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27 terms

3-PHARM 4

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Which binds to same site as Ach on nAchR but activates the receptor initially?
Depolarizing
Which phase may be inhibited by cholinesterase inhibitors
phase II
Which are cholinesterase inhibitors
neostigmine & pyridostigmine Note: they antagonize neuromuscular blockade (i.e. block breakdown of Ach)
Which has the shortest duration
succinylcholine
Note: b/c it's a depolarizing blocker
Which is a longer duration non-depolarizing NMB
Pancuronium
Which are the better non-depol b/c they have minimal cardiovascular effects (ie no His release)
vecuronium, pipecuronium, rocuronium,Rapacuronium
What are 3 effects specific to depol blockcade (succinylcholine)
hyperkalemia, myalgia, inc intraocular & intragastric pressure Note: hyperkalemia is rare but potentially fatal cardiac arrest can occur
3 factors altering responses to NMB's
myasthenia gravis, age, burns
Myasthenia gravis (inc or dec) responsiveness to NMB
inc
Note: so give lower dose of NMB
Aminoglycoside antibiotics (enhance or dec) NMB
enhance
Note: they do this by dec release of Ach
Succinylcholine is antagonized by ___
non-depolarizing blockers
What are 3 BDZs
Diazepam, lorazepam, clonazepam
Which is long acting that provides spasmolytic effects and muscular relaxant
diazepam
Which is intermediate acting and a favorite for older pts
lorazepam
Which is used if confined to bed (very strong)
clonazepam
Which is a GABAb agonist
Baclofen
Intrathecal __ is administered for severe spasticity assoc w/ spinal injury (can cause resp depression)
baclofen
What cause less hypotension than clonidine but hypotension still possible
Tizanidine
Note: dry mouth and drowsiness are side effects
What is commonly used to tx back spasms assoc w/ lower back injury or back strain
Soma
In Soma, __ is a sedative-hypnotic that has additive effects mixed w/ alcohol
metabolite meprobamate
Note: mixing may result in respiratory depression
What has no central mechanism and works at the sarcoplasmic reticulum
Dantrolene
General anesthesia is divided into inhalational and intravenous. Inhalation is divided into halogenated and non-halogenated. The one used today is ___
N20 (non-halogenated)
What are the inhalational agents
-flurane, halothane, N20
IV agents:
...
Barbituate=___
thiopental
Opioid=___
fentanyl
BDZ = ___
MIDAZOLAM
Others include Ketamine, Etomidate, Propofol