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C

C
a

a
rm

rm
ha

ha

ha
OWnd
lP

lP

lP
el

el
Phara
Pharma
ew

ew
not
ar

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C

tor C
(AHAel

TUst
Tust
TUS
a

a
rm

rm
ha

ha

ha
Is holb
lP

lP

lP
el

el
ew

ew

Note -If You have any Doubts

ar

ar

in any thing in pdf

C

Just Ask us in comment of any video,

Or confirm it from google

This Notes is Provided by Chandan MOCP

a

a
rm

rm

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Anit-1V

C
harmacolbgyo dugs acting n centa
Nevous Mtem
a

a
rm

rm
a
Suli
ha

ha

ha
Neurohumoval ransmission in the CNS
lP

lP

lP
proce 35 Occuy in velotion to
to nerve
Four
el

el
ew

ew
transmision wirlin the CNS
ar

ar
process ediated rough affarent
C

C
rons mitters. hese are as o1laws

Nonot ronomission OGCuYS throuanineusotansmitters,

phic oYe seledsedin toSyoptie eleft:t

a

a
rm

rm

Topidy stunulate or)"inhibit he post simoptic

ha

ha

ha
Meurons s
lP

lP

lP
DJleuso- modulatioy neuromodulators,
el

el

OCcuis through
ew

ew

by
TOhish ara ture leased by reuions and
ar

ar

CstrocutesOndact crlher torsloud Co) Cnhance

C

pTe OT) post synaptic TEsporsasS

3

/Naromeiatin OCCuYS through neuomediotos, which

a

a
rm

rm

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messenges cAMP cGnMP
are Sicond

C
T
iy Neuroheric affecs occurthrouho nerotrepie orbrs

which Secteted astvoctes

by ncurcnS
a

a
rm

rm
onger ime to
MiCIOglia ondactactovNCr
ha

ha

ha
requlate he qrowth ond morpelogy otmeurots
lP

lP

lP
-AVomeof{he major neuotransmittaxs ro
el

el
ew

ew
GABA
ar

ar
GABA (Cqammo -Amindbutyric acid) is a major
C

C
-

inhbitory neuTotronsmitter in mamma lion CAS:07

-9ti presentt fairly wriHormly

n he bin
Neiyittlegvamount asists inns, thepcriphery
a

J
rm

rm

from
GaA
GABABA Synthesized glurtamate by
het
ha

ha

ha
L-glutomic acid- decaybozylase
action of Cnzume
lP

lP

lP
(CnAD)
el

el
ew

ew

by taniaminas
- 31 1 turthe metabolised aA BA
ar

ar

5% CnA8A-T) t Succinic semi-aldehydei and

C

Succinic acid
a

a
rm

rm

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uhesis ABA g o

C
t lutomine
lutominase

.
ylutomate e
7
a

a
rm

rm
Slutomale
decatboxylase
ha

ha

ha
GABA
lP

lP

lP
el

el
Medanlo CaABA
ew

ew
CaABA
ar

ar
GABA-T eal
C

C
Succinict
Semialdehyde
Succinie Senialdehyee
i
a

dehydiogelase p31
rm

rm

Succinate
ha

ha

ha
Siisq)
ST Teceptoss
of GABA
lP

lP

lP
Uerc are 2 types
el

el
ew

ew

i GABAg
ar

ar
C

CoaBAA eceptoss
nS
-hese ionotvopic Jeceptois
are
and are
hey CaTC Socated pst-ynapttally
a

a
rm

rm

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mke ith chloide ion channeorennghel

C
the
Tedueton he
in
huperpolosisaton din
Causes

membrane excitabihhy

-he Teceptoyin he
a

a
major sofom otGaA8A
rm

rm
brain Consists o sub units namely "2a
ha

ha

ha
units
lP

lP

lP
two Sub,
el

el
i seABAs ece ptoS inc
ew

ew
-4t is a protein Ccupled veceptor
ar

ar
-43
C

C
activatio decreasesfoymation of cAMP
yese TCceptos Cause pre
ost- sunapte

inhibition.by inhibring calcium channel opening

t
a

and iieasngK Conductance

rm

rm

-Ahe antaqonist tos

ha

ha

ha
Competitive CaABAg Teceptor
lP

lP

lP
s Sacloten, which has
clinicaluse
1
el

el

lutamate
ew

ew

y
synthe siaed
-In brain glutamate is the
ar

ar

in
C

neTve temmalsrom 2 SouiceS

Cycle
) rem qlucose via Krebs Cycle and tran sanin-

ation of 01aglutararte
a

a
rm

rm

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qlulomineohich iakesaed in ghial
qhial

C
cells

hutamate isstored in Sunaptic vesicles

Teleased calcium dependent Caocytosi .

