All are GPCR's.
D1: SNpr, frontal cortex, nucleus accumbens, hypothalamus. Gs.
D2: Straitum, SNpc, pituitary, PFC. Gi.
D3: Nucleus accumbens, SNpc, VTA. Gi.
D4: PFC, hypothalamus, amygdala, hippocampus. Gi.
D5: Hypothalamus, striatum, nucleus accumbens. Gs.
Increased MAC (less potent): Hyperthermia, drugs that increase CNS catecholamines, increased CNS sodium, chronic ethanol abuse (desensitize GABA system).
Decreased MAC (more potent): INCREASED AGE, hypothermia, pregnancy, sepsis, acute ethanol intoxication.
Anesthetic drugs decrease MAC: Opioids, benzos, barbs, propofol, local anesthetics, N2O.
No change with duration of anesthetic, gender, weight, height.
Schedule I (no medical use) = hallucinogens, marijuana, heroin.
II = morphine/other opioid analgesics, cocaine, amphetamines, pentobarbital.
III = Codeine in combination, paregoric, glutethimidine, butabarbital.
IV = phenobarbital, chloral hydrate, benzodiazepine, other sedatives.
Occurs when combining 2 drugs that increase serotonin concentration. Especially prevalent with MAOi's.
Cognitive effects: Mental status changes
Autonomic effects: tachycardia, sweating, fever, labile BP, tachypnea, mydriasis, N/V/D.
Somatic effects: Hyperreflexia, muscle rigidity, ataxia.
Hyperthermia in 1/3 of patients.
"Hunter criteria": One or more of the following: Spontaneous clonus, ocular clonus with agitation and sweating, inducible clonus, tremor and hyperreflexia with temp >100.4F.
Can appear similar to neuroleptic malignant syndrome (distinguished by labs).
Treat with cyproheptadine, sometimes with propranolol or dantrolene or benzos.