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Pharmacology drugs 2

CNS-Anesthesia

QuestionAnswer
what is the oldest antiepilectic drug? potassium bromide
how does bromide ion work as an antiepilectic? it blocks the Cl- ion channels and is more permable than Cl-
Diazepam, aka valium, works as what? anticonvulsant, anti-anxiety, muscle relaxant, appitite stimulant
how does diazepam work? affects GABA binding and channel kinetics
how do barbiturates work? change channel kinetics to increase the effects of GABA
what is the drug of choice for status epilepticus? diazepam
why is diazepam such a good drug? highly lipid soluble and crosses BBB
what drug is used when barbiturates fail? KBr
how does levetiracetam work? presynaptically
how do phenytoin and carbamazepine work? limits frequency of Na channel opening by enchancing channel inactivation
how does zonisamide work? reduces Ca+2 currents and increases Na+ channel inactivation
Which drugs are excreted largely unchanged by kidneys and used in animal with liver problems? Bromide & levetiracetam
which compounds are commonly used in motivation, attention, and arousal are controlled by specific brain areas Norepi, epi, serotonin, dopamine
which drugs are used as neuroleptics? Phenothiazines - block multiple receptor types Acepromazine, chlorpromazine, azaparone Buterophenones - more selective for dopamine receptors Droperidol, haloperidol
how do neuroleptic drugs work? block catecholamine receptors
how do Alpha-2 adrenergic neuro drugs work? provides feedback inhibition of release
what are the alpha-2 adrenergic neuro drugs? Xylazine, detomidine, medetomidine
what are the reversal letters of alpha-2 adrenergic drugs? Yohimbine, telazoline, atapamazol
why do you give an animal endrophium? to test if the animal has myasthenia gravis
how does the endrophium test work? its a cholinesterase inhibitor and increases the amount of ACh and ACh receptors on the post-synaptic neuromuscular membrane
what is the gold standard test for myasthenia gravis? measure for serum ACh antibodies
what are the side effects of the endrophium test? SLUDD and bronchoconstriction
what are the two most common cholinesterase inhibitors used to treat MG? pyridostigmine (PO) and neostigmine (IM)
what are the side effects of muscarinic receptors with cholinesterase inhibitors? SLUDD, bradycardia, bronchoconstriction, weakness
what re the side effects of nicotinic receptors with cholinesterase inhibitors? paradoxical muscle weakness
what do you use for immunomodulaiton of MG? corticosteroids
what are the side effects associated with immunomodulation? iatrogenic cushings, wasting, muscle weakness, pu/pd, polyphagia, personality changes
what are the treatment options for organophosphate toxicity? atropine, diphenhydramine, 2-pam
what type of compound is atropine? systemic use muscarinic cholinergic blocker
what type of compound is diphenhydramine? systemic use nicotinic cholinergic blocker
what type of compound is 2-pam cholinesterase enzyme reactivator
what genus of ticks causes tick paralysis in the US? dermacentor
what genus of ticks causes tick paraylsis in Australia ixodes
what are the indications for using a Neuromuscular blockind drug? thoracotomy; obese animals intraocular surgeries; improve surgical access Reducing muscle contracture; endoscopy/intubation; balanced anesthesia
what must you keep in mind as far as precautions go when using Neuromuscular blocking drugs? no analgesic properties ventilatory assistance required
what is the most common depolarizing neuromuscular blocking drug? succinylcholine
what are the most common non-depolarizing neuromuscular blockind drugs? pancuronium, atracurium, vecuronium
list, from most sensitive to least sensitive, the body organs you commonly use neuromuscular blocking drugs for. eyes, larynx, jaw, trunk/limbs, diaphragm
how do non-depolarizing NMB work? compete with ACh at the receptor site and minimize ability of the muscle to contract. It is reversible with neostigmine
how do depolarizing NMB work? cause contraction of the muscle to the point of fatigue. It is NOT reversible.
