misc
What chemical substances/neurotransmitters
signal that a noxious stimulus has occurred
and should be perceived as pain? Where are
they located?
Substance P
>At receptor (sensitizer), inflammation,
vasodilation
>Dorsal horn (neurotransmitter)
Glutamate
>Dorsal horn (neurotransmitter)
A physiological state in which abrupt drug
cessation or the administration of an
antagonist will precipitate a withdrawal
(abstinence) syndrome.
What is Physical Dependence?
Esters in general are metabolized by
Plasma pseudocholinesterases
the difference in MOA between methylphenidate and amphetamine
CNs 2, 3, 4, 6, and V1 branch of CN 5
orbital apex
What chemical substances or
neurotransmitters can INHIBIT the
perception of noxious stimuli?(3)
Endogenous opioids
(Enkephalins/Endorphins)
Serotonin
Norepinephrine
A physiological phenomenon in which a
higher dose of a drug is required to produce
an effect, as a result of prior administration.
Shortening on efficacy interval.
What is Tolerance?
Amides metabolized by?
Microsomal P-450
The difference in MoA between Atomoxetine and
Clonidine and Guanfacine
Atomoxetine
Clonidine and Guanfacine
cavernous sinus
CNs 3, 4, 6, and V1 and V2 branches of CN 5
The four stages of anesthesia
analgesia, excitement, surgical anesthesia
and medullary depression
Psychological dependence and substance
abuse. A medical and psychosocial
phenomenon characterized by loss of
control over intake, preoccupation with
supply, continued use despite medical harm.
What is SUD?
Local Anesthetic Mechanism of action
Block voltage-dependent sodium channels thus preventing depolarization Work best when the axon is firing.
Non-ionized form crosses the lipid membrane. But the ionized form in the cytoplasm is the more effective blocking entity.
Stimulant SEs (5)
cerebellopontine angle
CNs 5, 7, 8 (+/− CN 9 and CN 10)
•There is a _____
correlation between MAC
and potency
inverse
MAC: the alveolar partial
pressure that abolishes a
movement response to surgical
incision in 50% of patients
Diazepam can be used to treat what two types of withdrawal?
BDZ and ETOH
Local Anesthetic system Toxicity timeline of events
PLASMA CONCENTRATION (µg/mL) | EFFECT
-----------------------------|------------------------------------
1–5 | Analgesia
5–10 | Lightheadedness, Tinnitus, Numbness of tongue
10–15 | Seizures, Unconsciousness
15–25 | Coma, Respiratory arrest
>25 | Cardiovascular depression
Clonidine and Guanfacine SEs (2)
Sedation, drowsiness
Hypotension, dizziness
Bradycardia
Dry mouth
Headache
Irritability or mood changes
CN 9, CN 10, and CN 11 (+/- 12, horner's)
jugular foramen
There is a _____ correlation between speed of induction and solubility
example of high v low?
inverse
NO = low solubility
halothane = high solubility
Speed of induction is dependent on :
•Solubility=B-G partition coefficient
(more soluble=slower),
•Alveolar Ventilation
•Concentration (%) of inhaled
anesthetic
•The more rapidly a drug equilibrates
with the blood, the more quickly the
drug passes into the brain to produce
anesthetic effects
All the inhaled and IV induction agents
(except _____ and _______) act at the _____ receptor
ketamine, opioids, GABAa
this fiber type is most susceptible to blockade
small myelinated fibers
Sympathomimetic toxicity sx and tx
Stimulant toxicity presents with restlessness, tachycardia, paranoia, psychosis
delusions, hyperthermia, hyperreflexia, seizures, necrotizing
arteritis, cerebral hemorrhage
Susceptibility to temperature extremes:
• Sympathomimetics like cocaine and amphetamines increase
endogenous heat production which increases risk of hyperthermia
during heat waves
Management is supportive, including benzodiazepines for agitation/seizures, IV fluids, cooling measures, and cardiac monitoring.
internal auditory canal
CN 7 and CN 8