a

a
rm

rm
action Glutomate
Tolcase
After onMd
ha

ha

ha
Tacapturedby neurona GaLo- transporieis (Th)
lP

lP

lP
ond type transport
neunon
bial
el

el
tothe
ew

ew
C15 (OT)into6 he qlial cellss
ar

ar
qlutamote hen covested te qlutamin
Aial
C

C
enzyme qlulanine Synthetase
Athe
Lates qlutomine enters he adjaccntneuron

alter hdrolygsiy
a

eplenish he qlutomivne
rm

rm

mitochondrial qlutamase
ha

ha

ha
upes of qlulamate réceptors
lP

lP

lP
five different
el

el

been identked
kve
ew

ew

dre (NMDA,AMPA f

.
OUt of these ive types, 3
ar

ar

Taceptors
C

Kanate) ase ionotropic

meta botropic receptors

other two

Teceptors is being
Role of metabotropic
a

a
rm

rm

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umfalded reseamch
b
s

C
NMDA Yaceptois "
- NMDA Tefe to N-melhy asportote

-Ihe
a

a
are onqe
Yeceptors invoved in a de
rm

rm
of dive1se tunctions
ke
ike memory OCquisiton,
ha

ha

ha
h
lP

lP

lP
develment fynapthcPlarticity9RIf
el

el
neuronalCeitotoxicity due tcevebral ischaemia
ew

ew
-t has atleast. binding modulato sites
site
ar

ar
C

C
AMPA kaiateoceptors
AmpA Nto
-
1etersto -0mino 3-hydroxuTmethylisoan.oe-

Popionie, acid
a

- Both
rm

rm

AMPA and kainate Teceptors mediate

ha

ha

ha
fast Cicitatoru4 sunaptic tronsmision associated
lP

lP

lP
with .intux ofodium ons through 3odium
el

el
ew

ew

channels
ar

ar

-AMPA ieceptors Consisting ot GLDR

1-4 Sub unr
C

- kaiate eceplors Conslst ot CnLDRs-1 F KHL

Sub unrb: ti
a

a
rm

rm

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cine
C

C
neuo-tonomtter Cnichedin
L4 s an inhibjtory

CO1d
medulla, spinal heJouwer braim stem f
a

a
rm

rm
Huactonally siilar to
44 sucturalyp
ha

ha

ha
to chioid
dinectly iked
lP

lP

lP
CrABA Teceptor and
el

el
jon chamc
ew

ew
Aunthesis
ar

ar
C

C
utamic acid
Hutamie acid

sbn decaybosyase (aAo)

t
yav
ii +onirohtyic aid (on6A) cot
a

a
rm

rm

iA H
ha

ha

ha
4ycine
lP

lP

lP
,E
el

el

Release ciok tosis Ca

k ho}
slef
ew

ew

erotonin(5-hydtoxytytoineSH) sa
ar

ar

inCNS ,
C

a neutotronsmitter as
4t is

TCqu lotor ot Smooth Muscle tunctan o in

Ond GIT onaaisvequlotor of platalet

a

a
rm

rm

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ar
tunc ton

C
Aunthesis , ufiti.
Sryplophad
a

a
tryrtophanydhonylase
rm

rm
Syehoxy nptophun. .
ha

ha

ha
lP

lP

lP
decarbo xulase i
el

el
5- hydro typtorine (sesotorin)
ew

ew
i 1ts
ar

ar
HT s stored in specia ised celb 7ke
C

C
cntesochomaf tin cells ncuyors as Co-transmtter

toqetheruk"oith, Various eptide homones ke

like

Somatostatin Vasoactivei intestinal peptide (vIP).

a

a
rm

rm

of S-HT through
- Daqra dation oCCuIS Throuqh oxidative
ha

ha

ha
deamination by MAO to s kydioxy indole
lP

lP

lP
acetaldehyda plowed
soidation to s-hydroxu
el

el
ew

ew

acette
indole bcid, ohick"|i3 CIeted
iv 'urine
ar

ar

Rhomacoloqialactos io
C

CNS
- Teqvlationotofmood, ehavipu, sleep
-thesmoregulation
a

a
rm

rm

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C

C
Conttac tan of vasculay moothmuscle
, CIcept in

hear?
skeletol SAMule
a

a
rm

rm
shimalates Pei talsi5,ih
ha

ha

ha
acid Pepsin tg:
lP

lP

lP
opamine 04
el

el
ew

ew
mast importont of the bioqenic
the :1.'
ar

ar
CNS
neurotransmitters h
C

C
disease ii characterised by a masked
arkinisos

Teduction the Concentra tion ot DA in basal

okile in schizophyenia theie is dopaminer

a

qongia
rm

rm

overactivit inthe pathuway of brain ohidh

ha

ha

ha
(: il sesht.
lP

lP

lP
Controls behaviour
el

el

primarily on inhib itony neurotransmitter

ew

ew

Tetypes ot DA Teceptorshavc becn identhed

ar

ar
C

OAMong
them OF DD belonq One
,

D D Dui belong to 0they group

a

a
rm

rm

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nhesig

C
urosina
tyrosine udroylase
a

a
L-Copd
rm

rm
Dopa decarboiykse
ha

ha

ha
lP

lP

lP
Doponne
el

el
Dopaineis token up n Ho the vesicles by
ew

ew
vesicula manoonino (VMAT
ar

ar
tranbporter
C

C
Teleascd by Ctocu tosi

Reuptake n to presunaptie teimial via VMAT

ORT PMAT.
a

1 s
rm

rm

enerdl Anacsthetic
ha

ha

ha
which
yeneral Anaestheties (As) re drugs
lP

lP

lP
loss 0t all Sensaion and
PTOduce TCveisible
el

el
ew

ew

Cons ciouSneSS
ar

ar

ttatwes of qencsal anaesthesia

he cardinal
C

Iass otall
scsaton, especally a
amne sid
yleep
a

a
rm

rm

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sclozaton
ai) gmmobilt g.
muscle 1

C
iV AH ton of Sontatic and autoMomic" Tefleres

dnaasthe sia
Mechanionof reral
not
Ahe mechanismot at tion ot GA is
a

a
rm

rm
precisely kholbn
ha

ha

ha
tven thei
lP

lP

lP
4nhalaton anaesthetics are non-sclec
el

el
3
dt tion
ew

ew
A molecular Jcvel, ongesthetics inteact wi
ar

ar
hdiophobice membrane protein
otneu1ona
C

C
YCgions

ohichare oon interlace oith membrane Jipids

Snhaled
.
anaeshetcs ike
like

and Prpo-otacihate
barbiturates,, benodioaepir
a

GnABA
es,domidate
rm

rm

meaiated hibiton and heie incTease chlorid

ha

ha

ha
lP

lP

channek
lP
on 4u. through its
el

el

otlurtamate on
ketamineblockshe action
ew

ew

NMOAeceptor
ar

ar
C

isousan
iiuan
dnhalaton 'anaesthe ticslikertlurneand
of icotne
decicasesw dutaton fot oeing
eceyor activate 30dium on channels leading
a

a
rm

rm

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to decease iex titatory effects ofi Ach at

