Pharmacology TAMU Herman Test 2

adverse effects with benzodiazepines

drowsy, ataxia (the loss of full control of bodily movements), memory loss, hepatic impairment, depressive if combined, impair intellectual functioning and motor dexterity, withdrawal of some can result in insomnia- less potent drugs don't have this effect,

side effects with barbiturates

addiction, drowsy, nausea, vertigo, tremors, enzyme induction, suppress the hypoxic and chemoreceptor's response to CO2- respiratory depression

withdrawal can cause death

can cause overdose due to respiratory failure

drug hangover form hypnotic doses

MOA Barbiturates

enhance GABA effects

block excitatory glutamate

block high frequency sodium channels

MOA benzodiazepines

enhance GABA effects

barbiturate actions

dose dependent CNS depression- sedation, hypnosis, anesthesia, coma, death

barbiturate therapeutic uses

anesthesia, anticonvulsant,

sedation, hypnosis

MOA zolpidem

binds to BZ receptor

no anticonvulsant or muscle relaxant activities

zolpidem side effects

psychomotor, nightmares, agitation, anterograde amnesia, headache, GI upset, dizziness and daytime drowsiness

zoleplon

fewer side effects

eszopiclone

longer duration

ramelteon MOA

melatonin agonist

may induce prolactin

ramelteon actions

sleep induction

BZ indications

GAD

seizure in progress

muscle relaxation

sleep disorders

amnesia

grandfather drug of BZ class

Valium (benzodiazapam)

mediated through alpha1-GABA receptor

sedation/hypnosis

anterior grade amnesia

anticonvulsant

mediated through alpha2-GABA receptor

muscle relaxant

reduction of anxiety

drug effects of BZ are terminated by

elimination and redistribution

active metabolites

BZ antagonist

flumazenil

buspirone MOA

serotonin and dopamine receptors

buspirone indications

GAD

buspirone side effects

headaches, dizziness, nervousness, nausea, and light-headedness

5 important benefits of anesthetics

reduced anxiety and sedation

lack of awareness

skeletal muscle relaxation

analgesia

first anesthetic

ether

patient conditions considered when giving anesthesia

organ function

medical conditions

concurrent medications

anesthetic side effects

suppress cardiovascular system

suppress respiration

preanesthetic medications

H2 blockers for reduced gastric activity

Benzodiazepines to allay anxiety and facilitate amnesia

Nonopioids or opiods for analgesia

Antihistamines to prevent allergic reactions

Antiemetics to prevent nausea

Anticholinergics to prevent bradycardia and secretion of fluids into the respiratory tract

stage 1 anesthesia

diminished pain perception

some memory loss

stage 2 anesthesia

agitation

stage 2 anesthesia

surgical

stage 4 anesthesia

paralysis and death

3 stages of general anesthesia

induction

maintenance

recovery

effects of inhalants

bronchodilation

increased brain perfusion

interfere with respiratory control

relationship of potency and MAC

low MAC = high potency

increase MAC

Hyperthermia

drugs that increase CNS catecholamines and chronic ethanol abusers

decrease MAC

Hypothermia, pregnancy, sepsis, acute intoxication, concurrent IV anesthesia and alpha 2- adrenergic receptor agonists

inhalants MOA

unknown but probably more than one receptor is involved

uptake of inhalants are effected by

solubility

CO

alveolar to venous partial pressure

MOA of neuromuscular blockers

block nicotinic ACh receptors in neuromuscular junction

MOA of inhalants

mostly unknown

potentiates GABA

N2O and ketamine are NMDA blockers

NMDA receptor is a glutamate receptor. Glutamate is the body's main excitatory neurotransmitter

earliest halogenated hydrocarbon

halothane

side effects of halothane

Hepatotoxicity in adults

Cardiac sensitization

Malignant hyperthermia

side effects isoflurane

dose dependent hypotension

smells bad and makes you cough