med chem III test III anticonvulsants stuff

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med chem III test III anticonvulsants stuff
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2013-04-08 17:25:29
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med chem III test III anticonvulsants stuff
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  1. 3 physiological mechanisms of drugs to treat seizures
    • 1. promote the inactivated state of voltage-activated Na channels
    • 2. Enhance GABA
    • 3. absence - limit activation of T-current, voltage sensitive Ca channel
  2. 5 off label uses of anti-convulsants
    • migraines
    • mood disorders
    • schizo
    • neuropathic pain
    • neuromuscular disorders
  3. most common seizure type and 4 causes
    • partial
    •    cortex lesion
    •    tumor
    •    developmental malformation
    •    damage (stroke or trauma)
    •   
  4. second most prevalent seizure and 2 causes
    • generalized
    •    inheritance
    •    multiple mutant genes
  5. pregnancy and anti-seizure meds
    • 5% increase in stillbirth, mortality and birth defects
    • metabolic epoxides and low epoxide hydrase activity
  6. 4 drugs for partial seizures
    • carbamazepine
    • clonazepam
    • phenytoin
    • valproic acid (adjunct)
  7. 2 drugs for absence seizures
    • clonazepam
    • valproic acid
  8. 3 drugs for grand mal seizures
    • carbamazepine
    • diazepam
    • phenytoin
  9. 2 drugs for status epilepticus
    • diazepam
    • phenytoin
  10. 4 stages of anesthesia
    • 1. analgesia
    • 2. delirium, excitation
    • 3. surgical planes - muscle relaxation and respiratory depression
    • 4. medullary paralysis, irreversible resp. depression and death
  11. relief of preoperative anxiety, smooths induction through stage II to stage III and decreases airway resistance to the general agent
    sedative-hypnotics
  12. activity to dry up respiratory and salivary secretions
    anticholinergics
  13. provides sedation but additional protection against allergic reaction
    antihistamines
  14. relieve pre-op pain and provide complete anesthetic activity, smooths induction process
    narcotic analgesics
  15. 2 MOA of GA's
    • produce a certain partial pressure of the gas in brain tissue
    • decrease neuronal activity by increasing the electrical threshol needed to induce an action potential
  16. ? affected in stage I
    sensory pathways
  17. ? affected in stage II
    inhibitory neurons
  18. ? affected in stage III
    depression of the reticular activation system neurons
  19. ? affected in stage IV
    CV and respiratory control neurons
  20. miller-pauling theory
    increased potency associated with the ability to induce ordered, crystal-like structure to water in neuron membranes
  21. potency action of GA's
    the ability of the agent to reduce surface tension - alter GABAA channels
  22. what can be added to LA's to prolong tissue localization
    epinephrine
  23. all LA's have a high potential to cause ? and do what to combat
    • allergic reactions
    • co-administer an antihistamine (diphenhydramie or NO)
  24. moa of LA's
    prevents generation and conduction of action potentials  and conduction by inhibiting ion fluxes, increasing the electrical excitation threshold. slow impulse generation and rise of the action potential
  25. metab of ester's
    degraded by esterases in the blood and tissue (1st pass effect)
  26. metab of amide's
    hepatically inactivated, finally the metabs are excreted renally
  27. metab of muscle relaxants
    • aproximately 50% excreted in the urine unchanged
    • remainder demethylated hepatically
    •    followed by renal and biliary excretion
  28.  states that will prolong the duration of action of muscle relaxants
    poor renal perfusion - shock or hypotension
  29. MOA of cholinergic muscle stimulants
    facilitate the transmission of impulses across the myoneural junction by inhibiting the destruction of acetylcholine by cholinesterase
  30. pts to caution with cholinergic muscle stimulants
    • bronchial asthma
    • epilepsy
    • peptic ulcer
    • hyperthyroidism
    • cardiac arrhythmias
    • recent coronary occlusions

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