C
cholinerqic 3ynapse3

By intluencinqi neuromal mannbjane protensgenerol

Sensor
tiringandSen
a

a
anaesthetic disrupt neuronal
rm

rm
prOce3smg he tholamuls Cousinq lass of
ha

ha

ha
analqe etHects:
lP

lP

lP
ConsCjousnES and
becouse
el

el
Sn addition, motor ot tivity Te dice
ew

ew
the decrtu neuronal ouputroml the ivtemo
ar

ar
C

C
covte
Pimidalaer
Midmal alveolar Concentration (MAC)

-9 e Xowest coMcentrationof the8hWG!

o
a

pulmonary clveoli nieed

anaestheticin
rm

rm

produce immobilit i eponse. I

to a paintul
ha

ha

ha
lP

lP

lP
Stimulus in So1 inidviduals
el

el

acceptedasa validmeajure9
ew

ew

inhalationa
potency of fls becausenr it remains
ar

ar

Constaitt mastuoung dults:

C

MA

he MACof allinhalational onaesthetics

'

decines proqTessively as ageadvdnces beiond

a

a
rm

rm

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So yeais 1

C
toge 3 of Anaesthe sia
neguadly descendm depression
aAscause
of Ake
4he CNS ,1
e he igner tuctios are aut
a

a
rm

rm
proqiesjively areas f Ahe
ha

ha

ha
brain are hvdvedbut in he sphnal cord
lP

lP

lP
oiwe 3tqments are affecte 3omeuwhat
el

el
he hiqhetsegments
thn,
ew

ew
corlhe
ar

ar
tferatstaaes f anacsthesia are
C

C
tage togeofaielgeia
Atarts rom beqininnina ofanaesthehc inhalotion

audlasts upto the sof consciousne.s3

a

a
rm

rm

s iS prooesively abolshed
ha

ha

ha
heat
hear and see
otetTemina Coscious,Can
lP

lP

lP
develops
Hee18adirom ikestateamnesia
el

el
ew

ew

the
NIDA
end of thisstage
ar

ar

Kelleses and rspiration TCmain notnia

C

ge tage of dc lirium
rom oss of onsCiousnes tobeqinning o veqular
4
a

a
rm

rm

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TESpNanoM
:1

C
ma sheut
s Seen, patlen
3hou
Agparent extitement

and hold is brealh ete

Struggle

-tet sate ond 8P, ma

may
fse and puils uts
a

a
rm

rm
dilate due to ymparthe tic stmulation
ha

ha

ha
tage ugical anaeslhesig
lP

lP

lP
-éxtends trom onsct of
ot Yeular Cspira tionto
el

el
ous, breathng
ew

ew
CcSSaton of Spontane
sli
ar

ar
-Okis hasbeendinvided in to -4 planes t
C

C
Plane Rovina eueballsJhio plare cnds Suohen
become. ised
Plane oss
. of covmeal ondlavyngeal refleres
a

a
rm

rm

plens 2 ppi tardilotmiiandheht vefiex

ha

ha

ha
is Jast
lP

lP

lP
glone Sntenoatal paralysisshallo obaominal
abdomnal
el

el

TEspiration, dilated pupil

ew

ew

atage Medulley RAvalysis

ar

ar
C

tessation ot bsealking to ailune of Cixulation

Ond dcalh.

fupil is dely dilated muscles are otall

a

a
rm

rm

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ar

ar
flabbyPulse hTeady(oy impercertbe md
5

C
6P i5 vey
Clossiceton generaljanocsikekea
Jhey ore classihicd
a

a
rm

rm
Snbalationol
-
N
ha

ha

ha
Sntavenous
lP

lP

lP
bsnhalational:
el

el
ew

ew
Jolatile liquidls
ar

ar
Nitrous oxide EEher isotlurone
C

C
Malohane, destlurane

Jevofuiane

nhalational anaasthetics caist in ; tuoo

a

Siqid
rm

rm

gas y
ha

ha

ha
Swtoavenou T i
lP

lP

lP
Subclassikedtti a
el

el

sladar actg
ew

ew

oactng duga
Benzeciozepiz
ar

ar

hioparttone Sad pàm, t

diazepam, Xora2e
C

Mehoheitone Sod midaólam.

i
progeol aroeshesa
ydisaoeiate
ketamine
to midate ogold
ovalaesia-tontanyl.
a

a
rm

rm

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ar
harmacokinotics avacsthetics

C
qases Nopours
-Suhalational anacsthetics are 09Napu

across plulmonanyaveok
|hat diffuse rapidy
a

a
and tisue barricrs
rm

rm
-She ot phormacokiveticsinicude
ha

ha

ha
PTinciple
lP

lP

lP
inductionmaintainencef TCCONery
el

el
Snduction
ew

ew
the
ar

ar
-9t is
he time interval betmen he admmistr
C

C
artion ot OMacshefic druq and he develome

nt of staqeo of Surgical anaethesia.

hilicity is key toctor ovemin phaimatbkinet-

a

a
rm

rm

ic3 ofinaucinq
ha

ha

ha
Mointainance
lP

lP

lP
-4 ise period dunnqohich thë paient
el

el
ew

ew

Temain IM a 3ustainecd stageofisurqical

ar

ar

onaesthesid;
C

4
-Ouring hs
is staget
age, theanaesthesjoloqit monror

he patients vital sign and Tespone2

a

a
rm

rm

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ar

ar
varlausstimuli" ContiollinqCoeentra hon
b

C
hased
anaeshetic to beinlaled CTifuzd
depihof anacsthesid
oM
o
Kecover
a

a
rm

rm
Ahe rocove1 phasetarls ohen tha onacstheh
ha

ha

ha
Atsc(ontinue
d
lP

lP

lP
drug
anacsthesioloqist has to
el

el
this phase the
burinq
ew

ew
hat there arc loyed oxic TCcactorts
CsurC
ar

ar
C

C
Tnhalatiorn eshetics

Wdrous oxide

mild Swuetish 3mel.

