Mod. 11 hahahaha

CNS Stimulants / Respiratory Analeptics

Used to stimulate:

1. CNS

2. Respiratory System

3. Cardiovascular System

Situation:
During surgery

Mnemonic:
“CNS, Breathing, Heart during surgery.”

MEMORY ANCHOR
CNS Stimulants / Respiratory Analeptics = what major structure?

C-R-C

1. CNS

2. Respiratory System

3. Cardiovascular System

Mnemonic:
“Central, Respiratory, Cardio.”

CNS Stimulants / Respiratory Analeptics stimulate what 3 systems during surgery? Mnemonic?

During surgery.

Mnemonic:
“During surgery, stimulate CNS-breath-heart.”

CNS Stimulants / Respiratory Analeptics are used during what procedure/situation?

D-N-M-E-C-S

1. Doxapram

2. Nikethamide

3. Methylxanthines

4. Experimental Antagonist

5. Carbon Dioxide

6. Strychnine

Mnemonic:
“Doxa Nike Methyl Experiments Carbon Strychnine.”

Enumerate the CNS Stimulants / Respiratory Analeptics in this set. Mnemonic?

D = Doxapram
N = Nikethamide
M = Methylxanthines
E = Experimental Antagonist
C = Carbon Dioxide
S = Strychnine

Mnemonic:
“Doxa Nike Methyl Experiments Carbon Strychnine.”

What does D-N-M-E-C-S stand for under CNS Stimulants / Respiratory Analeptics?

Doxapram

MOA → stimulates CNS, respiratory system, cardiovascular system
Respiratory effect → increases tidal volume
Cardio target → aortic artery + carotid artery
Overdose → convulsion

Mnemonic:
“Doxa wakes brain, breath, and blood vessels.”

DOXAPRAM MEMORY ANCHOR
Doxapram = what major structure?

C-R-C

1. CNS

2. Respiratory System

3. Cardiovascular System

Mnemonic:
“Central, Respiratory, Cardio.”

Doxapram stimulates what 3 systems? Mnemonic?

Tidal volume.

Mnemonic:
“Doxa deepens the tide.”

Doxapram stimulates the respiratory system by increasing what?

Stimulates the respiratory system by increasing tidal volume.

Mnemonic:
“Doxa makes bigger breaths.”

What is the respiratory MOA of Doxapram?

A-C

1. Aortic artery

2. Carotid artery

Mnemonic:
“Aorta and Carotid.”

Doxapram stimulates the cardiovascular system, specifically what arteries? Mnemonic?

Convulsion.

Mnemonic:
“Doxa overdose = convulsion.”

Doxapram overdosage causes what?

Doxapram.

Mnemonic:
“Doxa overdose convulses.”

Which CNS stimulant overdosage causes convulsion?

Nikethamide

MOA → stimulates CNS, respiratory system, cardiovascular system
Side effect → initially depresses brain followed by excitement
Availability → hard to find

Mnemonic:
“Nike first depresses, then excites.”

NIKETHAMIDE MEMORY ANCHOR
Nikethamide = what major structure?

C-R-C

1. CNS

2. Respiratory System

3. Cardiovascular System

Mnemonic:
“Central, Respiratory, Cardio.”

Nikethamide stimulates what 3 systems? Mnemonic?

Initially depresses the brain followed by excitement.

Mnemonic:
“Nike goes down first, then jumps up.”

What is the side effect of Nikethamide?

Initially depresses the brain, followed by excitement.

Mnemonic:
“Brain down → excitement up.”

Nikethamide initially depresses what, then causes what?

Hard to find.

Mnemonic:
“Nike is hard to find.”

Availability-wise, Nikethamide is described as what?

Methylxanthines

Also known as → Xanthine Derivatives
Nature → alkaloids
3 Forms → C-T-T

1. Caffeine

2. Theophylline

3. Theobromine

Think:
“Methylxanthines are alkaloid stimulants from coffee, tea, and cocoa.”

Mnemonic:
“Coffee, Tea, Theobromine.”

METHYLXANTHINES MEMORY ANCHOR
Methylxanthines = what major structure?

Xanthine Derivatives.

Mnemonic:
“Methylxanthine = xanthine derivative.”

Methylxanthines are also known as what?

