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Pharmacology 2 Exam2
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| Question | Answer |
|---|---|
| A focus | a group of neurons with synchronous, high frequency discharge |
| Causes of seizures | genetic defects, hypoxia at birth, head trauma, tumor |
| Partial or local seizures | starting at a focus, with limited spread |
| Generalized seizures | widespread seizure activity involving both hemispheres |
| Simple partial seizures | symptoms depend on the location of abnormal activity in the brain |
| Complex partial seizures | confused behavior and impairment of consciuosness |
| Tonic-clonic seizures | (Grnad mal): muscle rigidity followed by synchronous muscle jerks |
| Myoclonic seizures | sudden muscle contractions |
| Absence seizures | (Petit Mal): very frequent but brief (10-30seconds) episodes of loss of consciousness |
| Atonic seizures | sudden loss of muscle tone |
| Febrile seizures | fever-associated seizures in children (6 months to 5 years) |
| Status epilepticus | seizure activity that persists for a long time |
| Prolongation of Na+ channel inactivation to treat seizures | Phenytoin, carbamazepine, valproate, lamotrigine |
| Suppression of Ca2+ influx to treat seizures | valproate, ethosuximide |
| Potentiation of Gaba action to treat seizures | tiagabine: increased gaba action by prolonging the presence of GABA in the synapse vigabatrin: increased gaba action by inhibitng the enzyme that degrades gabe in the synapse benzo's and barb's: increase gaba action by binding directly to gaba receptors |
| Time course of local anesthesia | rapid onset 2-5 minutes 10-15 minutes |
| Time course of local anesthesia | Slow and variable recovery 15-60 minutes, hours |
| Congenital insensitivity to pain | inability to feel pain from birth |
| Allodynia | pain due to a stimulus that does not normally provoke pain |
| Dysfuntional pain | pain with no known tissue injury, or noxious stimulus (tension headache, IBS) |
| Central sensitization | leads to hyperalgesia and allodynia |
| mu opiod receptor | mediates almost all morphine-produced effects |
| delta opiod receptor | central excitation, analgesia |
| kappa opiod receptor | analgesia, dysphoria |
| Strong opiod agonists | morphine, heroin, hydromorphone, oxymorphone, methadone, meperidine, fentanyl, levorphano |
| Metabolism of heroin | Heroin --> MAM --> Morphine |
| Opiod withdrawal syndrome | occurs within hours after last dose of morphine |
| Opiod withdrawal syndrome symptoms 8-16 hours... | lacrimation, rhinorrhea, sweating, mydriasis, anorexia, nervousness, irritability, tremors, anxiety, restless sleep |
| Opiod withdrawal syndrome symptoms within 36 hours... | skeletal muscle fasciculation and twitch, severe painful cramps, uncontrolled vomiting, salivation, diarrhea, weakness, depression, unable to sleep, increased respiratory rate, BP, temp, blood sugar |
| Opiod withdrawal syndrome symptoms peak at _____ and subsides over the next ______ | 48-72 hours 10 days |
| Why is methadone used in treatment of opiod dependence? | methadone withdrawal is slower in onset, longer in duration, much less intense |
| Meperidine (Demerol) | mu-agonist The constipation and urinary retention is less common than with morphine |
| Meperidine toxicity | large repeated doses can lead to an excitatory syndrome -- hallucinations, tremors, muscle twitches, dilated pupils -- due to accumulation of its metabolite Normeperidine Not drug of choice for treatment of severe, prolonged pain |
| Fentanyl | mu receptor agonist 80 times more potent than morphine as an analgesic |
| Mild to moderate opiod agonists | codeine, oxycodone, hydrocodone, propoxyphene |
| Pentazocine and butorphanol | antagonist at mu receptor and agonist at kappa receptor |
| Naloxone and naltrexone | central and peripheral antagonists at mu and kappa receptors |
| Methylnaltrexone and Avimopan | peripheral only antagonist at mu and kappa receptors |
| Naloxone clinical use | treatment of opiod toxicity, especially respiratory depression Reverses effects of mu opiod agonists |
| Naltrexone | used in long-term management of opiod addiction Long duration of action |
| Methylnaltrexone | Peripheral only - used to treat opiod-induced constipation and block the peripheral actions of opiods dissociates from mu, delta, and kappa quickly |
| Alvimopan | blocks the peripheral action of opiods - used to treat opiod induced constipation mu > delta = kappa receptor affinity slow dissociation rate |
| Tramadol | activates mu opiod receptor inhibits NE and 5-HT intake less efficacious than morphine less opiod-like adverse effects |
| Tapentadol (Nucynta) | Atypical Opiod Activates mu opiod receptors and inhibits NE reuptake Comparable analgesic efficacy with morphine, less opiod-like adverse effects, less addiction potential, better GI tolerability |
| Gabapentin | Anti-convulsant effective for neuropathic pain, epilepsy Acts on a2delta subunit of voltage-dependent calcium channels, thus decreasing neural excitability |
| Pregabalin (Lyrica) | Anti-convulsant effective for neuropathic pain, epilepsy Acts on a2delta subunit of voltage-dependent calcium channels, thus decreasing neural excitability |
| Duloxetin (Cymbalta) | antidepressant Treats diabetic neuropathy, depression, fibromyalgia, chronic musculoskeletal pain SNRI |
| Ziconotide | used in Severe chronic pain must be delivered through intrathecal pump system N-type voltage-gated calcium channel blocker |
| Aura | phase predicting that migraine will occur |
| Triptins (Sumatriptan) | Selective 5-HT1B/1D receptor agonist Reduce both sensory activation in the periphery and nociceptive transmission in the brainstem Causes vasoconstriction -> contraindication coronary heart disease |
Created by:
Newby549
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