DRUGS Flashcards
(154 cards)
1
Q
What is the mechanism of action of nitrous oxide (N₂O)?
A
NMDA receptor antagonist.
2
Q
What is a key advantage of nitrous oxide (N₂O)?
A
Minimal cardiovascular depression, used in conscious sedation.
3
Q
How do Sevoflurane, Desflurane, Isoflurane, and Halothane work?
A
They enhance GABA-A activity.
4
Q
What is a major side effect of halothane?
A
Hepatotoxicity.
5
Q
Which inhaled anesthetic is associated with nephrotoxicity?
A
Sevoflurane.
6
Q
What are the primary concerns with Isoflurane and Desflurane?
A
Airway irritation.
7
Q
What is the mechanism of action of propofol?
A
Potentiates GABA-A receptors.
8
Q
What are the key properties of propofol?
A
Rapid onset, antiemetic effects, risk of hypotension.
9
Q
What is the mechanism of action of ketamine?
A
NMDA receptor antagonist.
10
Q
What are the effects of ketamine?
A
Causes dissociative anesthesia, increases BP & HR, and may cause hallucinations.
11
Q
How does etomidate work?
A
It is a GABA-A agonist.
12
Q
What is an advantage of etomidate?
A
Less cardiovascular depression.
13
Q
What is a risk of etomidate?
A
Adrenal suppression.
14
Q
How does methohexital work?
A
It is a barbiturate that enhances GABA-A activity.
15
Q
What is methohexital used for?
A
Short procedures due to its rapid onset.
16
Q
What is the function of benzodiazepines like midazolam, lorazepam, and diazepam in anesthesia?
A
They potentiate GABA-A receptors to provide sedation and amnesia.
17
Q
What drug reverses benzodiazepine effects?
A
Flumazenil.
18
Q
How do opioids (Fentanyl, Morphine, Remifentanil) contribute to anesthesia?
A
They act as mu-opioid receptor agonists to provide analgesia.
19
Q
What is a major side effect of opioids in anesthesia?
A
Respiratory depression.
20
Q
What is dexmedetomidine’s role in anesthesia?
A
It is an α₂-agonist that provides sedation and analgesia without respiratory depression.
21
Q
How does dantrolene treat malignant hyperthermia?
A
It inhibits the ryanodine receptor, preventing calcium release.
22
Q
How do local anesthetics work?
A
They block Na⁺ channels, preventing neuronal depolarization.
23
Q
How are ester local anesthetics metabolized?
A
By plasma esterases.
24
Q
Why do ester local anesthetics have a higher allergy risk?
A
Due to PABA formation.
25
How are amide local anesthetics metabolized?
By the liver.
26
What is the most commonly used local anesthetic?
Lidocaine.
27
Which local anesthetic has a risk of methemoglobinemia?
Benzocaine & prilocaine
28
What local anesthetic is used in topical applications and can cause vasoconstriction?
Cocaine.
29
What is the advantage of articaine over other local anesthetics?
It has a rapid onset and better tissue diffusion.
30
How do non-selective NSAIDs (Aspirin, Ibuprofen, Naproxen, Ketorolac) work?
They inhibit COX-1 & COX-2, decreasing prostaglandins.
31
What are the risks associated with NSAIDs?
GI ulcers and bleeding.
32
How does celecoxib differ from non-selective NSAIDs?
It selectively inhibits COX-2, lowering GI risk but increasing cardiovascular risk.
33
How does acetaminophen work?
It inhibits central COX, providing analgesia but weak anti-inflammatory effects.
34
What is the antidote for acetaminophen toxicity?
N-acetylcysteine.
35
What is the mechanism of sodium channel blockers (Phenytoin, Carbamazepine, Lamotrigine)?
They stabilize Na⁺ channels.
36
What is a common side effect of phenytoin?
Gingival hyperplasia.
37
What is the first-line drug for absence seizures?
Ethosuximide.
38
What is the first-line drug for status epilepticus?
IV Lorazepam.
39
What is the mechanism of action of levetiracetam (Keppra)?
SV2A modulator affecting neurotransmitter release.
40
How do SSRIs (Fluoxetine, Sertraline, Escitalopram, Paroxetine) work?
They inhibit serotonin reuptake.
41
What is the most common side effect of SSRIs?
Sexual dysfunction.
42
What is a key advantage of bupropion?
It does not cause sexual dysfunction but lowers seizure threshold.
43
What is a major risk of MAOIs (Phenelzine)?
Hypertensive crisis with tyramine-containing foods.
44
What is the treatment for serotonin syndrome?
Cyproheptadine (5-HT2A antagonist).
45
What is the standard formulation for dental anesthesia?
2% Lidocaine + 1:100,000 Epinephrine.
46
What formulation is used for hemostasis in dental procedures?
2% Lidocaine + 1:50,000 Epinephrine.
47
What is an alternative for vasoconstrictor-intolerant patients?
3% Mepivacaine (No Epinephrine).
48
What local anesthetic is used for long-duration procedures?
0.5% Bupivacaine + 1:200,000 Epinephrine.
49
What is the advantage of 4% Articaine + Epinephrine (1:100,000 or 1:200,000)?
Rapid onset and better tissue diffusion.
50
51
Nitrous Oxide (N₂O)
NMDA receptor antagonist, minimal cardiovascular depression.
52
Sevoflurane
Enhances GABA-A, risk of nephrotoxicity.
53
Desflurane
Enhances GABA-A, airway irritation.
54
Isoflurane
Enhances GABA-A, airway irritation.
55
Halothane
Enhances GABA-A, hepatotoxicity.
56
Propofol
Potentiates GABA-A, rapid onset, antiemetic, risk of hypotension.
57
Ketamine
NMDA receptor antagonist, increases BP & HR, dissociative anesthesia.
58
Etomidate
GABA-A agonist, minimal cardiovascular depression, risk of adrenal suppression.
59
Methohexital
Barbiturate, enhances GABA-A, used in brief procedures.
60
Midazolam
Benzodiazepine, pre-op sedation, anterograde amnesia.
61
Lorazepam
Benzodiazepine, anxiolytic, sedation.
62
Diazepam
Benzodiazepine, muscle relaxant, seizure treatment.
63
Fentanyl
Mu-opioid receptor agonist, strong analgesia, respiratory depression.
64
Morphine
Mu-opioid receptor agonist, analgesia, nausea risk.
65
Remifentanil
Mu-opioid receptor agonist, ultra-short-acting opioid.
66
Dexmedetomidine
α₂-agonist, sedation without respiratory depression.
67
Dantrolene
Inhibits ryanodine receptor, treats malignant hyperthermia.
68
Procaine
Ester, short-acting, metabolized by plasma esterases.
69
Chloroprocaine
Ester, rapid onset, low toxicity.
70
Tetracaine
Ester, long-acting, spinal anesthesia.
71
Benzocaine
Ester, risk of methemoglobinemia.
72
Cocaine
Ester, local anesthetic with vasoconstriction.
73
Lidocaine
Amide, most commonly used, intermediate duration.
74
Mepivacaine
Amide, longer duration than lidocaine, no vasodilation.
75
Bupivacaine
Amide, long-acting, risk of cardiotoxicity.
76
Ropivacaine
Amide, less cardiotoxic than bupivacaine.
77
Articaine
Amide, rapid onset, better tissue penetration.
78
Prilocaine
Amide, risk of methemoglobinemia.
79
Pramoxine
Topical anesthetic, used in skin preparations.
80
Phenacaine
Used in ophthalmic anesthesia.
81
Dyclonine
Topical anesthetic, found in lozenges.
82
Aspirin
Irreversible COX-1 & COX-2 inhibitor, risk of Reye’s syndrome.
83
Ibuprofen
Reversible COX-1 & COX-2 inhibitor, mild GI toxicity.
84
Naproxen
Longer half-life than ibuprofen, used for inflammation.
85
Ketorolac
Strong NSAID, high risk of GI bleeding.
86
Piroxicam
Long half-life, increased GI ulcer risk.
87
Celecoxib
Selective COX-2 inhibitor, lower GI risk, higher CV risk.
88
Acetaminophen
Central COX inhibition, hepatotoxic in overdose.
89
Methotrexate
Inhibits dihydrofolate reductase, hepatotoxicity risk.
90
Infliximab
TNF-α inhibitor, risk of infections.
91
Etanercept
TNF-α inhibitor, subcutaneous injection.
92
Adalimumab
TNF-α inhibitor, used in RA and psoriasis.
93
Phenytoin
Na⁺ channel blocker, causes gingival hyperplasia.
94
Carbamazepine
Na⁺ channel blocker, risk of SIADH.
95
Lamotrigine
Na⁺ channel blocker, risk of Stevens-Johnson syndrome.
96
Valproate
Na⁺ & Ca²⁺ blocker, hepatotoxicity, teratogenic.
97
Ethosuximide
T-type Ca²⁺ blocker, first-line for absence seizures.
98
Levetiracetam
SV2A modulator, mood changes.
99
Gabapentin
N-type Ca²⁺ blocker, used for neuropathic pain.
100
Topiramate
Enhances GABA, causes weight loss.
101
Lorazepam (AED)
Enhances GABA-A, first-line for status epilepticus.
