Week 4

Question 1

Skeletal muscle Relaxants

Neuromuscular blockers are?

Answer 1

Nicotinc (muscle) antagonist; used in majory surgery to induce temporary muscle paralysis.

Tubocurainin- duration of procedure

Succinylcholine- during intubation

Adverse effects- respiratory paralysis, cardiac dysfunction, muscle pain after use in surgery, and muscle damage may occur.

Question 2

What does baclofen do and where is its action take place?

Answer 2

Is a antispasticity drug. Takes place in CNS

Question 3

What are the adverse effects for skeletal muscle relaxants?

Answer 3

Sedation, confusion, headache, nausea, vomiting

Question 4

What drug is used for skeletal muscle spasms of a local pathology- trama (SCI) inflammation, reduces spasticity caused by upper motor neuron lesion?

Answer 4

Gaba -a agonist-inhibition

Diazepam (Valium)

Question 5

What is baclofen (liorseal)

Answer 5

• inhibition of monosynaptic and polysynaptic reflexes
• oral baclofen use has been established for multiple sclerosis, spinal cord injury, and intrathecal baclofen has been established for MS, SCI, and stroke.
• patients with stroke do not tolerate baclofen well.

Question 6

This drug reinforces both presynaptic and postsynaptic inhibition of the spinal cord. Also inhibits nocioceptor transmission in the spinal dorsal.

Answer 6

Tizanidine, (Zanaflex, alpha 1 receptor agonist)

Question 7

Patient reports getting a local injection of the toxin to reduce contraction associated with spastic disorders. Toxin blocs transmission at neuromuscular junction, last weeks- months?

Answer 7

Botulinum toxin- botox

Question 8

What is the difference between sedative and hypnotic drugs?

Answer 8

Sedative- reduce anxiety and exert a calming effect

Hypnotic - produce drowsiness and sleepiness.

Take pill->become sedative->increase dosage->become hypnotic

Question 9

A physical therapy student keeps having increased anxiety before test. He decides to go see a physician. What do you think the physician will prescribe?

Answer 9

Benzodiazepines

Agonist- diazepam, lorazxepam, triazolam, alprazolam, chlordizaepoxide===look for ams

Question 10

Where does the benxodiazepine potenitate Gabaergic inhibition?

Answer 10

The BZ does not directly activate the GABA receptor but enhances the effect of the GABA binding.

Question 11

What are the adverse effects of BZ

Answer 11

lead to day time drowsiness, impaired judgement, diminished motor skills, significantly impaired ability to learn new information.

Higher doses = date rape.

most common drug overdose to commit sucicide.

Question 12

What is epilepsy?

Answer 12

Chronic disorder of various causes with recurrent seizures. Seizures are a sudden, unprovoked attacks of subjective experiential phenomena involuntary movements or convulsions.

Question 13

The patient mentioned there was a unknown cause for his epilepsy? Is this a primary or secondary epilepsy?

Answer 13

Primary-unknown cause

Secondary =related to particular event (tbi, Stroke)

Question 14

The patient Lost consciousnes and the seizures originated in a localized area of one cerebral hemisphere. What type of siezure if this?

Answer 14

Parital complex seizure

Complex=consciousness is lost

Question 15

The patient had a seizure that originated in the localized area of one cerebral hemisphere but her consciousness remained inatack. What kind of seizure is this?

Answer 15

Simple Partial seizure

Simple-consciousness remains intack

Question 16

A type of seizure that takes place when a neuronal discharge involves both cerebral hemisphere.

Answer 16

Generalized seizures

Question 17

This seizure involves unilateral involvement, **no impaired Consciousness, jerking of the face, contralateral flexion and elevation of the arm, contralateral turning of the head, hallunications of sight, **

Answer 17

Simple partial seizures

Question 18

This seizure is localized onset that progresses bilateral involvement, impaired consciousness , amensic about the event, clumsy perserveration of ongoing motor events, chewing, drawing, walking.

Answer 18

Complex partial seizures

Question 19

Your working with a patient and all of sudden they have a sudden loss of consciousness, Sudden rigid extensor spasm (10-30 seconds) Rhythemic flexor spasm, respiration ceases, defacation, micturation,

Answer 19

Generalized

(Tonic -clonic seizure) grand mal

Question 20

Your working witha child when all of sudden he/she stares blanky for a few mintues. Mild chronic movements-eye blinking along with abrupt brief loss of consciousness.

Answer 20

Generalized seizures

Absence Seizures

Question 21

Your working with a patient when off a sudden your patient has brief contractions confied to the face, trunk, and extremites lasting only seconds.

Answer 21

Generalized Seizures

Myoclonic Seizures.

Question 22

Generalized seizures

Atonic seizures vs status epilepticus

Answer 22

atonic occur in children, drop attacks 10-30 secs, may involve entire body resulting in potential injury,

Status epilepticus- seizures are prolonged or prepeated that recovery does not occur between attacks, medical emergency

Question 23

OMG your patient is having a seziure. What do you do?

Answer 23

Ease the patient to the floor, put something soft under their head, turn patient gently onto their side.Dont put anything in their mouth and do not restrain their movements.

Basically dont let them fucking die

Question 24

What is the primary drug for seizure control? This drug alters conductance of potassium and calcium channels and blocks sodium channels.

Answer 24

Anti-epileptic drug

Phenytonin (dilatin)- most common

Question 25

What is the second most common Seizure drug?

Answer 25

Carbamazepine (tegretol)

Question 26

What are common side effects for phenytonin, carbamazepine, valproic drugs?

Answer 26

Anti-epileptic side effects

Atazia, nystagmus, drowsiness, sedation, confusion, visual disturbances, cardiac dysrhythmias

Question 27

What are the stages of anesthesia?

Answer 27

Analgesia(conscious), disinhibition(delirous), surgical anthesia (unconscious, no pain), medullary depression-severe respiratory or cardio supression

Question 28

What is the most common type of inhaled anesthetics?

Answer 28

Nitrous oxide - lacks sufficient potency to produce surgical anesthesia alone.

Question 29

What is an adverse effect from inhaled anesthetics and association with succinylcholine?

Answer 29

malignant hyperthermia

Question 30

Morphine and fentanyl are used in blanced anesthesia especially in high risk patients. What drug is this?

Answer 30

Opiods

Question 31

This is a intravenous anesthetic. Most commonly used and see rapid anesthesia and rapid patient recovery. What drug is this?

Answer 31

Propofol (diprivan)

Question 32

Creates a “dissociative anesthesia” where the patient is conscious but exhibits catatonia (unresponsive), WHat drug is This?

Answer 32

Ketamine (ketalar)