GABA & Sedatives
A patient treated for muscle spasticity develops hypotension, sedation, and respiratory depression after dose escalation. The drug acts on a metabotropic receptor that increases K⁺ efflux.
What is baclofen?
During surgery, an anesthetic with low blood-gas solubility reaches the brain rapidly, causing quick induction and recovery.
What is a low blood–gas partition coefficient?
A child has staring spells with 3-Hz spike-and-wave discharges on EEG and is treated with a drug that blocks T-type calcium channels.
What is ethosuximide?
A chemotherapy patient receives a drug that blocks a ligand-gated serotonin receptor in the area postrema to stop vomiting.
What is ondansetron?
A patient with hyperprolactinemia is treated with a drug that stimulates inhibitory dopamine receptors.
What is bromocriptine?
A hospitalized patient being treated for alcohol withdrawal is given a drug that increases the frequency of chloride channel opening and prevents seizures.
What are benzodiazepines?
A patient undergoing intubation experiences dissociative anesthesia with strong analgesia, increased heart rate, and bronchodilation.
What is ketamine?
A patient treated for focal seizures develops gingival hyperplasia, nystagmus, and folate deficiency.
What is phenytoin?
A migraine patient with chest tightness and dizziness is given a drug that constricts cerebral vessels via 5-HT1B/1D activation.
What are triptans (sumatriptan)?
A Parkinson patient takes a drug that prevents peripheral conversion of levodopa to dopamine, increasing CNS availability.
What is carbidopa?
A patient on long-term seizure therapy develops drug interactions due to CYP450 induction and experiences worsened CNS depression when drinking alcohol.
What is phenobarbital?
A cardiac patient receives an IV anesthetic that causes minimal blood pressure change but later shows suppressed cortisol synthesis.
What is etomidate?
A migraine patient on seizure medication loses weight and develops kidney stones due to carbonic anhydrase inhibition.
What is topiramate?
A patient taking SSRIs and MAOIs develops diarrhea, hyperreflexia, clonus, fever, and agitation.
What is serotonin syndrome?
A drug that blocks COMT and crosses the BBB is added to reduce dopamine breakdown in the brain.
What is tolcapone?
A patient with insomnia is prescribed a hypnotic that improves sleep but does not provide muscle relaxation or seizure protection.
What are Z-drugs (zolpidem, zaleplon, eszopiclone)?
A patient with liver failure requires a dental nerve block. The anesthetic used is hydrolyzed by plasma esterases rather than the liver.
What are ester local anesthetics?
A patient with minimal drug interactions is placed on a seizure drug that binds synaptic vesicle protein to reduce neurotransmitter release.
What is levetiracetam?
A depressed patient develops hypertension and tachycardia due to increased synaptic norepinephrine and serotonin.
What are SNRIs?
A schizophrenic patient with reduced extrapyramidal symptoms is treated with a partial dopamine receptor agonist.
What is aripiprazole?
A patient presents with agitation and seizures after abrupt discontinuation of a sedative used for anxiety. The drug normally increases GABA-A chloride channel opening frequency.
What are benzodiazepines?
A patient under halogenated anesthesia develops hypercarbia, muscle rigidity, and rising temperature after surgery.
What is malignant hyperthermia?
A patient in the ER has continuous tonic-clonic seizures without regaining consciousness. The first medication given acutely is:
What is lorazepam or diazepam?
A patient eating aged cheese while on antidepressants develops occipital headache, tachycardia, and severe hypertension.
What is MAO-A inhibition causing tyramine toxicity?
A patient with tremor, rigidity, and bradykinesia has loss of dopamine in the substantia nigra affecting this pathway.
What is the nigrostriatal pathway?