Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacology > Week 3 ~ Central Nervous System > Flashcards

Week 3 ~ Central Nervous System Flashcards

1
Q

What are 2 kinds of Analgesics?

A

Opioids

Nonsteroidial Anti Inflammatory Drugs (NSAIDS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the definition of pain?

A

An unpleasant sensory and emotional experience associated with actual or potential tissue damage

ACUTE: sudden onset and subsides once treated

PERSISTENT: Lasts longer than 6 weeks and difficult to treat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

10 Different Types of Pain

A
  • Somatic
  • Phantom
  • Visceral
  • Superficial
  • Referred
  • Vascular
  • Central
  • Cancer
  • Psychogenic
  • Neruopathic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 4 processes of the Pain Transmission Gate Theory?

A

Transduction
Transmission
Perception
Modulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the Pain Transmission Gate Theory?

A

How impulses from the damaged tissues are sensed by the brain

Pain Management drugs are aimed at altering this system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In Pain Transduction what does the tissue release?

A

*Bradykinin
*Histamine
*Substance P
*Prostaglandins
*Serotonin
*Leukotrienes
~These stimulate nerve endings and starts the pain process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 2 main pain fibres in Pain Transmission?

A

A-Delta Fibres

C Fibres

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What do A-Delta Fibres do?

A

Sensitive to mechanical and thermal pain.

Transmit local and sharp pain

Stimulate the sympathetic nervous system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What do C Fibres do?

A

Sensitive to mechanical, thermal and chemical stimuli

Transmit poorly localized and dull pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What happens in the Pain Perception phase?

A

Complex behavioural, psychological and emotional factors

Is controlled by the single gene and opioid receptor gene

Perception is diminished when there are many receptions and exacerbated when there are too few or missing ones. Relatively minor pain stimuli may be perceived as painful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are two types of endogenous neurotransmitters?

A

Enkephalins

Endorphins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What happens in Pain Modulation?

A

The body produces endogenous neurotransmitters:
Enkephalins
Endorphins——-> Produced to fight pain —-> Bind to opioid receptors —-> Inhibit transmission of pain by closing the gate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is Pain Tolerance?

A

The amount of pain a person can insure without interfering normal function

  • Not a physiological function
  • Is the point beyond which pain becomes unbearable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a Pain Threshold?

A

The level of stimulus needed to produce the perception of pain

*Measure of the physiological response of the nervous system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

3 Chemical Categories of Opioids?

A

Meperidine
Methadone
Morphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Opioid Drugs under the Meperidine Category

A

Meperidine

Fentanyl

Sufentanil

Alfentanil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Opioid Drugs under the Methadone Category?

A

Methadone

Propoxyphene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Opioid Drugs under the Morphine Category?

A

Morphine

Heroin

Hydromorphone

Codeine

Hydrocodone

Oxycodone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Opioid Analgesics Mechanism of Action: Three Classifications based on Actions

A

-Agonist: Bind to opioid pain receptor in the brain. Cause an
Analgesic response
-Partial Agonist: Bind to pain receptor. Cause a weaker neurological
Response then a full agonist
Agonist-Antagonist or mixed agonist
-Antagonist: Reverse the effects of these drugs on pain receptors.
Bind to pain receptor and exert no response
Competitive Antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

5 Types of Opioid Receptors?

A 
Mu*
Kappa*
Delta*
Sigma
Epsilon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Indications for Opioid Analgesics

A

~Moderate to severe pain

~Used as adjuvant analgesic drugs to assist the primary drugs with pain relief:

          1. NSAIDS
          2. Antidepressants 
          3. Anticonvulsants
          4. Corticosteroids

Opioids are also used for cough centre suppression or diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Contraindications for Opioid Analgesics?

