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38 Cards in this Set
- Front
- Back
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Which opiod is used for cough?
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Dextromethophan
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Which opiods are used for diarrhea? (2)
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1. Loperamide
2. Diphenoxylate |
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Where do opioids act
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Opioid receptors
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What are the 3 different receptors (3)
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1. Mu = morphine
2. delta = enkaphalin 3. Kappa = Dynorphin |
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What happens to synaptic transmission
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K+ channels open and Ca2+ channels close which leads to decreased synaptic transmission
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What NT's are inhibited (5)
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1. Ach
2. NE 3. Seratonin 4. Glutamate 5. Substance P |
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Besides pain what are 4 other uses for opiods?
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1. Cough - dextro
2. Diarrhea - see other card 3. Acute pulmonary edema 4. Addict maintenance |
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What are the 5 toxicities of opiod use?
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1. Addiction and tolerance
2. Constipation 3. Miosis - pinpoint pupils 4. respiratory depression 5. CNS depression is additive with other drugs |
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Which side effects don't obtain tolerance?
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Miosis and constipation
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How is opioid overdose treated and how do these agents work?
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Naloxone or naltrexone - both are opioid antagonists
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What type of drug is butorphanol?
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Mixed agonist/antagonist
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At which receptors does it act and how?
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Mixed agonist/antagonist at mu
Agonist at kappa |
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What is the clinical use and why is it preferred?
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Pain - it's preferred because it causes less respiratory depression than full agonists
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What is the toxicity?
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Don't mix it with other opioids because it will induce withdrawl if the oterh opioid is a full agonist
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How does tramadol work?
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Very weak opioid agonist
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What other NT's does tramadol affect and how?
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Inhibits serotonin and NE reuptake
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What is the indication for tramadol and why is it preferred?
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Chronic pain - it is non-addictive
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What are the toxicities?
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1. Similar to opioids
2. Decreases seizure threshold |
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What is the mechaism of phenytoin? (3)
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1. Use dependent blockade of Na+ channels
2. Increases nerve refractory period 3. Inhibits glutamate release |
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What are the 2 indications for phenytoin?
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1. Tonic-clonic seizures
2. Class IB antiarrhythmic |
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See seizure card set for SE of phenytoin
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Barbituriates: what is the common suffix for these drugs?
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"-barbital"
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Barbituriates: mechanism
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Decrease neuronal firing: they enhance the action of GABA by decreasing the DURATION of chloride channel opening
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Barbituriates: uses (4)
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1. Sedative for anxiety
2. Siezures 3. Insomnia 4. Thiopental is used to induce anesthesia |
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Barbituriates: overdose management?
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Symptomatic management so… assist with airway and BP
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Barbituriates: see seizure drug list for SE of barbituriates
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Benzodiazepine: what is the suffix for almost all of them?
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"zepam" or "zolam"
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Benzodiazepine: which is used for EtOH withdrawl
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chlordiazepozide
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Benzodiazepine: Which has the shortest 1/2 life?
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alprazolam (xanax)
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Benzodiazepine: what happens to REM sleep
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it decreases
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Benzodiazepine: machanism
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Enhance GABA by increasing the frequency of chloride channel opening
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Benzodiazepine: what are the short acting ones?
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"MOAT"
1. Midazolam 2. Oxazepam 3. Alprazolam 4. Triazolam |
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Benzodiazepine: which types of benzos have the highest addictave potential?
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The short acting ones
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Benzodiazepine: which are used for status epilepticus
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Lorazepam and diazepam
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Why are benzos preferred to barbituriates?
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Less respiratory depression
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How is benzo OD treated and how does this agent work?
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Flumazenil - competitive antagonist of GABA receptor
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What 3 drug classes bind the GABA receptor
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1. Benzo
2. Barb 3. EtOH |
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What type of receptor is GABA
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Ligand gated chloride channel
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