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PHC 722 > PHC 722 - MIDTERM 2 DRUGS > Flashcards

PHC 722 - MIDTERM 2 DRUGS Flashcards

1
Q

Articaine

A
  • Local Anesthetic
  • Blocks voltage gated Na channels in their inactive form by both membrane diffusion (slightly use dependent)
  • pKa = 7.8
  • Used for people who suck at giving shots. Better bone penetrability
  • Shorter-lived because of ester [Amide-Ester].
  • Vasodilator [use vasoconstrictor to counteract this]
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2
Q

Bupivacaine

A

Local Anesthetic

  • Blocks voltage gated Na channels in their inactive form by both membrane diffusion (slightly use dependent)
  • Amide
  • Super long acting
  • Vasodilator [use vasoconstrictor to counteract this]
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3
Q

Desflurane

A
  • Used to maintain general anesthesia
  • Special Vaporizer used, that heats it to 39C, very low solubility compared to NO, meaning that is has a quicker onset,
  • Pungent
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4
Q

Diazepam

A

Anti-Epiletpic / Benzodiazepine

  • GABA-A allosteric enhancement
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5
Q

Epinephrine

A

Adrenergic agonist

  • Affects all receptor subtypes of adrenergic system
  • Vasoconstrictor
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6
Q

Fentanyl

A

Opioid Agonist

80-100x more powerful than morphine

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7
Q

Halothane*

A

Will cause a dose dependent rx

2MAC –> 50% decreases in BP and CO
WILL affect CV system, therefore you need to avoid epinephrine otherwise you will damage the heart

Sensitizes heart to arrhythmogenic effects of epinephrine

BEST bronchodilator

p450 transformation in liver

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8
Q

Isoflurane

A

Pungent

  • NOT used for induction, will irritate the upper airways, but will bronchodilate,
  • if greater than 1 MAC it will increase intracranial pressure, can vasodilate coronary arteries

ONLY in operating room

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9
Q

Ketamine (G.A. Lectures)

A

IV general anesthetic; NMDA Antagonist, sympathetic stimulation, dissociative amnesia

Don’t use in cardiac patients, analgesic effects

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10
Q

Lidocaine*

A
  • Lidocaine* Local Anesthetic
  • Blocks voltage gated Na channels in their inactive form by both membrane diffusion and going through channel (slightly use dependent)
  • pKa = 7.94 [More in protonated form]
  • Amide
  • Vasodilator [use vasoconstrictor to counteract this]
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11
Q

Mepivacaine

A
  • Local Anesthetic
  • pKa = 7.9 [Amide]
  • Blocks voltage gated Na channels in their inactive form by both membrane diffusion (slightly use dependent)
  • Not as vasodilatory [can be used without vasoconstrictor]
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12
Q

Midazolam*

A

Titrated to 1-2 mg

Benzo

Will cause respiratory depression, and used for seizure treatment

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13
Q

Naloxone (G.A. lectures)

A

Competitive antagonist to opoid receptor; will take the place of morphine and block anesthesia

Will reverse analgesics, miosis, and respiratory depression, but not avoid induced seizures

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14
Q

Nitrous Oxide*

A

N2O

xxxxxx

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15
Q

Penicillin

A

…..

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16
Q

Phentolamine

A

Alpha-Nonselective Antagonist

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17
Q

Propofol

A

GABA-ergic

Hyponotic agent: Sedation, amnesia, anti-emetic, hypotension, apnea

VERY RAPID onset, distributed to peripheral tissues, used as an induction agent

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18
Q

Romazicon (Flumazenil)

A
  • GABAa receptor antagonist

- Used to treat benzodiazepine overdose

19
Q

Servoflurane

A

Nonpungent;

  • has low solubility, but not as soluble as Nitrous, but has a 2% MAC

Used at anesthesia induction at 4-8%,

  • will depress myocardial contractility ,depress respiration, reverse bronchoconstriction

Metabolized by p450

20
Q

Triazolam

A

Halcion

Benzo, used for anxiolysis

21
Q

Furosemide

A

Tx: Hypertension

  • Loop Diuretic
  • Inhibits Na+/K+/2Cl- transporter
  • Leads to higher concentrations of all of these and hence more water loss
  • Acts on the thick ascending loop of henle
22
Q

Hydrochlorothiazide

A

Tx: Hypertension

  • Thiazide Diuretic
  • Targets Distal Convoluted Tubule
  • Inhibits Na+/Cl- co transport
  • Higher concentration of these now we get more water loss
23
Q

Amiloride

A

Tx: Hypertension

  • K+ Sparing Diuretic
  • Works on collecting duct
  • Inhibits Na+/K+ channel [channel usually works to bring Na into the cell and push K out]
  • Less water is reabsorbed because water follows Na
24
Q