9t has
a

a
rm

rm

maintan JUsqical cloesthesia

used.
volaile ancestheies
ha

ha

ha
S07 Oxuqen and other
oith
lP

lP

lP
Bkehcltkane isötluzpneei pToppto e a musc
el

el
ew

ew

rolo1ont if Tequired.
ar

ar

olothane
C

s halogenoted volatile dinnestheic.

poor anahesicand poor musclen

vebiort
a

a
rm

rm

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albng opisid
-315sed iidh nithous
il.oxide

C
velaxanls
ondSkeletalmuste
5oturang
-34 is a 5truc hural dei va tivee ofetlurane
a

a
rm

rm
-Jt is also muscle relaxavtt Fis
ha

ha

ha
S
potent covonay Vasodilator
lP

lP

lP
Sevotluraneasth
el

el
ew

ew
-3t is non pungent A anaesthetc
ar

ar
-3t elaxant
C

C
is muscle

gntraverous anaestheties

hapedtal
-9t i a hoft acin iobanbiuate.
a

a
rm

rm

loio
-A Teduce cerebral loo intracranl
ha

ha

ha
pressuiC
lP

lP

lP
4t also veducsi vEspisotony Toteand Aidal y
el

el
ew

ew

Volume
ar

ar

Methonexitl
C

use as dectired d toTestlessnes3

Kiccups duing
COughnqrn ad TCCOver
a

a
rm

rm

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Progptol

C
analqesic o1) muscle sclarot affad
has Mo

dose dependent
-4 Causes Corlicol depression

has anti-Convulsatt action

a

a
for out potent
rm

rm
Preterred suge1y
ha

ha

ha
Cophcatios general angesthesa
lP

lP

lP
Puring Anaesthesia
el

el
ew

ew
Kespiratoy depression hypescorbia
ar

ar
3alivatbM, TCsprarto secte tios
C

C
-

Cardiac arh thmias astole

oungo cand a.sphuxia

a

pasm
rm

rm

Ater anoethesa
ha

ha

ha
lP

lP

Nausea
lP
? Yoming
el

el

Peisistinq Scdaton
ew

ew

Pneumonia
ar

ar
C

isluiips
Cmctqence delinum

ognitve defecls
a

a
rm

rm

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C

C
re-oMoc-hehicg
4 F i
-re-anaasthetics rele to the use of
dus
be fove anaes thesia make t more pleasant
a

a
rm

rm
and 3ate
ha

ha

ha
he aim of
ot pre-arlaeihetic medicabaM is to
lP

lP

lP
CsUTe comtost to ve parient and minimise
el

el
ew

ew
oadveise effectso anaesthesia
ar

ar
-ollouina are used as pieanaesthetcs
C

C
drugs

Antioaxiedy dugs
-Bezodiazepines 1ike
, didzepam
R si1 2
oTq2 pamare
o)
a

Uscd
rm

rm

iecabve hypaotes
ha

ha

ha
--n addiion to 820s,
lP

lP

lP
prome-thazine, s oidey
el

el

Used.
ew

ew

anthhistamine oith datve , aniemeic

ar

ar

Se
C

antchoinerqic actons
4t causes

T
neghgible

chilssen.
TEsp vabry
on
de press ioi
uselul
a

a
rm

rm

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iy ploid analqesics

C
-Marphne CO) pethidine, is sed
fertan May albobe used elk
ivAetdckolitegieg
a

a
rm

rm
-Atropimiety hyoscine)ytopyolale aye use
ha

ha

ha
heureduce salivarybronchal suietons,
lP

lP

lP
produce

Andkypotensin
el

el
DTaducardia
ew

ew
Antienehcs
ar

ar
Metochp1omide
C

C
domepeiidone 01) ondonseton, aye

LSed
pr gastric emytyng rior to
to emetqny

SUTqeg
be
se
a

druqs may Combined lh histomime H

rm

rm

rectptor blockeis
ha

ha

cceptor ha
lP

lP

bloc kers
lP
el

el

Rantidive 01) tamotidine ove given in niqnt

ew

ew

betore and M the t heore

morring betpse Surq
ar

ar

Ai
i
C

odative upotica
s that subduesoeacitam
cdative aard
the subject withorl nducing
and Calms
a

a
rm

rm

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sleep though droasiressmau be produced

C
- edation Tefes todecieased Tpoasiveness

ony level ofstnulatio

a

a
Hupnotics are the drugs hat indutes andor
rm

rm
maintavs, sleep simila, tonomal arausable
ha

ha

ha
lP

lP

lP
sleep
el

el
Sncreasim grades of CRS" depression
ew

ew
woesihesid oije
ar

ar
Sedation-hpnosis eneral
C

C
Classihcabion

Bavbituwat
actin shot act9 ata-ghort actng
a

a
rm

rm

butdbarbitove entone
pheno borbitone thio
ha

ha

ha
pentoborbitone methoveitove
lP

lP

lP
) Benzodiazepines
el

el

antiansiety
ew

ew

yenetic anticonyulsant
C
alazepom
ar

ar

dia2eram
diazeam
C

chlordietzpoxi lorazepam
lurazegam
Nitrazegom:

alprazolam
s oxazepam
OTa2epam
clonazepam
clobazam

riazolam algra2olam
a

a
rm

rm

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3)Neron benz.odiazepineypnoties

C
20piclone ,23lpide a2ale plon ie

Barburate
a

a
Barbrturatesa0lbstiuted derivativesof
rm

rm
baibiuieá acidpik
ha

ha

ha
lP

lP

lP
hese posses Sedative hyprotic properies, 6
el

el
antitonvubartsedative actiy S
ew

ew
echani
ar

ar
C

C
Barbiturates act On the channe modulotory

GABA eceptorondpotentiale the

Srteofsi
ChABA mediatedkinhibitory elfects iyinCieaimg
a

a
rm

rm

chloidekanmelcpering.
he vi duraHonso
ha

ha

ha
A dases, baubiturotes.direcy increase
lP

lP

lP
ABA mimet
chlotlde! on i conduclance plrand ehibit
el

el
ew

ew

action and ot
GVA&A failitatory: a i action
ar

ar

hatmacokinetics'+, Sy
C

ofiuns barliturates depends

rate ofasovption
he ti

OV solubity
a

a
rm

rm

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Jhey ave widelui distribute deptnding os ipd

