX 1 and 2.

Asprin - mild pain and fever - cannot be given to:

children under 16 - reyes syndrome 
peptic ulcer sufferers 
haemophilliacs / bleeding disorders
liver disease
anyone taking anti - coagulant drugs 

IBUPROFEN - lower side effects than asprin. Causes ulcers
NAPROFEN - longer lasting than ibuprofen.
Paracetemol - narrow therapeutic window - Toxic to liver at only 2-3 times normal dose.

Question 6

NSAIDS AND OPIOIDS

Answer 6

cocodaprin (asprin and codeine

COCOdamol - paracetemol and codeine

Question 7

Anti depressants - TRICYCLIC

Answer 7

Imipramine, nortriptyline, doxepin
cause dry mouth, blurred vision, constipation, urine infection.

Tricyclic antidepressants block noradrenalin uptake by the pre synaptic nerve. More available to act at post synaptic nerve. Antagonist.

Question 8

SSRI antidepressants

Answer 8

Fluoxitine, Citalopram, sertraine, paroxetine
cause headaches/convulsions.

SSRI - very similar to noradrenaline. Increase seratonin. they block the binding site which means there is more available to find the post synaptic cleft. antagonist.

Question 9

MAOA Inhibitors

Answer 9

does not act on the receptor of the pre-synaptic nerve.

Acts on the MAOA enzyme and reduced uptake by the nerve.

Phenelzine, tranylcypromide,

cause nausea, dizziness.

interact with marmite and red wine.

Question 10

Selective NSAIDS

Answer 10

Newer drugs - only inhibit cox2. Omeprozole, misoprosol. No affect on stomach.

Question 11

prodrugs - nsaids

Answer 11

metabolised to an active form - fenbufen, nabumefone.