which nerves do you monitor for a neuromuscular blockade? tibial, facial, ulnar
what are the two most commonly used stimulation tests when testing if an animal has a neuromuscular block? train of four; double burst
describe the characteristics of succinylcholine? rapid onset (30s) but short lived (5min in cats, 20 min in dogs)action depolarzing NMB precautions= incr intra-ocular/cranial pressure hyperkalemia muscle fasiculation and pain malignant hyperthermia
what are the characteristics of atracurium? intermediate duration of action non-depolarizing NMB (~35 min) few cardiovascular effects high histamine release metabolised through hoffman elimination not altered by hepatic or renal disease
what are the characteristics of pancuronium? it's a long acting non-depolarizing NMB (40min) causes NorEp to be released hepatic and renal disease will prolong effects of drug vagolytic effect
what are the characterisitics of vercuronium? intermediate duration of action (25 min) non-depolarizing neuromuscular blocker little effect on Aminoglycosides prolonged effects with hepatic and renal disease
what are the characterisitics of mivacurium? short acting non-depolarizing NMB causes histamine release
what is an opiate? drug derived from opium
what is an opioid? Term used to describe ALL drugs with morphine-like activity
what is a narcotic? Derived from the Greek word for stupor. Narcotic has historically been used to describe opioids.
what drug reverses the effects of opioids? naloxone
where are the receptors for opioid drugs located? Cerebral cortex, thalamus, PAG, spinal cord dorsal horn Peripheral sensory neurons and non-neurologic tissue
what are the endogenous mu ligand receptors? endomorphins
what are the endogenous kappa ligand receptors? dynorphins
what are the endogenous delta ligand receptors? enkephalins
which opioid receptor's effects are not reversed by naloxone or netrexone? sigma
which opioid receptor is stimulated by non-opioid related drugs? sigma
what is the purpose for using anesthesia? Humane restraint Efficiency Control convulsions Prevent recognition of pain Euthanasia Induction of anesthesia/Sedation/Maintenance
modifications to which carbon molecule of barbiturates confers sedative and hypnotic properties? C5
what activity do barbiturates have? anticovulsant, hypnotic, sedative Respiratory depressants (dose dependent) Cardiovascular effects: increased heart rate negative inotrope blood pressure/cardiac output changes variable
barbiturates inhibit the release of which biological substances? GABA, NE, ACh, glutamate
most common oxybarbiturate? how long lasting is it? pentobarbitol; short
most common thiobarbiturate? how long lasting is it? thiopental; ultra-short
which barbiturate is used in euthanasia solutions? pentobarbitol
which drug can evoke oxidative damage to feline RBC with repeated administration? propofol
what cardiovascular and respiratory effects does propofol cause? Cardiovascular Effects: Vasodilation (hypotension), negative inotrope. Enhances the dysrhythmogenic effects of epinephrine Respiratory Effects: depressant
Etomidate causes what side effects? -Inhibition of steroidogenesis (11-beta hydroxylase -Myoclonus, pain on injection -Hemolysis (propylene glycol effect)
Guaifenesin is normally given in conjunction with what other drugs? xylazine, ketamine, or thiopental
List what makes an ideal anesthetics Stable w/o preservatives; Inexpensive; Nonflammable; Easily vaporized; Low blood solubility; Very potent; No CV depression; Nonirritating to airways; Compatible with vasoactive drugs; skeletal muscle relaxation; Resists degradation; Nontoxic
What are the most accepted theories to explain the mechanism of action of local anesthetics? Meye-Overton Theory Protein Receptor Hypothesis Alterations in Neurotransmitter availability
Which organic inhalant anesthetic is not an ether? halothane
what are characteristics of the organic inhalant anesthetics? contain aliphatic hydrocarbon ethers (mostly) all are halogenated all agents require some mechanism for converting the liquid to a vapor (except NO)
why is thymol added to halothane? to better stabilize it and increase shelf life
Halogenation with Cl- and Br- do what to an inhalant anesthetic? increase potency