C
Soubittyh adgional blood loo
phase
are metabolized botk phase T and
a

a
Processes
rm

rm
microsoma oxida tioawile, phase
ha

ha

ha
Phase L Myolves
lP

lP

lP
woves s9ucuronyCjgafon
el

el
he oxe exietea thaugh uine but are,eod
ew

ew
Yeabsoybe Yom Toal tubulesi
ar

ar
8
C

C
harmacologicaleitect h r
in
-he ultrdishort lotmg barbiturotes cishibit dose
dependent-CN dajrassant.actongnft
a

-he longactiq. posses

rm

rm

barbitunates Sedatve
ha

ha

ha
Cartikonvulyant actions.eebis.
lP

lP

lP
eyimay shousl Myperalgeaic) acdoy,
je, twey mau
el

el

inciease Teaçtloi to pamultimuli

ew

ew

-ssedatue- hypmotic have no etlect on

ar

ar

doses
C

cardiovascula Fystem
dosesdecTeasa blood pressuse, heart rate
high
iu
deprass myocardium
a

a
rm

rm

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.

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dó not affecd
e dodive hypnotie dosts xCspiNation

C
heddosesdeptes5 espiralion and Cause

pulmonan Cdema vaand laroeal

slalloo TaTh,
edera
a

a
heiine,dand ,eiq ht.
rm

rm
rolonged se TnCYCases
ha

ha

ha
mooth.
eadmq to anzume
endoplasmic setculum,leadng
tSmoot
Ri
lP

lP

lP
induction i Joat
el

el
ew

ew
higne osc5 have rqlaxart affection GTT
ar

ar
badder uteiuS.
C

Assedatve-hgproties.
L tactng C
anaesthesia ul tra Ke
bar bituratesike
a

short-
-
S
rm

rm

thopertal CTC
sed as intrgvenoustast inducng
inducing,
ha

ha

ha
anacstheticS
lP

lP

lP
onq -acting baubrturatesie
tke
el

el

AB anticonig al'sants
ew

ew

L
pherooarbrtalare Used -this purpose,
ar

ar
C

treat hyperbi liyu bmae miaii s

dverse esfect
mctabolic
Repeate d
NEpeate se of barbiturates causes
a

a
rm

rm

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inductlo,
tolerance dut to nynte

C
-heu
Sheu CanCauseif psyecle wcll as physieal

dependeiceon oifhdraol Hatter relnge U9e

angpves
hey ot
a

a
ause impairmert judiembit
rm

rm
anddug aurtomd tism
ha

ha

ha
Jvey depestonturgenedema
lP

lP

lP
causerespirotoiy
el

el
hpersensitivity Teactons Causinq skin TaSh hi
ew

ew
oflip
Suclhingf uehds
ar

ar
C

C
2) Benzodiazepines (820)
2s)
-hese wee Iwthoduced, ofter basbturoteshey

repretened drugs to
hpokeiand edotve
a

actividestbëcausel Jra lu i
rm

rm

producet a i louwer degree ot. heurona

ha

ha

ha
Y Bz03 Y

bar bit urates

lP

lP

than
lP
depre3sion

oy
el

el

hyynotic st aosesdo ,
dootyattectespradon.
Y
ew

ew

Cosdiovasculartunctots
ar

ar

practically no action on other

C

hove
Bzo
yody 34stems Only on i injec the BP
8P

alls r Cardiac iControct decrease

decrcase
a

a
rm

rm

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820 distortion o sleep ochilectwe
causeless

C
g820do notaler dispositons of olhe

miciosomal onzume,induction. A

N acton:
Mechanism of
a

a
rm

rm
Benzodiazepines pre terntially
ha

ha

ha
OM midbroin
lP

lP

lP
onmbic 5Tem.
el

el
B205 facidate action,O ABATCCeptor
ew

ew
'
o,
B2Ps selectivelY ind g hgh affinty
ar

ar
C

C
auch
emodulatoyy Site on ABA eceptor, in

that the bndiwa ABA: to CaABAA

Yeceptor acittate de to' v

a

distnct
rm

rm

site is trom the nABA

-Jhs modulatory
ha

ha

ha
binding5ite ond.sapeciied 82Qshence
lP

lP

lP
t s also calledvasil uben2o diaze pine ece ptoy
el

el

:o
ew

ew

B2sneither "sukstilute orGiABA, actvark

ar

ar

of aABA
ABAAtceptor but ekanebindinq
C

ABAA eceptor.
to he ndng site of

equency
appear to nCTeas e ra ther
a

a
rm

rm

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than durationof CABA0ed chloride,
cbone.

C
haamacokinetics
t i
-Oalu midazolam given cither y TM,( Iv
a

a
rm

rm
Tourte
ha

ha

ha
- All other 82n
Cqiven orallu h
lP

lP

lP
ehler diazepbride
-8zos Uke diazepam, 0azèpan
el

el
hano7.bounro
ew

ew
mote protein

e
ar

ar
Mave high voltne f distibuhon
he
C

C
Ctass plaentál: boirier and pibei,ued
cavtiously S in eqráno
e y
-Achve metaboites of presenthe; dru are asp
a

bloups
rm

rm

Midazolam hydroxymelkgmidazslam
ha

ha

ha
piu
lP

lP

lP
diazepam 0Aq2epamMoidia 2cpam
el

el

turazepam huoroxymetlun2epam
ew

ew

alprazolom: alpha'-hychoayalpazolam
ar

ar

Alsas
C

-o theal aicty
S
euoses
i
-o treat insomid
a

a
rm

rm

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ar

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oiprcanac3the the ditatonand inducton
mé of