C-T-T

1. Caffeine

2. Theophylline

3. Theobromine

Mnemonic:
“Coffee, Tea, Theobromine.”

Methylxanthines are alkaloids in what 3 forms? Mnemonic?

C = Caffeine
T = Theophylline
T = Theobromine

Mnemonic:
“Coffee, Tea, Theobromine.”

What does C-T-T stand for under Methylxanthines?

Caffeine

Source → coffee
Stimulates → brain, cardiovascular system, little respiratory action
Also stimulates → urinary system + GI tract
Has → antioxidant action

Mnemonic:
“Coffee wakes brain, heart, urine, gut.”

CAFFEINE MEMORY ANCHOR
Caffeine = what major structure?

B-C-R

1. Brain

2. Cardiovascular System

3. Respiratory System, but only little action

Mnemonic:
“Brain, Cardio, little Resp.”

Caffeine stimulates what main systems? Mnemonic?

Respiratory system.

Mnemonic:
“Caffeine breath boost is little.”

Caffeine has little action in what system?

U-G

1. Urinary System

2. Gastrointestinal Tract

Mnemonic:
“Urine and Gut.”

Caffeine could also stimulate what 2 systems? Mnemonic?

Antioxidant action.

Mnemonic:
“Coffee antioxidant.”

Caffeine has what protective action?

Theophylline

Source → tea leaves
Stimulates → brain, respiratory, cardiovascular system
Also stimulates → urinary system + GI tract
Has → lipolysis function + antioxidant action
Aminophylline → beta-2 selective bronchodilator
Horse use → broken-wind with phlegm

Mnemonic:
“Theophylline from tea helps breathing and burns fat.”

THEOPHYLLINE MEMORY ANCHOR
Theophylline = what major structure?

Tea leaves.

Mnemonic:
“Theo from tea.”

Theophylline comes from what source?

B-R-C

1. Brain

2. Respiratory System

3. Cardiovascular System

Mnemonic:
“Brain, Resp, Cardio.”

Theophylline stimulates what 3 main systems? Mnemonic?

U-G

1. Urinary System

2. Gastrointestinal Tract

Mnemonic:
“Urine and Gut.”

Theophylline could also stimulate what 2 systems? Mnemonic?

Lipolysis function.

Fat loss.

Mnemonic:
“Theo thins fat.”

Theophylline has what fat-related function?

Antioxidant action.

Mnemonic:
“Tea antioxidant.”

Theophylline has what protective action?

Beta-2 selective bronchodilator.

Mnemonic:
“Amino opens beta-2 bronchi.”

Aminophylline is what kind of bronchodilator?

Respiratory centers.

Mnemonic:
“Amino = airway action.”

Aminophylline has more action in what centers?

Broken-wind.

There is presence of phlegm.

Mnemonic:
“Amino helps horse wind.”

In horses, Aminophylline is used to treat what?

Phlegm.

Mnemonic:
“Broken wind = phlegm wind.”

Broken-wind in horses has presence of what?

Theobromine

Source → cocoa
Stimulates → cortex
Result → increased motor and mental ability
Also stimulates → urinary system + GI tract
Has → antioxidant action

Mnemonic:
“Theobromine from cocoa boosts cortex.”

THEOBROMINE MEMORY ANCHOR
Theobromine = what major structure?

Cocoa.

Mnemonic:
“Theobromine = cocoa.”

Theobromine comes from what source?

Cortex.

Mnemonic:
“Theobromine turns on cortex.”

Theobromine stimulates what brain area?

M-M

1. Motor ability

2. Mental ability

Mnemonic:
“Motor and Mental.”

Theobromine stimulation of the cortex results in increased what 2 abilities? Mnemonic?

U-G

1. Urinary System

2. Gastrointestinal Tract

Mnemonic:
“Urine and Gut.”

Theobromine could also stimulate what 2 systems? Mnemonic?

Antioxidant action.

Mnemonic:
“Cocoa antioxidant.”

Theobromine has what protective action?

Experimental Antagonists

Old books → experimental
Nowadays → commonly used
3 Drugs → A-Y-T

1. 4-Aminopyridine

2. Yohimbine

3. Tolazoline

Mnemonic:
“Amino, Yohi, Tola.”

EXPERIMENTAL ANTAGONISTS MEMORY ANCHOR
Experimental Antagonists = what major structure?

Commonly used.

