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What is the difference between an analgesic and an anesthetic?
An analgesic is medication that relieves the sensation of pain, where as an anesthetic is a medication that removes all sensation.
Both effect the CNS.
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Briefly describe the nervous system and its different parts.
The nervous system is comprised of two main components, the CNS or central nervous system (brain & spinal cord) and the PNS the peripheral nervous system (all nervous tissue outside the CNS).
The PNS is two parts also, the autonomic and the somatic nervous systems. The autonomic controls automatic or involuntary functions and the somatic controls motor or voluntary functions.
The autonomic system is also two parts, the sympathetic (fight or flight)and the parasymathetic (feed & breed) nervous systems.
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What is the opiate prototype?
Morphine
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What is an opiate antagonist?
Naloxone
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What does an opiate agaonist/antagonist do?
Decreases pain (agonist effect) and has fewer respiratory depressant and addictive side effects (antagonist effect).
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What is nitrous oxide?
An inhaled an anesthetic.
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What is the function of a benzodiazepine?
To decrease anxiety, induce amnesia, control seizures and assist in sleeping.
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What is the antagonist for benzodiazepines?
Romazicon, flumazenil
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What are the three functional classes of CNS stimulants? What do they do?
Amphetamines (amphetamine sulfate) - Increase the excitatory neurotransmitters (norepi & dopamine), treat drowsiness, fatigue, & suppress appetite.
Methylphenidates (Ritalin) - Most common drug for ADHD, similar MOA as amphetamines.
Methylxanthines (caffeine) - Block adenosine receptors, relax bronchial smooth muscle, similar to amphetamines with a much lesser effect.
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What is Haldol?
A high potency antipsychotic that affects the nerves.
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What are extrapyramidal symptoms and how are they treated?
Common side effect of antipsychotic medications that may include tremors of the muscles and/or dystonic reations. Treated with diphenhydramine.
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What are tricyclic antidepressants (TCA's) and what do they do?
Used to treat depression by blocking the reuptake of norepi and serotonin. They have anticholinergic properties causing blurred vison, dry mouth, urinary retention, and tachycardia. They may increase the possiblity of seizures and have very severe cardiotoxic effects if taken in overdose.
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What do selective serotonin reuptake inhibitors (SSRI's) do?
Block the reuptake of serotonin with less severe side effects than TCA's.
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What do monoamine oxidase inhibitors (MAOI's) do and what is the prototype?
Block monoamine oxidase, but are insufficient in the treatment of depression. Phenelzine (Nardil) is the prototype.
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What is the autonomic ganglia?
A group of autonomic nerve cells located outside the CNS.
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What are preganglionic nerves?
Nerve fibers that extend from the CNS to the autonomic ganglia.
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What are post ganglionic nerves?
Nerve fibers that extend from the autonomic ganglia to the target tissues.
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What is a synapse?
The space between the nerve cells.
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What is a neuroeffector junction?
A specialized synapse between a nerve cell and the organ or tissue it inervates.
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What are neurotransmitters?
Chemical messengers that conduct a nervous impulse across a synapse.
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What is a neuron?
A nerve cell.
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What is cholinergic?
Pertaining to the neurotransmitter acetylcholine (ACh).
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What is adrenergic?
Pertaining to the neurotransmitter norepinephrine.
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Which system is considered "Thoraco-lumbar"?
Sympathetic
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Which system is considered "Cranio-sacral"?
Parasympathetic
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What is a sympathomimetic?
A drug or other substance that causes effects like those of the sympathetic nervous system, also called adrenergic.
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What is sympatholytic?
A drug or other substance that blocks the sympathetic nervous system, also called antiadrenergic.
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What is a parasympathomimetic?
A drug or substance that causes effects like the parasympathetic nervous system, also called cholinergic.
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What is parasympatholytic?
A drug or other substance that blocks or inhibits the actions of the parasympathetic nervous system, also called anticholinergic.
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How do the following adrenergic receptors react when stimulated?
Alpha 1
Alpha 2
Beta 1
Beta 2
Beta 3
Dopaminergic
- Alpha 1=vasoconstriction
- Alpha 2=decreases norepi, inhibits sympathetic response
- Beta 1=Heart (increases chronotrope, inotrope & dromotrope)
- Beta 2=lungs (bronchodilation), decrease in uterine contractions
- Beta 3=lipolysis
- Domaminergic=increased renal perfusion
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What are the class IA & IB sodium channel blocker prototypes?
Class IA is procainamide and IB is lidocaine
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What are the classes of antidysrhythmics?
- Class I=sodium channel blockers
- Class II=beta blockers
- Class III=potassium channel blockers
- Class IV=calcium channel blockers
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What drug is a classified as a misc. antidysrhythmic?
Adenosine (Adenocard)
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What kind of hypertensive drugs are there?
Diuretics (lasix), adrenergic inhibitors, angiotensin converting enzyme (ACE) inhibitors and direct vasodilators (nitro).
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What kind of hemostatic agents are there?
Antiplatelets (asprin)-limit aggreation, anticoagulants (heprin/warfarin)-disrupts clotting cascade, and fibrinolytics (streptokinase)-breaks down fibrin.
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What are the two main bronchodilators and their respective classes?
- Albuterol-sympathomimetic, beta 2 agonist.
- Atrovent-parasympatholytic, anticholinergic.
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What are the two antihistamine receptors?
- H1-bronchoconstriction & vasodilation
- H2-increase in gastric acid release
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What is an antitussive?
A medication that suppresses the stimulus to cough in the CNS.
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What is an expectorant?
A medication intended to increase the productivity of coughing.
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What does a mucolytic do?
Makes mucus more watery.
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What is peptic ulcer disease (PUD)?
An imbalance between factors in the GI system that increase acidity and those that protect against acidity.
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What is the prototype H2 blocker and what does it do?
Cimetidine. Blocks acid secretion and returns balance of the protective and aggressive factors.
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What is an antacid?
An alkalotic compound used to increase the pH in the gastric environment and are mostly aluminum, magnesium, calcium, or sodium compounds.
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What is a laxative?
A medication used to decrease the firmness of stool and increase the water content.
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What do antiemetics do?
Prevent vomiting or treat prophylacticly for motion sickness.
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What drug is used as a local anesthetic for the eyes?
Tetracaine
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What are the two hormones produced in the posterior pituitary gland?
oxytocin & vasopressin (ADH)
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Which endocrine gland is responsible for the regulation of blood Ca++ levels?
Parathyroid
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The adrenal cortex synthesizes glucocorticoids and mineralcorticoids. What do they do?
Glucocorticoids regulate the metabolism of glucose and mineralcorticoids regulate sodium and water balance.
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In the Islet of Langerhans, in the pancreas what are the alpha and beta cells responsible for?
Alpha cells secrete glucagon increasing blood glucose levels and beta cells secrete insulin decreasing blood glucose levels.
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What medication is used to treat absent seizures?
Ethosuximide
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What medication is used to treat partial seizures?
phenytoin
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