C
vuesthesai

gkeletal* mušcle të velarant

> su
As
As.titoulsante
a

a
rm

rm
-rcatment of olcoholithdtaoa
ha

ha

ha
Adveise actoMs
eactos
lP

lP

lP
drosiness, tatique,dsorlentaton,
el

el
ew

ew
Folexance develoRs louly
ar

ar
1 0eSt
dependnce i ml
C

C
Non pettodiazepine hypnoticS
-j0s tupe5 of 8zo TeceptorS have si1tihed
been idettihed
a

82 872
rm

rm

-82 TCCeptors are touMd hroughout he brain

s
ha

ha

ha
lP

lP

lP
arqe coMcentraionsînMe ceicbcllutJhey
s
el

el

TESPons ible tor anttianxiety, sedatdve

ew

ew

huproiccffects
ar

ar

hi
C

82TCceptos,s ound mainly he cerebal

avld afe
COexhippocampus, pmalCord
sasciated ohi muscle relazqion anticonyulsant
a

a
rm

rm

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C

C
-Non -bonodiazepine.3 ike 2olpidem 2aleplob 2eficle

cs20picloneact oMs 82 recepib3| nl

Jhese dhugs hove mininal mubleelosad
a

a
have
rm

rm
On-ticonvulsant
ha

ha

ha
1
lP

lP

lP
Certyally dctivq Muscle sclaxatt k
el

el
Jhese skeletol muscle tone
ew

ew
dvugs e duce
ar

ar
a Scle hve ac ton in the cerebrospinal ani
C

C
thout alteina Colsciausnes5

Apastichys Characterise by an increaseit

Sie1or
oic srenqh sthetch Tefiexes ond leor muscle
a

a
rm

rm

uith, muscle ueakness.

Spasm, alorg
ha

ha

ha
-t asso ciate oth disease ike Cerebral palsy
lP

lP

lP
and multiple Jclerosis
el

el

Aedispashe Control
he 3ymptoms
ew

ew

drugs
of spastdly
heactity of inhbitory neurons
ar

ar

cithe enhancinq
b
C

of he etler laic COT) irdeearingdectly totk

skeletal muxcle exttation contractiontCouphiq

he mode of dction isino'spæcitic f 3 dascibed

a

a
rm

rm

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as dcgre35 otsdpres sants opalusiriaphc reflexes
sefiexes

C
levél
at Spmol
Mepharinroup- '
-4 involvesarugske
ikecarisoprodol, ehlor2oxonone
a

a
rm

rm
metkocasbamo
chlor mezatorne E
ha

ha

ha
Spinaql Meuwon bloc kino aqents
kes drugs are
lP

lP

lP
3te itL
at heleve"ofbra
el

el
ew

ew
spasm
ise to bveot S musle"
ar

ar
Benzoiazepine roup
C

C
i
avtspastic acdon
Diazepom Chlorazepam,, have
nt
Juey enhance CnABA-cigic tranImisJion IbToin
h
a

other CnA BA ynapses.

as wel as
rm

rm

hey inhbit bothmonosynaptc QS ellas

ha

ha

ha
narke daton.
lP

lP

lP
poly,synaptic eilexLJandpidduce
el

el

CaABA deiivative
ew

ew

actve nABA- mimetic driy

ar

ar

Baclofen Orall
S
C

àa agonist onne4 cepto1s J

oick
secepto1s -protein Couples ceptos
Ohe afc
neurons byncteasing potasshu
Meuron S
hich hyperpolarise
a

a
rm

rm

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on conductancei and-. reducmgaliun ion
conduro

C
-At spimal level, nhibitsbothManosunaptie

polysunapte Tesponsec3

St 5 used Televepeinhulpastici t
a

a
rm

rm
educes ain assocate th pastic tmdrton
ha

ha

ha
'
iventral Agonist
lP

lP

lP
i2.onidine s a
el

el
geristwthactiono
ew

ew
CNS0 alteis,neuronol acthity he 3pincel
ar

ar
Cord
C

C
-St antaqomlses Spaoticity atdasës oichave
wiiwimal effed o blood presure in Compaison

to clovidine
a

a
rm

rm

rtti-epileptics
ha

ha

ha
RL
plepy 15 Common. neuroloqicalabnomality
lP

lP

lP
by of ScizuresS
el

el

Charo cterise d ocCurence

SVii
ew

ew

mcans paroymal abnorma discharg

-ASeizuse
ar

ar

tHe quency rom an gTegate

art igh
C

neuions cerebral COvte.

'S TOU

tpilepsy INokvesKCurrent SCizune

a

a
rm

rm

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onvulsiosNeLmVolun:loryplent y posmodic,

C
O)prolonqed controxrfonsofJkeletol s, muscle
Connils
epilepsy rthout i
Apatient iyVe
.
a

a
rm

rm
lassitication otT Scizure3
ha

ha

ha
ADeizure ae classiked in to
lP

lP

lP
Ogereratsed izue
el

el
ew

ew
trom both ceebral
heoe seizures arise
ar

ar
and diencephelo 3 multaneosly inioli
hemisp heies
C

C
the entire
body . si
are ot iffient tyges

Jeizuc
a

)yadd maCo Toniclonle

rm

rm

aosciated with an
ha

ha

ha
Usually
hese auTO
lP

lP

lP
PTiOY Jeizuie5
sti
el

el

tornic
e patient fals tohe ground in stiff
ew

ew

with an epilepfic,Cy Caused by toric

ar

ar
C

aruq eal tmuseles this 5 olloued

Contracton
o

clowic Convulsions then Coma which ma

minutes
astor5-30 a
a

a
rm

rm

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macory absence sehures
eit

C
m
.

