Pharm 1 - Anesthesia-Analgesia

drraythe's version from 2015-06-13 12:16


Question Answer
What GABA receptor do we care about for anes/analg? Mechanism of this receptor?GABA-A. Ligand-gated-ion-channel
What Glutamate receptor do we care about for anes/analg? Mechanism of this receptor?NMDA. Ligand-gated-ion-channel
What dopamine receptor do we care about for anes/analg? Mechanism of this receptor?D2. G-protein coupled receptor
What adrenergic receptor do we care about for anes/analg? Mechanism of this receptor?Alpha-2. G-protein coupled receptor
What action do we want to do on GABA-A?Agonize
What action do we want to do on NMDA?Antagonize (MDMA makes you hyper, you want to be unconscious)
What action do we want to do on D2?Antagonize (antagonize r2D2 he's too hyper)
What action do we want to do on alpha-2?Agonize
NT involved/type for GABA-A?GABA (inhibitory)
NT involved/type for NMDA?GLUTAMATE & to lesser extent, glycine (Glut=excitatory) (gly need for channel to work) (sugar hops you up like MDMA)
NT involved/type for D2?Dopamine (modulatory)
NT involved/type for Alpha-2?Norepi (modulatory) (minimally use epi, also)
Subunits of GABA-A? NMDA? D2? Alpha-2?5, 7, --, --
Is GABA-A pre or post synaptic?Post
Is NMDA pre or post synaptic?Post
Is D2 pre or post synaptic?Post
Alpha-2 pre or post synaptic?Pre
DRUGS for GABA-A? (4)Propafol, Diazepam, Midiazolam, Isoflurane (Gabbing away until you took too much Propafol & DIAZED like MJ, ISO sorry for your loss)
DRUGS for NMDA?Ketamine, Tiletamine, D-methadone (That D took Ketamine & woke up on the tiles)
DRUGS for D2?(Phenothiazines) Acepromazine, Promazine, Chlorpromazine (what a dope pro)
DRUGS for Alpha-2?Zylazine, Detomidine, Medetomidine, Romifidine, Dexmedetomidine (2 z's the rest are mi's)
For anesthesia, potency correlates with?Lipid solubility
If anesthesia interacts with the lipid bilayer, it interacts with ___, esp. ___Ion channels, K+ channel
What does anesthesia do to GABA?Enhances it - GABA is inhibitory (so you sleep)
4 pillars of anesthesia?Mental, Motor, Sense, Stability
Excitatory NTs?Glutamate, Aspartate (excitable on sugar)
Inhibitory NTs?GABA, Glycine (too much gabbing about soap will inhibit me from talking to you)
Modulatory NTs? (5)Dopamine, ACh, 5-hydroxytryptamine, Norepi, Histamine
Pre-synaptic molecular targets for anesthesia?**K-CHANNELS! (pre-K), voltage-gated Ca++, " " Na+, synaptic vesicle proteins
Post-synaptic molecular targets for anesthesia?*NMDA receptors *AMPA receptors, EAAT
What are the 3 glutamate receptors? # Subunits?**NMDA (7)
AMPA (4)
Kainate (5)
What does the glutamate ion channel do under regular circumstances?Glycine & Glutamate bind & it allows Ca++ to go into cell for excitation
What are the dissociative anesthetics? What receptor do they work on?Ketamine, Tiletamine. Work on NMDA receptor (taking all the drugs- MDMA+ketamine)
What are the opioids? What receptor do they work on?D-methadone. Work on NMDA receptor. (Take all of the drugs-- MDMA & meth!)
What do ketamine, Tiletamine & D-Methadone do? (Act where to prevent what? )Antagonize glutamate receptors (NMDA) post-synaptically to prevent Ca++ influx
What does GABA stand for? What is it?Gamma-Amino-Butyric-Acid. An inhibitory NT
The ion the GABA receptor is permeable to? Which does what?Cl- (Cl- hyperpolarizes, so it reduces excitability)
What are the two categories of drugs which act on GABA subunits? Which Subunit do they act on? Example of drug?Volatile anesthetics (Beta subunit, Isoflurane) (why IS you B so VOLATILE?), Injectable anesthetics (Alpha subunit, Propafol)
Three clinical categories for drugs acting on GABA receptors?Anesthesia-IV agents. Anticonvulsants. Neurosteroids. (GABA-AAN!!)
IV anesthesia agents for GABA receptor? (3 Categories + their drugs)(1) Propafol (induction)
(2) Benzodiazepines - Diazepam, Midazolam (sedation, induction) (Diazepines make Mi Di)
(3) Barbiturates - Thiopental, Phenobarbital (sedation, induction) (Barb & Theo are tall)
Anticonvulsants that work on GABA?Benzodiazepines, Barbiturates (ben & barb hate seizures)
Neurosteroids which work on GABA?Alphaxolone (al uses steroids alone-its a fact)
D receptors & their corresponding g-proteinsD1-Gs, D2-Gi, D3-Gi, D4-Gi, D5-Gs (D1 & 5 are S, the rest are I)
Functional aspects of dopamine in regards to anesthesia? (3 Overall effects & the system they belong to)(1) Motor block- nigrostriatal system
(2) Mental/behavioral block - mesolimbic/mesocortical system
(3) Endocrine control - tuberohypophyseal system
What is dopamine metabolized by? Where are they? Products?MAO (in blood/brain, what causes blood infusion to be short lived) (I will drain your blood MAO!), COMT (brain/tissues) → products are DOPAC & HVA
Clinical apps of Dopamine? (5)Anesthesia, Parkinson’s dz, Inhibit prolactin/stim GH release, Cause vomiting, Treat Schizophrenia
6 things adrenergic/adenoreceptors contain/require?NOREPI/EPI, VMAT (vesicular monoamine xporter), NET (norepi xporter), SNAPs (synaptosome-associated-proteins), VAMPs (vesicle associated membrane proteins), presynaptic receptors
3 clinical applications of adrenoreceptors?(1) Anesthesiology (2) Premedication/sedation (3) Analgesia (adreno-line, does opposite what youd think, classical anesthetic shit) (adreno?? GO AAP)
What antagonizes benzodiazepines?Flumazenil (Ben has the flu - he's down & out)