475 Drugs
Terms
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- Acetylsalicylic acid
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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
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Codeine derivative
As potent as morphine
Antitussive - Heroin
- - 2x as potent
- Hydromorphone
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- More potent than morpheine, codeine
- Analgesic & antitussive - Levorphanol
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- 4-5x as potent as morphine
- Less constipating
- Dextro isomer antitussive (not analgesic) - Meperidine
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- Less potent than morphine
- No miosis - Loperamide & dephenoxylate
- - GI
- Methadone
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- 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
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- Pure opioid antagonist
- Long acting - Naltrexone
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- Antagonist
- Reversal of adverse effects, diagnostic testing, treatment of withdrawal to prevent high - Nalorphine
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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
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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
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- Most popular volatile
- Mild analgesic - Enflurane
-
- Excitement at higher doses
- Seizure-like EEG activity (twitching)
- Malignant hyperthermia - Sevoflurane
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- Volatile
- CNS depression with seizure-like activity
- Nephrotoxicity, fluoride ions, compounds A to E - Desflurane
-
- Mild analgesic
- CO production
- Minimal metabolism & rapid excretion - Propofol
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- IV
- Sedation, maintenance of anaesthesia, anticonvulsant, apnea
- Less hangover
- Myocardial depressant - Thiopental sodium
- - IV barbiturate
- Methohexital
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- IV
- Ultra short-acting barbiturate, 3x as potent as thiopental - Etomidate
-
- IV
- Rapid induction, consciousness in 5-10 minutes
- Decreased adrenal steroidogenesis - Midazolam
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- 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
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- CV surgery
- High dose + muscle relaxant + O2 ventilation
- Stable BP, CO
- Post-op ventilatory support - Neuroleptanalgesia
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- 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