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Neurosci Drugs

what drug is commonly used in suicide attempts? Barbituates because they can depress the respiratory centers and also have widespread effects. Often combined with alcohol
Ethosuximide Anti-epileptic that is effective at preventive "Absence Seizures". Other drug with similar indications for use is clonazepam
tiagabine prevents GABA reuptake. Used as add on drug
vigabatrin inactivates GABA-T (transaminase which deactivates GABA in the synaptic cleft).Used as add on drug
phenytoin class 1 anti-epileptic. It has dose dependent elimination. Less sedative effects than phenobarbital. Sides: gingival hyperplasia and excessive hair growth
carbamazepine non-epileptic use it is used for trigeminal neuralgia. (stops inappropriate firing of neurons which is associated with pain). Also approved for treatment of bipolar disorder
-flurane (volatile anesthetic) contraindications if patient has suffered blood loss (trauma), as it inhibits the baroreceptor reflex and the BP will drop. Patients with CAD because this (+) ionotrope and can cause ischemia.Contraindicated in M.S and DMD patients because of risk of malignant hyperthermia
Dantrolene it is the treatment for malignant hyperthermia (in addition to packing the patient with ice). It is also used to treat Neuroleptic Malignant syndrome. This drug works by blocking the ryanodine receptor
How does smoking effect anesthetic management? If you cannot stop a month before the surgery, then do not stop; eg if you stop 1 week pre-op airway can become more reactive
What drug is typically used for status epilepticus? Lorazapem; you would not use phenobarbital because a dose high enough to suppress respiration would be necessary
Describe an antiepileptic drug that is approved for use for other conditions Carbazamapine is approved for the treatment of trigeminal neuralgia, migraine, and bipolar disorder
Lorezapam Used intravenously to treat status epilepticus. Since it has a short half-life often the person will be control with this drug then switched to phenytoin
valproic acid & lamotrigine unlike other anti-epileptics these are effective at treating both grand-mal/focal seizures as well as "absence seizures"
Balanced Anesthesia The use of an intravenous hypnotic agent followed by a combination of intravenously administered drugs to maintain anesthesia (the desired effects)
What are the clinical effects of a potent anesthetic? A potent anesthetic must cause analgesia, amnesia, atonia, and hypnosis.
sevoflurane preferred drug for induction. Unlike the other fluranes, it is essentially odorless, does not irritate the airway, and is cardiostable. It can be transformed to a nephrotoxic compound by chemicals used in anesthesia machines
Propofol Is an IV agent used in general anesthesia. It has anti-emetic properties, quick induction of hypnosis. It also has a dose-dependent t1/2. Sides effects: CV depression, and allergic reaction to solvent (albumin), PRIS
Bell's phenomena Seen in phase II of anesthesia: it is a dangerous phase b/c of increased muscle tone and pooling of secretions
Ketamine is used when patient is severely hypovolemic because it ↑ sympathetic tone (1ary myocardial depressant) and has analgesic properties. Sides: emergence phenomenon
Remifentanil is used for analgesia in anesthesia. There is rapid sensitization and this drug has a short half life. Acute tolerance may develop and increased dose of opioids may be needed post-op
scolopamine used to ensure retrograde and anterograde amnesia
desflurane cannot be used for induction of anesthesia because it is very irritating to the airway
isoflorune is an old drug in this class. uses?
nitrous oxide A myocardial depressant and sympathomimetic effects typically cancel. It is contraindicated in those with HF, b/c it will cause decompensation (sympathetic tone is always high--compensation). Also, CI in those with pneumothorax or pneumocephalus
Etomidate an agent used for INDUCTION of anesthesia is used... when other agents are contraindicated due to head trauma and cardiovascular instability b/c it decreases CBF. Only used if no other option are available. sides: seizures, adrenal suppression(give cortisol), temporal phlebitis
PRIS (PROPOFOL INFUSION SYNDROME) Since propofol may interfere with long chain FA transport, use may lead to progressive hepatic encephalopathy, lactic acidosis, lipidemia, rhabdomyolisis, CVS collapse
volatile agents all of these agents, save NO2, are considered powerful agents and may cause Malignant hyperthermia. These agents mainly work on GABA(A)-R and by stabilizing the desensitized form of nAchR
DILI (drug induced liver injury) aka"halothane hepatitis". Metabolism of fluranes could lead to formation of a hapten and immune destruction of the liver. Diagnosis of exclusion with all but halothane. Also, Desflurane and sevoflurane are broken down to CO and nephrotoxins, respect.
-fluranes This class characteristically ↑ chronotropy (increase risk of ischemia). They also decrease SVR, thus can increase cerebral blood flow. They inhibit baroreceptor reflex. They also increase metabolic demand, eg dangerous to patients w/mitochondrial dsx
flurane contraindications may ↑ CBF and cause ↑ ICP leading to herniation. Blood loss due to any cause, b/c it inhibits the baroreceptor reflex. ↑ risk of malignant hyperthermia in those with MS or DMD. ↑ risk of arrhythmia when used with epinephrine
TIVA (total intravenous anesthesia) agents used are PROPOFOL to induce and maintain, KETAMINE to maintain anesthesia and for analgesia, desmedetomidine (sedation), and remifentanil (hypnotic analgesic). Etomidate
ondansetron a 5-HT3 receptor antagonist, which is used as an anti-emetic
amisulpride is a 2nd generation antipsychotic which is highly effective. It may have severe side effects including AGRANULOCYTOSIS
clozapine is used only when other antipsychotics are ineffective in treating schizophrenia. Significant weight gain can occur with the drug. Risk of agranulocytosis,
aripiprazole a D2 partial agonist--so it antagonizes when dopamine is high but stimulates when levels are low.
The "Z drugs" are zolpidem, zaleplon, zoplicone. They both work at GABAa agonist, but are not classified as benzodiazepines. They are used to treat "ZZZ" (sleep) disorders. Sides= fugue state
citalopram a pure SSRI (Selective serotonin reuptake inhibitor). Because it does not have effects on other pathways it lacks some side effects that produced by SSRIs like fluoxetine. Sides: sexual sides. do not use with MAOIs
duloxetine is an SNRI. At low doses it only acts as an SRI; medium doses SRI+NRI; high may affect the dopamine receptor. Used for MDE, anxiety, fibromyalgia. Sides; Sexual
imipramine A tricyclic antidepressant. Sides: anticholinergic side effects, cardiac conduction delays, drug-drug interactions.
tranylcypromine (irreversible) MAOIs; from the phenethylamine and amphetamine classes. Has may sides including--sexual dysfunction, insomnia, and can have pressor effects. It also requires a tyramine free diet.
Created by: 16310914