A

~Known drug allergy

~Severe asthma or respiratory insufficiency

~Pregnancy

~Elevated Intracranial Pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Adverse Effects of Opioid Analgesics

A 
Hypotension
Palpations
Flushing 
Nausea
Vomiting
Biliary Tract
Urinary Retention
Itching
Respiratory Depression
Aggravation of asthma
Wheat Formation
Sedation
Disorientation
Euphoria
Tremors
Lowered seizure thresholds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

2 Opiate Antidote

A

Naloxone (Narcan)

Naltrexone (ReVia)
-Bind to opiate receptors and prevent a response
- Used for complete or partial reversal of opioid-induced
Respiratory depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Opioid Tolerance
Common physiological result of chronic opioid treatment Larger dose of opioids is required to maintain the same level of Analgesia Opiates cause a physical and psychological dependance
26
What are Analgesics?
Medications to relieve pain without causing loss of consciousness
27
Non-Opioid Analgesics: Acetaminophen
Has analgesic and antipyretic effects Little to no anti inflammatory effects Available OTC Is a component of many combination products with opioids
28
Acetaminophen Mechanism of Action
Similar to the action of salicylates Blocks pain impulses peripherally by inhibiting prostaglandins synthesis
29
Indications of Acetaminophen
Mild to moderate pain Fever Alternative for those who can't take aspirin
30
Dosage of Acetaminophen
Healthy adults is 4000mg per day Overdose causes hepatic necrosis or long term ingestion of large doses can cause nephropathy
31
What's the antidote for Acetaminophen toxicity?
Acetylcysteine
32
Acetaminophen Drug Interactions
Dangerous interactions with alcohol Other Hepatotoxic Drug Liver Dysfunction
33
What are Anaesthetics?
Drugs that depress the central nervous system ~Depression of consciousness ~ Muscle relaxant ~Loss of responsiveness to sensory stimulation (including pain)
34
What is General Anaesthetic?
Drugs that induce a state in which the CNS is altered to produce varying degrees of: ~Depression of consciousness ~ Skeletal mm relaxation ~ Visceral Smooth mm relaxation
35
2 Types of General Anaesthetics?
Inhaled Anaesthetics: Volatile liquids or gases that are Vaporized in oxygen and inhaled Injectable Anaesthetic: Administered Intravenously
36
Inhaled Anaesthetics
Inhaled Gas: Nitrous Oxide ("laughing gas") Inhaled Volatile Liquids ~Desflurane (Suprame) ~ Halothane
37
Injectable Anaesthetics
Ketamine (Ketalar) Propofol (Diprivan) Thiopental (Pentothal) - Isoflurane (Forane)
38
Indications for Injectable Anaesthetics
Uses: ~ To induce or maintain general anaesthesia ~ To induce amnesia ~ To reduce anxiety ~ As an adjunct to inhalation-type anaesthetics
39
Adjunctive Drugs for Injectable Anaesthetics
Opioid Analgesics Benzodiazepine Anticholinergic
40
Opioid Analgesic Drugs
Alfentanil (Alfenta) Fentanyl Meperidine (Demerol) Morphine
41
Benzodiazepine Drugs
Diazepam Lorazepam Midazolam
42
Anticholinergic Drugs
Atropine
43
What is the Overton-Meyer Theory?
When a sufficient number of inhalation anaesthetic molecules dissolve in the lipid cell membrane. Effects: 1. Orderly and systematic reduction of sensory and motor CNS Function 2. Progressive depression of cerebral and spinal cord functions
44
General Anaesthetic Indications
Used during surgical procedures to create Unconsciousness Skeletal Muscular Relaxation Visceral Smooth Muscle Relaxation Rapid onset and quickly metabolized
45
Contraindications of General Anaesthetic
Known drug allergy Pregnancy Narrow Angle Glaucoma Known susceptibility to malignant hyperthermia
46
General Anaesthetic Adverse Effects
Affect the heart, liver, kidneys, peripheral circulation, respiratory tract Myocardial Depression Malignant Hyperthermia
47
What is Malignant Hyperthermia?
Sudden elevation of body temperature greater than 40c, tachypnea, tachycardia, muscular rigidity
48