Mnemonic:
“Old experimental, now common.”

Experimental Antagonists were experimental in old books, but nowadays are what?

A-Y-T

1. 4-Aminopyridine

2. Yohimbine

3. Tolazoline

Mnemonic:
“Amino, Yohi, Tola.”

Enumerate the Experimental Antagonists. Mnemonic?

A = 4-Aminopyridine
Y = Yohimbine
T = Tolazoline

Mnemonic:
“Amino, Yohi, Tola.”

What does A-Y-T stand for under Experimental Antagonists?

4-Aminopyridine

MOA → stimulates the brain
Uses → antagonizes Curare drugs
Use → reverses overdose of muscle relaxant action
Use → antagonizes paralysis caused by aminoglycoside
Use → treats tetanus or paralysis caused by Clostridium botulinum

Mnemonic:
“Aminopyridine wakes brain and reverses paralysis.”

4-AMINOPYRIDINE MEMORY ANCHOR
4-Aminopyridine = what major structure?

Stimulates the brain.

Mnemonic:
“Amino wakes the brain.”

What is the MOA of 4-Aminopyridine?

Curare drugs.

Muscle relaxants.

Mnemonic:
“Amino attacks Curare.”

4-Aminopyridine antagonizes what drugs?

4-Aminopyridine.

Mnemonic:
“Amino reverses Curare overdose.”

If a patient is overdosed with Curare drugs / muscle relaxants, what is used to reverse the action?

Aminoglycosides.

Mnemonic:
“Amino fixes aminoglycoside paralysis.”

4-Aminopyridine is used to antagonize paralysis caused by what antibiotics?

T-C

1. Tetanus

2. Paralysis caused by Clostridium botulinum

Mnemonic:
“Tetanus and Clostridium botulinum.”

4-Aminopyridine is used to treat what disease or paralysis caused by what organism? Mnemonic?

Yohimbine

MOA → Alpha-blocker
Effect → stimulates the brain
Uses → correct sedation
Uses → correct arrhythmia and hypertension associated with amitraz
Amitraz note → for mange treatment; not allowed if body temperature is increased

Mnemonic:
“Yohi blocks alpha, wakes sedation, fixes amitraz effects.”

YOHIMBINE MEMORY ANCHOR
Yohimbine = what major structure?

Alpha-blocker.

Stimulates the brain.

Mnemonic:
“Yohi blocks alpha to wake brain.”

What is the MOA of Yohimbine?

Sedation.

Mnemonic:
“Yohi wakes sedation.”

Yohimbine is used to correct what CNS-related state?

A-H

1. Arrhythmia

2. Hypertension

Mnemonic:
“Amitraz Arrhythmia + Hypertension.”

Yohimbine is used to correct what 2 amitraz-associated conditions? Mnemonic?

Mange treatment.

Mnemonic:
“Amitraz = mange med.”

Amitraz is used for what treatment?

Body temperature.

Mnemonic:
“Amitraz avoided when animal is hot.”

Amitraz is not allowed when what is increased?

Tolazoline

Adrenergic blocker
Stimulates the brain
Used when there is histamine release / allergic reaction
Used at the same time to stimulate the brain

Mnemonic:
“Tola blocks adrenergic and wakes allergy brain.”

TOLAZOLINE MEMORY ANCHOR
Tolazoline = what major structure?

Adrenergic blocker.

Mnemonic:
“Tola blocks adrenergic.”

Tolazoline is what kind of blocker?

Brain.

Mnemonic:
“Tola turns on the brain.”

Tolazoline stimulates what?

Histamine.

Allergic reaction.

Mnemonic:
“Histamine release = Tola time.”

Tolazoline is used when there is a release of what?

Allergic reaction.

Mnemonic:
“Histamine = allergy.”

Histamine release indicates what reaction?

Carbon Dioxide

Stimulates the brain for oxygen-carbon dioxide exchange.

Physiological.

Mnemonic:
“CO₂ controls oxygen exchange.”

CARBON DIOXIDE MEMORY ANCHOR
Carbon Dioxide = what major structure?

Oxygen-carbon dioxide exchange.

Mnemonic:
“CO₂ wakes the exchange.”

Carbon Dioxide stimulates the brain for what exchange?

Physiological.

Mnemonic:
“CO₂ exchange = physiological.”

