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35 Cards in this Set
- Front
- Back
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The most commonly used parenteral anesthetic in the US
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Propofol
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This anesthetic works via enhancing GABAergic neurotransmission within the CNS
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Propofol
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Metabolism of propofol proceeds rapidly via ______ ________ to its glucuronide and sulfate conjugates
*phase II metabolism... |
hepatic conversion
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This general anesthetic acts similarly to PCP
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ketamine
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This general anesthetic acts as an antagonist within the cationic channel of the NMDA receptor
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ketamine
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Ketamine can only be used alone in procedures of short duration that do not require muscle relaxation because...
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ketamine does not relax skeletal muscles
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This may accompany recovery from anesthesia and is characterized by visual, auditory and confusional illusions
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emergence dilerium
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Disturbing dreams and hallucinations can occur up to 24 hours after the administration of this general anesthetic
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ketamine
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Does ketamine have a potential for abuse?
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Yes, like PCP is can be abused
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This general anesthetic can be administered by IV injection or rectally
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Etomidate
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This general anesthetic is the ester of a carboxylated imidazole solubilized in 35% propylene glycol
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etomidate
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This general anesthetic is a potent, short acting (<3 min) hypnotic agent without analgesic activity and with a rapid onset of action
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etomidate
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Barbiturates are ______ _______ and have serious therapeutic shortcomings
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sedative-hypnotics
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Ultrashort-acting barbiturate used by IV to produce rapid unconsciousness, usually combined with general anesthesia after
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Thiopental
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These are often referred to as sleeping pills, sedative medications, and soporifics used to treat insomnia
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hypnotics
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This class of drugs causes drowsiness and facilitates the initiation and maintenance of sleep
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sedative-hypnotics
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Small doses cause _______ while larger doses cause _______, and largest doses can be used for surgical anesthesia
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sedation, hypnosis
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Do all anxiolytic drugs cause sedation?
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NO
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Two classifications of sedative-hypnotics
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GABAa receptor agonists and Melatonin receptor agonists
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benzos, imidazopyridines, cyclopyrrolones, pyrazolopyrimidines and barbiturates are all what class of sedative-hypnotics?
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GABAa receptor agonists
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These are used as daytime anxiolytics, sleep inducers, anesthetics, anticonvulsants and muscle relaxants
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benzos
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This newer type of benzo posses a shorter elimination half life, which clinically improves sleep while reducing daytime sedation
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triazolobenzodiazepines
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Is acute tolerance developed to the benzodiazepine that will diminish CNS effects before the drug is eliminated from the CNS?
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variable determining how well the benzo will work as a hypnotic
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Is redistribution of the benzodiazepine from the CNS to other tissues very rapid?
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variable determining how well the benzo will work as a hypnotic
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Is there a rapid drug elimination by biotransformation and the metabolite active?
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variable determining how well the benzo will work as a hypnotic
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Three medications belonging to the class of nonbenzodiazepines are known as the Z drugs and are safer than benzos...
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1. zolpidem (ambien)
2. zopiclone (lunesta) 3. zaleplon (sonata) |
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zolpidem is an
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imidazopyridine
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zopiclone is a
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cyclopyrrolone
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zaleplon is a
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pyrazolopyrimidine
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Molecular modifications to melatonin resulted in this potent and selective melatonin receptor agonist
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ramelteon (Rozerem)
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Does rozerem posses abuse liability? Is it a controlled substance?
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NO
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What receptor does Rozeren primarily bind with? Does it bind with other sleep receptors?
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melatonin M1 receptor, no it doesn't bind with other receptors like GABA1, dopamine or opiate receptors
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The melatonin molecule was reengineered by substituting the nitrogen of the indole ring with a carbon to give an indane ring bio-isostere of melatonin... this gives this drug
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ramelteon (rozerem)
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This older class of drugs are used as sedative-hypnotics but toxicity limits their widespread use
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barbiturates
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These sedative-hypnotics can cause significant CNS depression, physical dependence, many DDIs and tolerance
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barbiturates
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