Neuro drugs I Flashcards Preview

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Flashcards in Neuro drugs I Deck (17):

How do opioid analgesics work?

act at mu opiod receptors. alter synaptic transmission by opening K channels and closing Ca2+ channels. this decreases synaptic transmission and inhibits the release of ACh, norepinephrine, 5-HT, glutamate, and substance P


Apart from pain, what are some uses of opioids?

cough suppression (dextromethrophan), diarrhea treatment (loperamide), acute pulm edema


How do you treat opioid toxicity?

naloxone or naltrexone, which are opioid receptor antagonists


What is butorphanol?

this is a PARTIAL mu opiod receptor agonist. It is a kappa opioid receptor agonist. it produces anagesia but causes less resp depression than full opioid agonists. However, it can cause opioid withdrawal in a patient who is also taking a full opioid agonist, and can't be easily reversed with naloxone


What should I know about opioid receptor types?

mu: morphine
delta: enkaphalin
kappa: dynorphin


What is the mechanism and toxicities for tramadol?

weak opiod agonist. also inhibits serotonin and NE reuptake. good for chronic pain. toxicities: decreases seizure threshold and can cause serotonin syndrome


How do barbiturates work?

facilitate GABA action by increasing the DURATION of Cl channel opening. neuron firing decreases.


Toxicities and contraindications of barbiturates?

contraindicated in porphyria. can cause respiratory and CV depression


How do benzodiazepines work?

facilitate GABA-A action by increasing the frequency of Cl channel opening. decreases REM sleep. many have long half-lives and active metabolites (but not triazolam, oxazeam, midazolam- so these three have greater addictive potential)


Which benzos are used for status epilepticus?

lorezepam and diazepam


How do you treat benzo toxicity?

flumazenil (competitive antagonist at the GABA benzo receptor)


What are the non-benzodiazepine hypnotics and how do they work? treatment of toxicity?

zolpidem (ambien), zaleplon, (eszopiclone)
work by binding the BZ1 subtype of GABA receptor, and may be reversed by flumazenil
used for insomnia


What are the inhaled anesthetics and what is a major complication? Effect on blood flow to the brain?

halothane, enflurane, methoxyflurane, nitrous oxide, among others. increase cerebral blood flow
all but nitrous oxide can cause malignant hyperthermia- inhaled anesthetics and succinylcholine induce fever and muscle contractions.


Thiopental: class, uses, effect on blood flow

highly potent, high lipid solubility, rapid entry to bran. used for induction of anesthesia and short procedures. decreases cerebral blood flow. effect terminated by rapid redistribution to the tissues


Midazolan: class, uses

most common drug for endoscopy. may cause severe post-op resp depression, decrease BP (treat OD with flumazenil), and anterograde amnesia


Ketamine: class, function, effect on blood flow

PCP analogues. block NMDA receptors. act as CV stimulants. cause disorientation, hallucination, and bad dreams. increase cerebral blood flow


What is propofol? uses, MOA

used for sedation in ICU, rapid anesthesia induction, and short procedures. less post-op nausea than thiopental. potentiates GABA-A

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