Carbon Dioxide stimulation is described as what?

Strychnine

Alkaloid from plant → Strychnos nue vomica
MOA → stimulates brain, respiratory centers, cardiovascular system
Cardio targets → carotid and aortic arteries
Not used → toxicologic effect outweighs pharmacologic effect

Mnemonic:
“Strychnine strongly stimulates but is too toxic.”

STRYCHNINE MEMORY ANCHOR
Strychnine = what major structure?

Strychnos nue vomica.

Mnemonic:
“Strychnine from Strychnos.”

Strychnine is an alkaloid from what plant?

B-R-C

1. Brain

2. Respiratory Centers

3. Cardiovascular System

Mnemonic:
“Brain, Respiration, Cardio.”

Strychnine stimulates what 3 systems/centers? Mnemonic?

C-A

1. Carotid arteries

2. Aortic arteries

Mnemonic:
“Carotid and Aortic.”

Strychnine stimulates the cardiovascular system through what arteries? Mnemonic?

The toxicologic effect outweighs the pharmacologic effect.

Mnemonic:
“Strychnine stimulates but toxicity wins.”

Why is Strychnine not used?

Strychnine.

Mnemonic:
“Strychnine = too toxic.”

Which CNS stimulant is not used because the toxicologic effect outweighs the pharmacologic effect?

COMPARISON / EXAM TRAP CARDS

Doxapram.

Mnemonic:
“Doxa deepens tidal volume.”

Which CNS stimulant stimulates respiratory system by increasing tidal volume?

Nikethamide.

Mnemonic:
“Nike down then excited.”

Which CNS stimulant initially depresses the brain followed by excitement?

Caffeine.

Mnemonic:
“Coffee = Caffeine.”

Which Methylxanthine comes from coffee?

Theophylline.

Mnemonic:
“Tea = Theo.”

Which Methylxanthine comes from tea leaves?

Theobromine.

Mnemonic:
“Cocoa = Theobromine.”

Which Methylxanthine comes from cocoa?

Yohimbine.

Mnemonic:
“Yohi blocks alpha and wakes sedation.”

Which Experimental Antagonist is an Alpha-blocker used to correct sedation?

CNS Stimulants / Respiratory Analeptics
= stimulate CNS, respiratory, and cardiovascular system during surgery.

Major Drugs / Groups → D-N-M-E-C-S

1. Doxapram

   • Stimulates CNS

   • Stimulates respiratory system by increasing tidal volume

   • Stimulates cardiovascular system: aortic + carotid arteries

   • Overdose → convulsion

2. Nikethamide

   • Stimulates CNS, respiratory, cardiovascular system

   • Side effect: initially depresses brain followed by excitement

   • Hard to find

3. Methylxanthines / Xanthine Derivatives → C-T-T

   • Caffeine → coffee; brain/cardio/little respiratory; urinary + GI; antioxidant

   • Theophylline → tea leaves; brain/resp/cardio; urinary + GI; lipolysis; antioxidant

   • Aminophylline → beta-2 selective bronchodilator; more respiratory action; broken-wind in horses with phlegm

   • Theobromine → cocoa; cortex; increases motor + mental ability; urinary + GI; antioxidant

4. Experimental Antagonists → A-Y-T

   • 4-Aminopyridine → stimulates brain; antagonizes Curare drugs, aminoglycoside paralysis, tetanus / Clostridium botulinum paralysis

   • Yohimbine → Alpha-blocker; corrects sedation; corrects amitraz-associated arrhythmia and hypertension

   • Tolazoline → adrenergic blocker; histamine/allergic reaction + stimulates brain

5. Carbon Dioxide

   • Stimulates brain for oxygen-carbon dioxide exchange

6. Strychnine

   • From Strychnos nue vomica

   • Stimulates brain, respiratory centers, carotid + aortic arteries

   • Not used because toxicologic effect outweighs pharmacologic effect

Master Mnemonic:
“Doxa Nike Methyl Experiments Carbon Strychnine.”

MASTER MEMORY MAP
CNS Stimulants / Respiratory Analeptics = how do you remember the whole topic?

Local Anesthetics

Main idea → applied locally to nerve tissue
Effect → relief from pain
MOA → blocks conduction of sensory nerve impulse
Consciousness → no effect
Types by ROA → T-I-C-P-E-I-IV
Formulations → B-V-D-O-P
Drug clue → all end in -caine

Mnemonic:
“Local blocks nerve pain, consciousness remains.”