General Anaesthetic Drug Interactions
Anti hypertensives B-Blockers Tetracycline
49
What is Local Anaesthetic used for?
Used to a specific part of the body due to pain Interferes with the nerve impulse transmitting to specific areas of the body. Doesn't cause loss of consciousness
50
2 Types of Local Anaesthetic?
Topical Parenteral (Spinal Injection)
51
2 Types of Parenteral Local Anaesthetic?
Central: Spinal or Intraspinal Ie. Epidural or Intrathecal Peripheral: Infiltration, nerve block, topical
52
4 Types of Parenteral Anaesthetic Drugs?
Lidocaine Mepivacaine Procaine Tetracaine
53
Local Anaesthetic Drug Effects?
Paralysis ~ 1st: Autonomic activity is lost 2nd: Then pain and other sensory functions are lost 3rd: Motor activity is lost *As drug wears off the recovery occurs in reverse order Motor --> Sensory --> Autonomic Acvitity
54
Local Anaesthetic Indications?
Surgical/Dental and Diagnostic Procedures Treatment of certain types of chronic pain *Infiltration anaesthetic or nerve block anaesthetic*
55
Infiltration Anaesthesia
Used in minor surgical or dental procedures Given in a circular pattern Injected intradermally, subcutaneously or submucosally across the path of nerves supplying the targeted area
56
Nerve Block Anaesthesia
Used for surgical, dental and diagnostic procedures Therapeutic management of pain Injected directly into or around the nerve trunks or nerve ganglia that supply the area to be numbed
57
Local Anaesthetic Contraindications
Drug allergy Spinal Headache
58
What are Neuromuscular Blocking Drugs?
Prevent nerve transmission in certain muscles resulting in paralysis of the muscle Used with anaesthetics during surgery Paralyze respiratory and skeletal muscles and so the patient is unable to breath on their own *Do not cause sedation of pain relief!*
59
2 Types of Neuromuscular Blocking Drugs?
Depolarizing Non Depolarizing
60
How Neuromuscular Blocking Drugs affect the body?
First sensation is muscles weakness followed by total paralysis Smaller rapidly moving muscles like fingers and eyes are affected first and then limbs, neck and trunk Then intercostal muscles and the diaphragm are affected resulting in cessation of respiration *Recovery of muscular activity will occur in reverse order*
61
What are Sedatives?
Drugs that have an inhibitory effect on the CNS to reduce nervousness, excitability and irritability without causing sleep
62
What are Hypnotics?
Causes sleep. *A sedative can become a hypnotic if it is given in larger doses*
63
What are Sedative-Hypnotics?
Dose dependant at low doses, they calm the CNS without inducing sleep and at high doses they calm the CNS to the point of causing sleep *Habit forming and have low therapeutic index*
64
What are the sleep stages?
Rapid eye movement (REM) sleep Non rapid eye movement (non-REM) sleep
65
4 Categories of Barbiturates?
1. Ultrashort: Short surgical procedures 2. Short: Sedative-hypnotic, control convulsive conditions 3. Intermediate: Same as short 4. Long: Sedative-hypnotic, epileptic seizures
66
Name of an Ultra Short Barbiturate?
Thiopental (Pentothal)
67
Name of a Short Barbiturate?
Pentobarbital
68
Name of an Intermediate Barbiturate?
Butalbital
69
Name of a Long Barbiturate?
Phenobarbital
70
What's a Therapeutic Index?
Dosage range which the drug becomes effective but above that range rapidly becomes toxic *Barbiturates have a very narrow therapeutic index!*
71
Barbiturate Mechanism of Action
Act primarily on the brain stem (reticular formation) Inhibits gamma-aminobutyric acid (GABA) Inhibit the nerve impulse travelling in the cerebral cortex
72
Barbiturate Drug Effects?
Low Doses = Sedative High Doses = Hypnotic effects and lower respiratory rate Enzyme Inducers = stimulate liver enzymes that cause the metabolism Or breakdown of many drugs and shorten duration Of action
73
Barbiturate Indications:
Sedative Hypnotic Anticonvulsant Anaesthetics for surgical procedures
74