Fl- is added to an inhalant anesthetic why? to increase stability usually
what are the inorganic inhalant anesthetics? Nitrous Oxide
What is the difference between a gas and a vapor? Gas- an agent that exists in its gaseous form at room temperature and sea level pressure Vapor- the gaseous state of a substance that, at room temperature and sea level pressure, is a liquid
define saturated vapor pressure. maximum concentration of molecules in the vapor state that can exist for a given liquid at each temperature
Why is the saturated vapor pressure important to medicine? Anesthetics with a high SVP will require a smaller proportion of the total gas flowing through the vaporizer to pass through the vaporizing chamber to produce a given concentration than will anesthetics with a low SVP
What determines whether or not the animal will go to sleep? Partial pressure of the Gas in the brain (not the concentration of the gas in the brain)
Which inhalant anesthetic has a boiling point near room temperature? desflurane
what is a partition coefficient and how is it clinically important when applied to inhalation anesthetics? The ratio of the concentration of anesthetics in 2 phases such a blood and gas. (describes the affinity of an anesthetic for one solvent over another) indicates speed of anesthetic induction, recovery, and change of anesthetic depth
Increased solubility in the blood (larger blood/gas PC)--> ? increased uptake of anesthetic into blood
increased cardiac output--> ? increased uptake of anesthetic into blood
How does a decreased cardiac output affect how quickly and animal will go to sleep when being anesthetized with an inhalant anesthetic? prolongs time of how quickly the animal will go to sleep
Define minimum alveolar concentration (MAC). minimum alveolar concentration of an anesthetic that prevents gross purposeful movement in 50% of the subjects exposed to a noxious stimulus ~ED50
what does the MAC represent? MAC represents alveolar concentration not inspired or delivered.
what factors affect MAC? pregnancy status, age
What are the differences in the cardiovascular effects of the ether anesthetics and halothane? Halothane decreases CO to change BP; Ether anesthetics vasodilates to change BP
by what enzyme does inhalant anesthesia metabolism occur? liver metabolism by cytochrome p450
list, from most to least, the order of metabolism of halothane, methoxyflurane, sevoflurane, isofluran. methoxyflurane> halothane> isflurane> sevoflurane
Compound A is associated with which inhalant anesthetic? Sevoflurane
T/F: Compound A is directly nephrotoxic? False: its metabolites are nephrotoxic
1. How do local anesthetics work? Inhibit propagation (conduction) of nerve impulses; block Na+ channels which cause rapid depolarization by allowing rapid inward movement of Na+
2. Briefly describe a differential blockade? Larger concentration block all pain and muscle function temporarily lost Smaller concentration block local pain and muscle function remains intact
3. In a basic environment are local anesthetics more ionized or non–ionized? Why? ionized b/c anesthetic is a weak base.
4. What causes the local block to wear off after local anesthetic is injected near a nerve? Local block worn off by systemic circulation Intrinsic action on nerves Rremoval by systemic circulation Local anesthetics themselves have vascular effects Cause vasodilation at clinical doses (except cocaine)
5. Why is epinephrine sometimes added to lidocaine? to produce vasoconstriction to prolong the local anesthetic's effect
6. What topically applied local anesthetic can cause hemoglobin damage, especially in cats? benzocaine
7. What are the generic names of the 3 most commonly used local anesthetics in veterinary medicine? Which is the longest acting and which is the shortest acting? lidocaine (shortest) < bupivicaine < Mepivicaine (longest)
8. Of the 3 drugs in question 7 which is most cardiotoxic? bupivicaine
9. Briefly describe the differences between local infiltration of local anesthetic and a peripheral nerve block. local infiltration is where you are trying to anesthetize a region/local area, a peripheral nerve block is when you’re aiming for a specifically named nerve
10. 2% lidocaine contains how many milligrams/milliliter? 0.02mg/ml
Created by: clcxrf