102
Fosphenytoin
Na⁺ channel blocker, used for status epilepticus.
103
Phenobarbital
Enhances GABA, used for refractory seizures.
104
Fluoxetine
SSRI, longest half-life, risk of sexual dysfunction.
105
Sertraline
SSRI, commonly used for depression and anxiety.
106
Escitalopram
SSRI, fewer drug interactions.
107
Paroxetine
SSRI, short half-life, withdrawal risk.
108
Venlafaxine
SNRI, hypertension risk at high doses.
109
Duloxetine
SNRI, used for neuropathic pain.
110
Bupropion
Dopamine reuptake inhibitor, no sexual dysfunction.
111
Mirtazapine
α₂ antagonist, causes weight gain and sedation.
112
Trazodone
Serotonin modulator, causes priapism.
113
Amitriptyline
TCA, anticholinergic side effects.
114
Nortriptyline
TCA, less sedating than amitriptyline.
115
Phenelzine
MAOI, risk of hypertensive crisis with tyramine.
116
Cyproheptadine
5-HT2A antagonist, treats serotonin syndrome.
117
2% Lidocaine + 1:100,000 Epinephrine
Standard for dental procedures.
118
2% Lidocaine + 1:50,000 Epinephrine
Used for hemostasis.
119
3% Mepivacaine (No Epinephrine)
Alternative for vasoconstrictor-intolerant patients.
120
2% Mepivacaine + 1:20,000 Levonordefrin
Alternative vasoconstrictor.
121
0.5% Bupivacaine + 1:200,000 Epinephrine
Long-duration anesthesia.
122
4% Articaine + Epinephrine (1:100,000 or 1:200,000)
Rapid onset, better diffusion.
123
124
What is the mechanism of action (MOA) of inhaled anesthetics?
Enhance GABA-A receptor activity, inhibit NMDA receptors (some), and hyperpolarize neurons via potassium channels.
125
What are the side effects of inhaled anesthetics?
Respiratory depression, hypotension, malignant hyperthermia (except N₂O).
126
What is the mechanism of action of nitrous oxide (N₂O)?
NMDA receptor antagonist.
127
What are key characteristics of nitrous oxide (N₂O)?
Minimal cardiovascular depression, used in conscious sedation.
128
What is a key adverse effect of halothane?
Hepatotoxicity.
129
What anesthetic is associated with airway irritation?
Isoflurane/Desflurane.
130
What is the mechanism of action of propofol?
Potentiates GABA-A receptors.
131
What are the key effects of ketamine?
Dissociative anesthesia, increases BP & HR, causes hallucinations.
132
What is the treatment for malignant hyperthermia?
Dantrolene (inhibits ryanodine receptor, preventing Ca²⁺ release).
133
What is the MOA of local anesthetics?
Block Na⁺ channels, preventing depolarization.
134
How are ester local anesthetics metabolized?
By plasma esterases.
135
Why do esters have a higher allergy risk?
Due to PABA formation.
136
How are amide local anesthetics metabolized?
By the liver.
137
What is the most commonly used local anesthetic?
Lidocaine.
138
What is the MOA of non-selective NSAIDs?
Inhibit COX-1 & COX-2 → ↓ prostaglandins.
139
What are the risks of NSAIDs?
GI ulcers, bleeding.
140
What is a key feature of selective COX-2 inhibitors like celecoxib?
Lower GI risk, higher cardiovascular risk.
141
What is the MOA of acetaminophen?
Inhibits central COX, weak anti-inflammatory.
142
What is the antidote for acetaminophen toxicity?
N-acetylcysteine.
143
What is the MOA of sodium channel blockers like phenytoin and carbamazepine?
Stabilize Na⁺ channels.
144
What is a notable side effect of phenytoin?
Gingival hyperplasia.
145
What is the first-line drug for absence seizures?
Ethosuximide.
146
What is the first-line drug for status epilepticus?
IV Lorazepam.
147
What is the MOA of SSRIs?
Inhibit serotonin reuptake.
148
What is the risk of SSRIs?
Sexual dysfunction.
149
What is a key benefit of bupropion?
No sexual side effects but lowers seizure threshold.
150
What is a major risk of MAOIs?
Hypertensive crisis with tyramine-containing foods.
151
What is the treatment for serotonin syndrome?
Cyproheptadine (5-HT2A antagonist).
152
What is the standard formulation for dental anesthesia?
2% Lidocaine + 1:100,000 Epinephrine.
153
What is an alternative for vasoconstrictor-intolerant patients?
3% Mepivacaine (No Epinephrine).
154
What anesthetic is used for long-duration procedures?
0.5% Bupivacaine + 1:200,000 Epinephrine.