Barbiturate Contraindications
Known allergy Pregnancy Severe liver disease Significant respiratory difficulties
75
Barbiturate Adverse Effects?
Nausea/vomiting Diarrhea/constipation Drowsiness/lethargy Vertigo Mental Depression Respiratory Depression/Apnea Bronchospasms/cough Hypotension Reduced REM sleep resulting in agitation
76
Barbiturate Toxicity and Overdose
Respiratory Arrest CNS depression ranging from sleep to coma and death
77
Barbiturate Additive Effects
If ingested with the following it will intensify the CNS depression Alcohol Antihistamines Opioids Benzodiazepines
78
Barbiturate Inhibited Metabolism
Mono amine oxidase inhibitors (MAOIs) will prolong effects of barbiturates
79
Barbiturate Increased Metabolism
Reduces anticoagulant response leading to possible clot formation
80
What are Benzodiazepines?
Most commonly used sedative-hypnotic because of their favourable adverse effect
81
2 Classifications of Benzodiazepines?
Sedative-Hypnotic Anxiolytics (Relieves Anxiety)
82
Benzodiazepine Sedative-Hypnotic Types
Long Acting: Flurazepam (Apo-Flurazepam) Short Acting: Temazepam (Restoril) Triazolam (Halcion)
83
Benzodiazepines Mechanism of Action
Depress CNS activity Affect hypothalamic, thalamic and limbic systems of the brain Activate Benzodiazepine receptors *Doesn't suppress REM and doesn't increase metabolism of other drugs!*
84
Benzodiazepines Drug Effects
Calming effect on CNS Useful in controlling agitation and anxiety Reduce excessive sensory stimulation, inducing sleep Induce skeletal muscle relaxation
85
Benzodiazepine Indications
Sedation Sleep Inducing Anxiety Relief Depression Skeletal muscle relaxation Alcohol withdrawal Epilepsy Balanced Anesthesia Moderate or conscious sedation
86
Contraindications of Benzodiazepines?
Known drug allergy Pregnancy Narrow angle glaucoma
87
Benzodiazepines Adverse Effects?
``` Mild/Infrequent: Headache Vertigo Drowsiness/Dizziness Lethargy ``` *Fall hazard in frail elderly*
88
Benzodiazepine Drug Interactions
Grapefruit and grapefruit juice alter drug absorption Kava and Valerian further CNS depression Other CNS depressants further CNS depression
89
Drugs under the Nonbarbiturate or Non Benzodiazepine Sedatives:
Buspirone `Chloral Hydrate Tizanidine Paraldehyde
90
What is a Seizure?
Brief episode of abnormal electrical activity in the nerve cells of the brain
91
What are convulsions?
Involuntary spasmodic contractions of any or all voluntary muscles throughout the body including skeletal and facial muscles
92
What is Epilepsy?
Chronic and recurrent pattern of seizures
93
2 Types of Epilepsy's?
Primary (Idiopathic) ` No apparent cause (50% of cases) Secondary ` Distinct cause identified ie trauma, infection
94
Classification of Epilepsy
1. Partial ` Simple ` Complex 2. Generalized 3. Unclassified 4. Status Epilepticus
95
What are Anti-Epileptic Drugs?
*Also known as anti-convulsants Control and prevent seizures while maintaining quality of life and to minimize adverse effects Usually lifelong Serum drugs need to be measured
96
Anti-Epileptic Drugs Mechanism of Action
Exact mechanism is unknown and thought to alter the movement of sodium, potassium and calcium ions across nerve cells in the brain Prevent degeneration Spread of excessive electrical discharge from abnormally functioning nerve cells and protect surrounding normal cells Reduce nerve stimulation and transmission of impulses from one nerve to the next
97
Anti-Epileptic Drug Adverse Effects?
Drowsiness Vision Problems *Narrow Therapeutic Index*
98
Anti-Epileptic Drug Interactions?
Increased bone marrow toxicity Decrease in half life Increase CNS depression Breakthrough seizures Increased or decreased drug levels
99
First Choice Anti-Epileptic Drugs
Carbamazepine Phenobarbital Phenytoin Primidone Valproic Acid
100
Some Second Choice Anti-Epileptic Drugs
Clonzepam Levetiracetam Clorazepate

Pharmacology (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions