Flashcards
Week 10 Gastrointestinal pharmacology and local and general anaethesia
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- 1HCL secretionsecreted by parietal cells in the stomach
- 2Drugs which reduce acidantacids
H2 receptor antagonists
Proton pump inhibitors - 3Antacidsalkali to neutralise effect of acid
good for short term management of minor symptoms
not useful for ulcer healing - 4Antacids adverse effectsconstipation, diarrhoea
- 5H2 receptor antagonists mechanism of actionBlock H2 receptor, 90% reduction in HCL secretion, e.g. ranitidine
- 6H2 receptor antagonist adverse effectsvery few, and well tolerated
- 7Proton pump inhibitors mechanism of actionblocks acid secretion via proton pump e.g. omeprazole, pantoprazole
- 8Proton pump inhibitor adverse effectsinhibit P450, drug interactions,
long term: increase risk of pneumonia and osteoporosis, B12 malabsorption - 9HCL secretion stimulated byGastrin, histamine, acetylcholine
- 10Gastrin mechanism of actionacts on receptors to cause release of histamine and parietal cell influx of Ca to increase HCL
- 11Ach mechanism of actionacts on muscarinic receptors and parietal cells to increase HCL secretion
- 12Histamine mechanism of actionacts on H2 receptors on parietal cells to increase HCL secretion
- 13Vomiting nausea CTZChemoreceptor trigger zone, vomiting centre, outside blood-brain barrier
- 14Drugs used to treat vomiting and nausea: D2 receptor antagonist (dopamine) Mechanism of action:acts in CTZ to prevent vomiting reflex, peripherally increase gut motility
e.g. metoclopramide - 15D2 receptor antagonist adverse effectsblocks CNS receptors, fatigue, motor restlessness
- 16Drugs used to treat nausea and vomiting: Histamine (H1) antagonists mechanism of action:blocks H1 receptors in vomiting centre
e.g. promethazine - 17H1 receptor antagonist adverse effectsBlocks CNS receptors, fatigue, dry mouth, constipation
- 18Drugs used to treat vomiting and nausea: 5HT3 antagonists Mechanism of action:particularly effective for prevention and treatment of post-operative and chemotherapy induced vomiting.
e.g. ondansetron, tropisetron - 195HT3 antagonists adverse effectsconstipation, diarrhea, headache
- 20Drugs that target the GITGastric secretion: HCL and pepsinogen secretion
Vomiting (nausea): in response to ingestion of toxic substances, unwanted side effects - 21Local anaesthesiareversible loss of sensation in a localised area
- 22General anesthesialoss of sensation and loss and consciousness
- 23Local anaesthesia desirable properties:sufficient duration of action
low systemic toxicity at effective concentrations
quick onset
reversible - 24LA mechanism of action:blocks NA channels, halts nerve action potentials, small fibres first, large fibres last. reverse order for recovery.
- 252 types of LA propertiesester: cocaine, procaine, short duration of action
Amide: lignocaine, bupivacaine, long duration of action
ester= reactive metabolite= allergy and hypersensitivity - 26Administration of LA routestopical, infiltration, nerve block, spinal, epidural, different onset and duration of action
- 27LA duration of actionincrease with vasoconstrictor (e.g. adrenaline), increase due to contact with nerve, decrease rate of absorption
- 28LA adverse effectscardiovascular, hypersensitivity, CNS (seizures/coma), treat acute toxicity by giving respiratory assistance, drugs to control seizures (diazepam)
drugs to control hypotension (adrenaline) - 29General anaesthetics desirable properties:analgesia
amnesia
loss of consciousness
inhibition of sensory and autonomic reflexes - 30GA desirable propertiesuse combination of drugs to achieve balanced anaesthesia
- 314 stages of anaesthesia1. analgesia= conscious but not drowsy, without amnesia
2. delirium= amnesic, irregular respiration
3. surgical anaesthesia = re-establishment of regular breathing
4. medullary paralysis = severe depression of medulla, require circulatory and respiratory support - 32GA mechanism of actionnerve block, increase inhibitory and excitatory neurotransmitters
- 33Inhalational GA agents mechanism of actionPK uptake and distribution from lungs to blood to CNS:
depends on solubility, conc in inspired air, ventilation rate, and pulmonary blood flow - 34Types of inhalational agents GAGaseous: nitrous oxide
volatile liquid: halothane, enflurane, isoflurane - 35GA: inhalation agents: solubility indicatorslipid solubility: determines potency
aqueous solubility: determines rate of induction and recovery - 36Inhalation agentsprovide controlled anaesthesia
- 37Nitrous oxide advantages/disadvantagesadvantages: non-flammable, rapid induction, no muscle relaxant activity
disadvantages: low potency, no surgical anaesthesia, can cause decrease in RBC - 38Halothane advantages and disadvantagesmoderately potent
disadvantages: little analgesia and muscle relaxation, resp depression, hypotension, hypoxemia - 39Enflurane advantages and disadvantagesfast induction and recovery
Disadvantages: may cause seizures, potential renal toxicity - 40Intravenous (IV) agents GA:induce anaesthesia, hypnosis, analgesia, muscle relaxation, control of autonomic reflexes
- 41IV agents GA: advantages/disadvantagesadvantages: rapid onset, short duration, no resp irritation
Disadvantages: inability controlling depth, severe resp and cardiovascular depression - 42Other agents GA used in combination muscarinic receptor antagonist: mechanism of action:limit bronchial and salivary secretion
e.g. atropine - 43Other agents: neuromuscular blockers mechanism of actionprevent reflex movement and paralysis of skeletal muscles
e.g.suxamethonium - 44Other agents: anxiolytics mechanism of actiondecrease anxiety
e.g. diazepam - 45Other agents: opioids mechanism of actionanalgesia, sedation
e.g. morphine - 46Other agents antipsychotics mechanism of actiondecrease vomiting, cause sedation
e.g. droperidol - 47GA overall goalbalanced anaesthesia
induction (IV)
maintenance (inhalation)
muscle relaxation
analgesia
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- User has deleted their subject information Flashcards on Week 10 Gastrointestinal pharmacology and local and general anaethesia, created by Deleted user on 16/10/2017.
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- Deleted user · Oct 2017
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- Oct 16, 2017
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- Created by Elizabeth Then · Oct 15, 2017
- Copied by Elizabeth Then · Oct 16, 2017
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