-Attockappear3 örlhartcoming d
Jhere iFmloss iot ConsclouSnesS

iathaut las
-he for! teoeconds
a

a
Senurelasts
rm

rm
'

ot Postural Cortrol
ha

ha

ha
-Shese are ChaTacterise d brapidbhnkinaq of
lP

lP

lP
eyehds, clonick of hands, "ele
el

el
ew

ew
Muoclone Se2ure3
ar

ar
-hese bilarteral epileptie
C

C
myoclonus chaaeterie
sudden and brief skeletat muscle corntxacti

nohich may involve theertre

of the bd2
a

onc'pat
rm

rm

ScizusE
ha

ha

ha
chordcteise
Shese are dbs3den 1asyof
lP

lP

lP
el

el

postural
ew

ew

i
Awe COscious neas mau be impaired tor a brief
ar

ar

la
peidd but there
C

isno pst-ictal scbtion."

tis
(omusion.

e) CloricsuIeI
a

a
rm

rm

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muxle
-her are chanacterisc8 byepetitive i

C
Jeals

tonic SeUEO
Shese are chaac terisedbriid violent, muulo=
a

a
rm

rm
shiff xed extended tmbs
Contiac ton oith
ha

ha

ha
w Yortial
lP

lP

lP
Seizues
el

el
also Ktolon as Socalisedtoxal seizures.
ew

ew
hese dre he mast Comm on30izuies
ar

ar
C

C
Jhe Seizure acfivity issesticted to a, ditete
belonginq to O1e cesebral hemispheic Only
ared

-Jkese aye of3 ypes.t

a

Jacksonian seiunes)-
rm

rm

9ple partial3einuies
ha

ha

ha
chaacteised
hese are y
by urilateral clonic
lP

lP

lP
movements. which om
ben Onegtaup of muxles
t
el

el

to adjacent graup
ew

ew

and spread qradually

ar

ar

No loss of (o5Cusnesj
i
C

5Coipkypodial eizutes Rychomotor eplgg

temporal the trortal

iheseorignafe of

be and are aCcompanjed by partial lass of

a

a
rm

rm

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,

Consclous nes5

C
artientbehaves aspartially Cosciousoith

automatism r
ainleizunes, oag condatu gEceralsed
a

a
rm

rm
Sciure3:3ihs
ha

ha

ha
-hese are the tupe when partiol Sei2res
lP

lP

lP
gene ralisedtonic /'clonic/ Tonic clonic
el

el
Proqres
'
ew

ew
Sci2uesS
ar

ar
-Yatients USuallu Yepost aura, bebre the 3cizues
C

C
diy velosified scizucs
a d
-4t coveis undetermined
yi tpilepsiesandenlete
a

Sundromes 1ike ebrile 5úzures. 0) itantile

rm

rm

Spasm.
ha

ha

ha
qene rali ze
Jhese sare d toncclonic
lP

lP

Convuls jons
lP
of
duration Frightening
el

el

5hort which may appear

ew

ew

but or usuallu baniqn

ar

ar

Mechanism ofactionof t- epletig

C

ru
Antconvulsant rugs act
bdiffeei mechon
a

a
rm

rm

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supass epetitiye i7inga toy potedida
Ss

C
us thebrain t
by4 pertic
tuo
-Mechanis arelassihedin.
Mechgnin rndmaandartlalSeinures
a

a
L
rm

rm
Jhey are turther Sub-classiked intoollaoing
ha

ha

ha
sub-types i
lP

lP

lP
1

Sahibitionf channels
el

el
Use- depedent JodiuM ion
ew

ew
drug Tke pheny toincdtbama2e pine eteblock
ar

ar
gated sodiumchannels
C

C
voltage

b)vihoncement of A BA
ergic acfio
phenobarbital benzodiazepines actvate
drugsw like
a

GaA BAA receptois to

to acillateopejtingof chloride
rm

rm

u a tyissj siics
ha

ha

ha
channels
lP

lP

lP
) Blockade, ofNMoA ){ AMPA Teceptors iat
el

el

drugs ike felbamate block NMDA receptors.

ew

ew

-dr ike pheriobayrbitat block AMPA Seceptors

ar

ar

geted, Nupe
C

8lbckade of voltage calcium

channels.

9dective blockinq of ynaptic Vascular protein

a

a
rm

rm

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nerotropic, hctovs
By blaekig eflects f

C
(absenceselzures
Meckonin in peitmal

-4 involvesinhbiton 6fType"cakuconeb
a

a
rm

rm
ethosuximide inhibit calkium ckonnels
drugs ke
ha

ha

ha
rugs
lP

lP

lP
-Uuges dugs uSe
el

el
treot epilegy
ew

ew
bscnce+ Jusim
9anazolone
ar

ar
i N:
Muoclonie
C

C
qcneiaised MHoric
yielaonoze pom
clobazam
Sc12u1 Vtgebabin
loic topiramae
she tonid inys Sebomerte
a

a
rm

rm

>qsond mal pi 2onisami

ha

ha

ha
25imple paial evetivacelan Carbomo2eie
pherutoin e
o
lP

lP

lP
avtlal partal ottarbaze
Complex parhal
pine
o1tatbazegme phenobsbitone
enuses r .9abagentMi
el

el

Secontday qerenalsed-
uimi done
ew

ew

r INdls
ACTH
yfantile le pm ACTH,i alproate
ar

ar

3pasm
unclassifca ti batrmMiga
C

lamotngine
Midazolam, JanoA 2oloe
hi l ebile reclal
diazepam

diazepam
. '
a

a
rm

rm

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Alcolnols andsvam i'y

C
(ethonel) are ydony desivotves (oH) of
Alcohols
aliphatichyorocobons
a

a
Pre parafion
rm

rm
ha

ha

ha
z-uMaseE Converta
SuasuNegt stoich malase dcdo
lP

lP

lP
el

el
alcohol
YPe
ew

ew
Moited liquores Beer, '3tout
ar

ar
z (3-19
C

C
alcoholic sis
wines 2g Aht smes l)
(-161)
orified es (6-227)
anes (12-161)
a

vesCent
tfer
rm

rm

ushisky, brandy Vodka

spirits Rum, Cain,
ha

ha

ha
uo-551)
lP

lP

lP
haumocologisal etecis-(aaude)
el

el
ew

ew

harmacokinetics
ar

ar

absorbe d trom GIT

-Lhanol israpidly
C

BBB a5 1as placertal barriex,

but he Cocentra ton in rain BVery close

a

a
rm

rm

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Concentraton
hat nbiop3

C
alkokol me tá
Me bolise
taboli
of ohso1ked sed
-About 15
bieath
and eicieted, throuqMa
a

