Week 15, 16 Drugs Flashcards
(33 cards)
Sodium Thiopental
Parenteral General Anesthetic Barbiturate--> GABA.A-R (X) induction> 10 min (-) t 1/2= 12 hrs> hangover (-) CNS depression, reduce blood flow/intracranial P (-) CV- HYPOtension (-) Respiratory depression
Propofol
Parenteral General Anesthetic
–> GABA.A-R
(X) induce, maintain
(+) anti-emetic, less hangover, sensual dreams
(-) pain on injection, excitation on induction
(-) LARGE BP Drop: vasodilation, depress myocardial contractility, blunts baro-R
(-) ^^Resp depression
Etomidate
Parenteral General Anesthetic
(X) induce for pt @ risk for HYPOtension (no bp effect)
(-) pain on injection, myoclonus
(-) nausea, vomit
(-) suppression of adrenocortical response
(-) CNS, CV, Respiratory depression
Ketamine
Parenteral General Anesthetic
“dissociative anesthesia”
NMDA-R antagonist
analgesia, unresponsive, amnesia, (+)broncodilator*
(X) iv, im, oral> pt with bronchospasm, children for short, painful procedures
(-) nystagmus, salivation, lacrimation, spontaneous mvmnt
(-) ^ ICP
(-) emergence delirium- disturbing hallucinations
(-) HTN (sympathomimetic)
Midazolam
Parenteral General Anesthetic short-acting BZD --->+ GABA.A-R (X) conscious sedation, anxiolysis, amnesia (X) induction or pre-op anxiolytic - slow induction, long duration (-) respiratory depression, HYPOtension (O) neuromuscular disease
Isoflurane
Inhaled General Anesthetic *mod blood:gas (X) maintain or induce(*irritant) \+NO for reduced dose (-) airway irritant, resp depressant, (-)HYPOtension, arrythmias (-) ^ ICP
Desflurane
Inhaled General Anesthetic -LOW blood:gas= rapid *special admin equip (X) out-pt surgery, maintain (+) skeletal muscle relax (-) HYPOtension, arrhythmia, ^ICP (-) resp depression, cough
Sevoflurane
Inhaled General Anesthetic *metab to Fl in liver/ cmpd A-nephrotoxic (X) in/out pt (X) induce, maintain (X) children, adults (-) HYPOtension, arrhythmia, ^ ICP (-) resp depression, less irritant
Nitrous Oxide
Inhaled General Anesthetic
- insoluble, ^ concent of other anesthetics
(X) enhance induction
(X) sedation and analgesia @ 50%
(-) dilute O2> use 100% O2
(O) pneumothorax, dissolve in gas pocket , abuse liability
Cocaine
Local Anesthetic- Ester
—/NERT on adrenergic N
(X) topical anesthetic of URT
(+) vasoconstrict–/bleed
Procaine
Local Anesthetic- Ester
(X) infiltration anesthesia
- low potency, slow onset, short duration
Tetracaine
Local Anesthetic- Ester
-potent, long duration
(X) spinal anesthesia, topical and opthalmic
Benzocaine
Local Anesthetic- Ester
- SLOW absorption= LONG duration
(X) topical application to wounds/ulcerated surfaces
Lidocaine
Local Anesthetic- Amide
-fast, intense, long lasting
+ vasoconstrictor (epi)
(X) local of intmed duration
Bupivacaine
Local Anesthetic- Amide
(X) sensory>motor LONG lasting
(X) epidural childbirth**
(-) cardiotoxicity
Ropivacaine
Local Anesthetic- Amide
(X) similar to bupivacaine + less cardiotoxic
(X) epidural childbirth**
(+) sensory»»»>motor
Amitryptiline
Tri-Cyclic Antidepressant
-LONG t 1/2
(X) MDD (2nd to SSRI), chronic pain
(-) 2-3 weeks for effect, reduce REM, anti-cholinergic
(/) overdose toxicity: seizure, coma, cardiac conduction deficit
Clomipramine
Tri-Cyclic Antidepressant
(X) MDD (2nd to SSRI), OCD
(-) 2-3 weeks for effect, reduce REM, anti-cholinergic
(/) overdose toxicity: seizure, coma, cardiac conduction deficit
Fluoxetine
SSRI
-LONG t 1/2 (for weening off)
(X) MDD, OCD, panic, PTSD, anxiety, PMDD, ween off
(-) SSRI discontinuation syndrome (1-7 days after)- dizziness/light-head, vertigo, anxiety, fatigue, headache, tremor, visual disturbance
(-) nausea, insomnia, sex dysfunction
(O) MAOIs- serotonin reaction
Sertraline
SSRI -shorter t 1/2 (X) MDD, OCD, panic, PTSD, anxiety (-) SSRI discontinuation syndrome (1-7 days after)- dizziness/light-head, vertigo, anxiety, fatigue, headache, tremor, visual disturbance (-) nausea, insomnia, sex dysfunction (O) MAOIs- serotonin reaction
Buproprion
Atypical Anti-depressant
–/DA and NE reuptake
(X) MDD, nicotine withdrawal, SAD
Mirtazapine
Atypical Anti-depressant
—/a2 NEauto-R in brain
(X) MDD
(-) ^^ appetite
Duloxetine
SNRI
(X) MDD, fibromyalgia, back pain
(-) sleep disturb, GI, sex dysf
(O) liver disease
Phenelzine
MAOI
irreversible—/MAO deamination of NE, DA, 5HT, tyramine
(X) MDD (2nd choice to SSRI), narcolepsy
(O) tyramine in diet
(-) toxicity; agitation, hallucination, convulsions
–> stimulation in normals, correct sleep in depressed