Spironolactone

A

Tx: Hypertension and Congestive Heart Failure

  • K+ Sparing Diuretic
  • Aldosterone Receptor Antagonist
  • Prevents aldosterone from inserting the Na and K channels that cause K loss through anti-diuretic action;
  • Also prevents insertion of Na/K transporter on the blood side of the tubule [hard to describe it but its a transporter that takes K from the blood and puts it into the renal tubule cell and takes Na from the tubule cell and puts it into the blood]
25
Q

Methyldopa

A

Tx: Hypertension

  • Adrenergic Neuron Inhibitor (Centrally acting)
  • Metabolite replaces central NE and likely activates A2 receptors
26
Q

Phentolamine (Cardiac Lecture)

A

Tx: Hypertension and also to reverse or shorten the action of epinephrine in local anesthetics

  • Alpha-nonselective antagonist
27
Q

Prazosin

A

Tx: Hypertension

  • Selective A1-adrenergic antagonists
28
Q

Bisoprolol

A

Tx: Hypertension

  • Class II Anti-Arrhythmic (Beta Blockers)
  • Beta-Adrenergic Antagonist
29
Q

Propanolol

A

Tx: Hypertension

  • Class II Anti-Arrhythmic (Beta Blockers)
  • Beta-Nonselective Antagonist
  • Anti-Arrhythmic
  • Automaticity Inhibitors
  • Decrease conduction through pacemaker cells
  • Decreases sympathetic activity of the heart
  • Increase threshold
  • Increase refractory period
30
Q

Labetalol

A

Tx: Hypertension

  • Class II Anti-Arrhythmic (Beta Blockers)
  • Beta-Adrenergic Antagonist
31
Q

Sotalol

A

Tx: Hypertension, Myocardial Ischemia, CHF and Cardiac Arrhythmias

  • Class II Anti-Arrhythmic (Beta Blockers)
  • Beta-Adrenergic Antagonist
  • Also K+ channel blocker
32
Q

Captopril

A

Tx: Hypertension

  • ACE-inhibitor
  • Decreases levels of Bradykinins [can lead to dry cough]
33
Q

Enalapril

A

Tx: Hypertension

  • ACE-inhibitor
34
Q

Losartan

A

Tx: Hypertension and CHF

  • Angiotensin-II Receptor Antagonist
  • “SARTAN”
  • Prevents aldosterone from being released, prevents direct vasoconstriction on blood vessels, prevents sympathetic stimulation of renin release [All via AT1 receptor]
35
Q

Amlodipine

A

Tx: Hypertension

  • Ca-Channel Blocker
  • Arterial Vasodilator [Need Ca to contract]
  • Vaso-selective
36
Q

Verapamil

A

Tx: Hypertension, Myocardial Ischemia and Cardiac Arrhythmias

  • Class IV (Ca-Blocker)
  • Anti-Arrhythmic
  • Decrease conduction speed [Decrease AV nodal conduction = negative chronotropy]
  • Decrease contraction [Decrease T-Tubule entry = negative inotropy]
  • Decrease refractory period in myocytes
37
Q

Hydralazine

A

Tx: Hypertension

  • Arterial Vasodilator
38
Q

Sodium Nitroprusside

A

Tx: Hypertension and Myocardial Ischemia

  • Arterial and Venous Vasodilator
39
Q

Glyceryl Trinitrate (Nitroglycerin)

A

Tx: Myocardial Ischemia

  • Organic Nitrate = Vasodilator
40
Q

Isosorbide Dinitrate

A

Tx: Myocardial Ischemia and CHF

  • Organic Nitrate = Vasodilator
41
Q

Digoxin

A

Tx: Congestive Heart Failure

  • Cardiac Glycosides (Calcium Exit)
  • [Inotropes CHF & emergency]
  • Inhibits Na/K ATPase
  • Positive Inotropy [Less Na gradient to drive Ca out during relaxation, causes Na channels to have less specificity and Ca can go through them] Occurs in myocytes
  • Negative Chronotropy [Longer refractory period and takes longer to get to threshold] Occurs in pacemaker cells
42
Q

Lidocaine (Cardiac)

A

Tx: Cardiac Arrhythmias

  • Anti-Arrhythmic
  • Class I (NA & K-channel blockers)
  • Increases refractory period
  • Reduces velocity of depolarization
  • Prevents depolarization (if we block all Na channels theoretically)
43
Q

Quinidine

A

Tx: Cardiac Arrhythmias

  • Class II (Na Channel Blockers)
  • Blockade of cardiac Na channels (Decrease excitability threshold = decrease automaticity)
  • Blockade of cardiac K+ channels (Increase action potential duration; lidocaine does not do this)
  • Potent inhibitor of CYP2D6 (decrease codeine-to-morphine metabolism = decreases analgesia) and reduces the clearance of digoxin
44
Q

Amiodarone

A

Tx: Cardiac Arrhythmias

  • Class III (K-blockers)
  • Increase refractory period [Action plateau is longer]
  • Conduction velocity is not decreased

PHC 722 (5 decks)

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