Nervous System Flashcards
(25 cards)
Pancuronium special property amongst curarae drugs
It has antivagal properties so no need to give glycopyrrolate as it already has stopped tracheobronchial secretion
Non depolarising steroidal drugs vs non depolarising non steroidal drugs ; (smooth muscle relaxant -SMR)- curarae drugs
Pancuronium,Rocuronium,Rapacurium,Vecuronium …………………Doxacurium,Mivacurium,Atracurium,Galamine,d-TC
Galamine why not used
Nephrotoxicity and Teratogenicity
Safest drug SMR in hepatic and renal failure
Atracurium. ………which undergo HOFFMAN DEGRADATION i.e self destruction by non enzymatic degradation
d -Tubocurarine(d-TC) contraindicated in ??????
it release histamine causing bronchospasm so c/i in bronchial asthma…….it also cause vasodilatation which lead to hypotension
Full form of NDRI and one example?
Nor-epinephrine Dopamine Reuptake inhibitors………….BUPRIOPION (Atypical Antidepressant) used as antismoking drug, in ADHD(Attention Deficit Hyperactivity Disorder) common in adults ,anti obesity
Antiepileptic drugs used as anti obesity ????
Zonisamide and Topiramate (Felbamate not used clinically as it cause hepatotoxicity and agranulocytosis) ……….fun fact is wt gain drug is VALPROATE
Newer drug for obesity ?????
LORCASERINE (5- HT i.e. Serotonin agonist) and it is now FDA approved
Antibiotic with SMR (smooth muscle relaxant property) c/i in MYSTHENIA GRAVIS
Aminoglycosides( Neomycin - highest SMR-c/i in MG),Quinolones,Macrolides
Line of drug in OPC poisoning
1st line is ATROPINE which control muscarinic manifestation and 2nd line is OXIMES which reactivates Cholinesterase enzyme
ORGANOPHOSPHORUS COMPOUND POISONING (OPC) examples and binding sites….???????
Malathion ,Parathion……..binding sites are esteritic site of enzyme cholinesterase (not on anionic site) which inactivates it so Ach gets accumulated ……..OXIMES binds to anionic site and reactivates the enzyme which comes under Tx
TEST for MG 1) inj Edrophonium 2) inj d-TC 3) definitive test 4)confirmatory test
1)Tensilon test also k.a Ameliorative test as it increases ms power 2) Provocative test 3) Radioimmuno Assay 4) single fibre electromyography
How steroid act as antidepressant?
Inhibits synthesis of IL -1 and IL- 6 and catabolism of igG
Use of every immunosupressant??????
Autoimmune ds and organ transplantation
Immunosupression caused by 1)cyclosporine ,tacrolimus and 2)sirolimus ,everolimus
1)They are calcineurine inhibitor or blocker which inhibits synthesis ,storage and release of IL-2 , its ADR is NEPHROtoxic maximum in TACROlimus which is MACROlide………………2)M-TOR Blockers block at M-TOR receptor
Uses of SIROLIMUS????????
Commonly for ❤️ transplantation ,putting stent like in MI pts PTCA ( Per Cutaneous Transluminal Coronary Angioplasty) -Drug eluting stent,post menopausal breast cancer,renal angiolipoma with tubular sclerosis
Toxicity of M-TOR receptor blockers
i.e sirolimus and everolimus……..they are myelosuppressants so it causes thrombocytopenia,Hyperlipidemia, Infection
Preferred drug for causing dryness of tracheobronchial secretion
Glycopyrrolate which don’t cross BBB and atropine cannot be used as it crosses BBB
Anticholinesterase or acetylcholinesterase types?????? These are the drugs which inhibit acetylcholinesterases thus increasing availability of Ach and prolong action
(1) reversible- physostigmine ,Neostigmine,Pyridostigmine,Edrophonium,tacrine and rivastigmine. (PEN is water siluble and rest including physostigmine are lipid soluble ) (2)organophosphates which include malathion ,parathion, ecothiophate,nerve gases like tabun ,sarin,diflos and carbamates which include carbaryl and propoxur
Preferred Tx for MG is????and its other uses…????
Neostigmine as it does not cross BBB so no A/E on CNS and has direct Nm receptor agonistic action; other uses are Tx of cobra bite,post opt paralytic ileus,atony of bladder,reversal if competitive sk ms relaxant
Symptoms of anticholinesterase poisoning
Pin point pupil,salivation, lacrimation,sweating,bronchoconstriction,diarrhoea,urination ,bradycardia,hypotension,coma
Antidote of choice for both OCP poisoning and carbamate poisoning
ATROPINE
Mydriatics -shortest acting and longest acting
Tropicamide shortest………Atropine longest
Anticholinergic reverse the bronchoconstriction caused by stimulation of M3 receptors……so they are used in Tx of COPD and bronchial asthma……what are the drugs???????
Ipratropium …..non selective action on all ms receptors whereas tiotropium is somewhat selective blocker on M1 and M 3 receptors