LOCAL ANESTHETICS MEMORY ANCHOR
Local Anesthetics = what major structure?

Drugs applied locally to nerve tissue in effective concentration.

Purpose:
Provide relief from pain.

Mnemonic:
“Local = placed on nerve area.”

What are Local Anesthetics?

Conduction of a sensory nerve impulse.

Mnemonic:
“Block sensory signal = block pain.”

Local Anesthetics provide relief from pain by blocking what?

No.

They have no effect on consciousness.

Mnemonic:
“Local pain block, brain awake.”

Do Local Anesthetics affect consciousness?

Local Anesthetics block pain locally without loss of consciousness.

Mnemonic:
“Local = awake but numb.

What is the main difference between Local Anesthetics and general anesthesia?

7 Types → T-I-C-P-E-I-IV

1. Topical / Surface Anesthesia

2. Infiltration Anesthesia

3. Conduction / Nerve-block Anesthesia

4. Paravertebral Anesthesia

5. Epidural / Extradural

6. Intrathecal

7. I.V. Regional Anesthesia

Mnemonic:
“Topical Infiltrates, Conducts, Para, Epidural, Intrathecal, IV.”

TYPES OF LOCAL ANESTHESIA MEMORY ANCHOR
Types of Local Anesthesia by ROA = what major structure?

T-I-C-P-E-I-IV

1. Topical / Surface Anesthesia

2. Infiltration Anesthesia

3. Conduction / Nerve-block Anesthesia

4. Paravertebral Anesthesia

5. Epidural / Extradural

6. Intrathecal

7. I.V. Regional Anesthesia

Mnemonic:
“Topical Infiltrates, Conducts, Para, Epidural, Intrathecal, IV.”

Enumerate the types of Local Anesthesia by ROA. Mnemonic?

Skin and mucous membrane.

Mnemonic:
“Topical = top surface.”

Topical / Surface Anesthesia is applied where?

S-E-N-E-T-A-G

1. Skin

2. Front of eyeball

3. Inside of nose

4. Ear

5. Throat

6. Anus

7. Genital area

Mnemonic:
“Skin, Eye, Nose, Ear, Throat, Anus, Genitals.”

Topical / Surface Anesthesia is used to numb what areas? Mnemonic?

Topical / Surface Anesthesia

Mnemonic:
“Topical touches the surface.”

Which type of local anesthesia is applied on skin and mucous membrane?

Making numerous subcutaneous injections of small amounts of local anesthetic.

The drug diffuses into surrounding tissue.

Mnemonic:
“Infiltration = inject many small amounts.”

What is Infiltration Anesthesia?

Surrounding tissue.

Mnemonic:
“Infiltrate = spread around.”

In Infiltration Anesthesia, local anesthetic diffuses into what?

Infiltration Anesthesia

Mnemonic:
“Infiltration = many small injections.”

Which type of local anesthesia uses numerous subcutaneous injections?

Injecting local anesthetic into the immediate vicinity of a nerve.

Not in the nerve, but near the nerve.

Mnemonic:
“Nerve-block = near nerve, not inside nerve.”

What is Conduction / Nerve-block Anesthesia?

Immediate vicinity of a nerve.

Mnemonic:
“Block beside the nerve.”

In Conduction / Nerve-block Anesthesia, where is the anesthetic injected?

No.

It is injected near the nerve.

Mnemonic:
“Near nerve, not nerve.”

In Nerve-block Anesthesia, is the local anesthetic injected inside the nerve?

Local anesthetic is applied in spinal nerves as they emerge from the intervertebral foramina.

Mnemonic:
“Para-vertebral = beside vertebra, spinal nerve exit.”

What is Paravertebral Anesthesia?

Spinal nerves.

Mnemonic:
“Para-vertebral = spinal nerve.”

Paravertebral Anesthesia is applied to what nerves?

Intervertebral foramina.

Mnemonic:
“Foramina = nerve exit holes.”

Spinal nerves in Paravertebral Anesthesia emerge from what?

Injecting local anesthetic into the epidural space of the spinal canal.

Mnemonic:
“Epidural = epidural space.”

What is Epidural / Extradural Anesthesia?