a
urine 3ueat
rm

rm
ethanol cleased
raconof
ha

ha

ha
si2able
-A 15
lP

lP

lP
firstpasshepatkn:metàbolism)onichfolbos
el

el
ZCio-O3 der kine tics
ew

ew
EThanol i
ar

ar
irst me lubolied
to acetaldehude
C

C
Ovnd hen to aceid acld t) i
Melabism alkolel e Livar
a

a
rm

rm

Aalal yrgenese
ha

ha

ha
al Acdaldehie
lP

lP

lP
v Alehyde
el

el

dehydhogerese
ew

ew

Acetic acid
ar

ar
C

pt

,aty acids
L0,
a

a
rm

rm

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alcohol enyoiogerase ound mainly
mainly
hevenzume

C
intestine odises
HNer Slomach bd
k, co
acetaldehyde
amrt1S1. ethanolo
om folouas Zero orderkinees
a

a
Metao
rm

rm
Anoher
esenzume mized fu
tunt tio ozidase
oxidase *
A YPuso)
ha

ha

ha
2S ot ethano
lP

lP

lP
remaiing
is esportsibte6r
el

el
Metabolism
ew

ew
Abou 15-so facelaldeude il overte
ar

ar
renzyme aldchyele
C

C
acetate in he liver:

dehydngence (ALOH)

- Onlui 20-25 of ce-taldedé,is erte

o
a

acetc ocidutsde live enzume

rm

rm

to
ha

ha

ha
aldekude. oidoweoch
lP

lP

lP
his eads tormatony oacetüte olich
el

el

to CO ater
F
ew

ew

tuyther mclabolised
ar

ar

Hecs01gan
C

CN3
acute effacts of alcohol CNS ae
he L

Sedation rom anaiety loss ot, mhibitions

reef
a

a
rm

rm

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one,tpaved judaenent s ell diving

C
skiltheseelfecis; OCCur atbledd level bl

So-bo mga
o
Blod b elfec
-
leveu,o 120 ;6o mqld1, lead
a

a
rm

rm
iket otoxia, slurred Speech nental cloading e
ha

ha

ha
-ivess blo
lP

lP

lP
2o0-300 mgde poduceCmesis
el

el
3fupor Jevels above 300 mq/d3 Jead
ew

ew
Como Cardiovascu lay degressionl
ar

ar
Jethal
C

C
-Jevelhr above3 50O mg/d9 dye ethal ss:
Meast

At bbod Cincentratotolk of(0o Mq/dgcthane,

a

deereades myotordial tontracktH

rm

rm
ha

ha

ha
Large bs depress Yasomotor centre Jeadim
lP

lP

lP
el

el

Smooth 1s mscles oheT effkct

ew

ew
ar

ar

thonol Causes5 cutoncous VasodiGton

C

produces selaxation ofutnus only att

kign doses e
diuiesis i 1
a

a
rm

rm

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Whamacological gttecb i

C
ot Several Vitaloqans
a

a
Nervous
Cm5Tem
rm

rm
effectsn
ha

ha

ha
Joleranceindependonce are Major
lP

lP

lP
CNS
LL
el

el
drinkes, if fonced
hronicalcohol
ew

ew
to i
Cpefience distressivq withdhowl umprtoms h
ar

ar
C

C
hyieal degendance

Neurotoricity

krons/3heavyi) crinkes atoia, demensia,

a

a
rm

rm

peipheral neuopathes
ha

ha

ha
-Alcdha ao impaivs sual atuity ulth painles

-
lP

lP

lP
of vision on chronie'* consumptio
blurin
el

el
ew

ew

arld CTT
iver
ar

ar

ChTontc Czcesive cthänol Conšumptlon CausesaH

C

inflammation.
liverwith
-9eads toieversiblehepate recsis, tibrosis
a

a
rm

rm

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aidiovaštulat System

C
Chronic

RbIoS15
Cardiomypoth Venticuor pertrophu bois
a

a
Mdocxine lecdralylealance
rm

rm
ltecs
ha

ha

ha
-Chn alcoholism tan Proelicetesticulor "atvophy,
lP

lP

lP
unaecomastia and im pote nce
el

el
ew

ew
-Pseudo- Cuskngs un diome sobserved in chyortc
ar

ar
alcoholiecs
C

C
oetal deve lop ment

Consumptia of abourt 6-10 s of aleo pe

ddu durimg prenoncyauses toctal aleoheto

a

a
rm

rm

3ndrome
ha

ha

ha
dical io
lP

lP

lP
-As askn antisegtics oici
el

el

- St hazasrmgertt acion
ew

ew

used to veatmethanral próbing

ar

ar
C

Disulfivam:-
3
Jhe enime aldehdeldi dehydrocgenaje is inhibired

by disulfisam nd other drns mcluding

a

a
rm

rm

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C

C
metronidazole oralhypogcemc3, Sorne cephalopoi

lite, citote tan uin aotisephcs ke nitro-urntbin

-when aleohol is
a

a
Consumed
Mpiesence
rm

rm
ha

ha

ha
disul firaM, ConNerslon ot acetaldehude o aceic atid
lP

lP

lP
signifecanty Yeduced
el

el
ew

ew
nence acetaldeh effec s
ar

ar
CicCumulotes Cause
C

C
iketacial lushmg yomiin
ncuseaomiivng dizzme ss

heod ache
a

ence
rm

rm

disulHrom Can b used CS an aveson

ha

ha

ha
trom
hea to disouiog people ConSu minq
lP

lP

lP
el

el

alcohol
ew

ew

'
ar

ar

Agve1se Teactions ofdisulfirom include skin rashes,

C

metalie aste abdomiral uset

a

a
rm

rm

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