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Glossary of 475 Drugs

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Acetylsalicylic acid
Salicylate
Irreversibly inhibit COX1&2
Ibuprofen
Phenylpropionic acid derivative
Papaverine
Smooth muscle depressant, relaxatino of arterioles
Enkephalins
- striatum, nucleus accumbens
- natural transmitter for pain inhibition
beta-endorphin
- hypothalamus, pituitary, periaqueductal grey
- stress
Dynorphin
- Anterior hypothalamus, substantia nigra
Laudanum
Tincture
Paregoric
Anti-diarrheal galenical prep
Codeine
Morphine prodrug
Relatively weak
Antitussive (codeine itself)

Hydrocodone
Codeine derivative
As potent as morphine
Antitussive

Heroin
- 2x as potent
Hydromorphone
- More potent than morpheine, codeine
- Analgesic & antitussive
Levorphanol
- 4-5x as potent as morphine
- Less constipating
- Dextro isomer antitussive (not analgesic)

Meperidine
- Less potent than morphine
- No miosis
Loperamide & dephenoxylate
- GI
Methadone
- Same potency as morphine, longer duration of action
- Little sedation, less withdrawal
Oxycodone
- Often combined with NSAIDs
Propoxyphene
Less potent
Tramadol
- Racemic mixture
Fentanyl, sufentanil, alfentanil, remifentail
- Meperidine-like
- Strong analgesics
- Immediate & short-lived action -- neuroleptanalgesia

Naloxone
- Pure opioid antagonist
- Long acting
Naltrexone
- Antagonist
- Reversal of adverse effects, diagnostic testing, treatment of withdrawal to prevent high
Nalorphine
Antagonist at mu, weak agonist at kappa -- analgesic & sedative (weak)
- Much lower efficacy
Pentazocine, cyclazocine, nalbuphine
- Morphine antagonist effects with middling analgesia; less mental disturbance than nalorphine
Buprenorphine
Partial mu agonist
Lower Rmax
Maintenance of heroin addicts
Rat painkiller


u1 & u1
- beta-endorphin
k1, k2, k3
- Dynoprhin
- 1: pentazocine; 2,3: nalorphine
- Hypothermia, miosis, sedation, analgesia, dysphoria, hallucinations

delta 1,2
- metenkephalin
delta1,2
- Metenkehalin
- Etorphine
- Analgesia, smc inhibition

u1, u2
- Euphoria, prolactin release, miosis, decreased intestinal motility, respiratory depression
Nitrous oxide
- Gas
- Weak; better sedative & analgesic
Ether
- Volatile
- Maintains good respiration
- Catecholamines
- Explosive


Halothane
- Volatile
- Potent; limited analgesia
- Short, rapid breaths, BP drop, increased bleeding in obstetrics, NMJ blocker
- Low mortality
- Post-op hepatitis



Methoxyflurane
- Volatile
- Slow inductance, emergence
- Nephrotoxic
- Not used too often
- Analgesic



Isoflurane
- Most popular volatile
- Mild analgesic
Enflurane
- Excitement at higher doses
- Seizure-like EEG activity (twitching)
- Malignant hyperthermia

Sevoflurane
- Volatile
- CNS depression with seizure-like activity
- Nephrotoxicity, fluoride ions, compounds A to E

Desflurane
- Mild analgesic
- CO production
- Minimal metabolism & rapid excretion

Propofol
- IV
- Sedation, maintenance of anaesthesia, anticonvulsant, apnea
- Less hangover
- Myocardial depressant


Thiopental sodium
- IV barbiturate
Methohexital
- IV
- Ultra short-acting barbiturate, 3x as potent as thiopental
Etomidate
- IV
- Rapid induction, consciousness in 5-10 minutes
- Decreased adrenal steroidogenesis

Midazolam
- IV benzodiazepine
- Sedation, anesthetic adjunct
- 7-15 minutes, longer w/ fentanyl

Ketamine
- IV
- Sedation, analgesia, amnesia
- NMDA blocker (cation channels, glutamate)
- Dissociative anesthesia -- catalepsy
- Separation of normal communication between sensory cortex & association areas
- Eyes open, nystagmus
- Stimulates CV system -- hypovoluemic patients
- Stimulates secretions, hallucinations






Fentanyl
- CV surgery
- High dose + muscle relaxant + O2 ventilation
- Stable BP, CO
- Post-op ventilatory support


Neuroleptanalgesia
- Drug-induced depression of activity, lack of initiative, reduced response to stimuli, analgesia
- Able to respond to simple commands
- Fentanyl + midazola (short-acting benzo)
- Add thiopental for unconsciousness


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