Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Oral Boards J > NSAIDs, anticholinergics > Flashcards

NSAIDs, anticholinergics Flashcards

1
Q

Ketorolac Class

A

NSAID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Ketorolac Use

A

pain relief and anti-inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Ketorolac MOA

A

reduces inflammatory response by decreasing the activity of cyclooxygenase (COX) 1 and or 2, thus inhibiting prostaglandin synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Ketorolac Dose

A

IV 15 - 30 mg, given during emergence

Lower dose for elderly and CKD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Ketorolac Pharmacokinetics

A 
Onset = 30 min 
DOA = 4 - 6 hours 
Metabolism = hepatic 
Elimination = renal (60% unchanged)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Ketorolac Contraindications

A

Ortho surgery due to delay in bone healing

Bleeding risk with intracranial surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ketorolac Considerations

A
  • Decreases postop opioid requirements
  • Low incidence of N/V
  • Lack of respiratory depression
  • Communicate with surgeon prior to admin
  • Ok to use with stable and healing bone fracture
  • Caution with asthma d/t bronchoconstriction d/t decrease in leukotriene production
  • Caution with renal disease d/t renal vasoconstriction d/t decrease in leukotriene production
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Atropine Class

A

Antimuscarinic (tertiary amine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Atropine Use

A

bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Atropine MOA

A

Competative antagonism of ACh @ muscarinic receptors opposing PSNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Atropine Dose

A

With edrophoniuim = 7 mcg/kg
Non-symptomatic bradycardia = titrate to effect with small doses
Sympomatic bradycardia in ACLS = 0.5 - 1 mg bolus, 3mg max

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Atropine Pharmacokinetics

A 
Onset = 1 - 2 min 
DOA = 1 - 2 hours 
Metabolism = liver 
Elimination = renal and hepatic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Atropine Contraindications

A

Caution with CAD, pheochromocytoma, hyperthyroidism, and myasthenia gravis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Atropine Considerations

A
  • crosses the BBB

Tachycardia, sedation, anticholinergic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Glycopyrrolate Class

A

antimuscarinic (quaternary ammonium)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Glycopyrrolate Use

A

Antisaligogue, often given with Neostigmine for reversal of NMB, bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Glycopyrrolate MOA

A

Competitively antagonizes ACh at postganglionic muscarinic receptors

Blockade at postsynaptic muscarinic receptors leads to: mydriasis, blurred vision, tachycardia, decreased salivation/pharyngeal secretions/bronchial secretions, bronchodilation, decreased tone/motility of lower esophageal sphincter, decreased bladder tone

18
Q

Glycopyrrolate Dose

A

With neostigmine= 0.2mg glyco for 1mg neo

Concentration 0.2mg/mL (neo concentration 1mg/mL) therefore, 1mL of glyco per 1 mL of neo

19
Q

Glycopyrrolate Pharmacokinetics

A 
Onset = 2 min 
DOA = 2 - 4 hours 
Metabolism = portion by liver 
Elimination = renally, larger portion unchanged
20
Q

Glycopyrrolate Contraindications

A

Caution with CAD, pheochromocytoma, hyperthyroidism, and myasthenia gravis

21
Q

Glycopyrrolate Considerations

A

Tachycardia & Does not cross BBB

22
Q

Scopolamine Class

A

antimuscarinic (tertiary amine)

23
Q

Scopolamine Use

A

Antiemetic, antisialagogue, and sedation

24
Q

Scopolamine MOA

A

Competitively antagonizes ACh at muscarinic receptors

Peripheral tissues innervated by parasympathetic postganglionic nerves
Tertiary amine = crosses BBB
Blockade at postsynaptic muscarinic receptors leads to: mydriasis, blurred vision, tachycardia, decreased salivation/pharyngeal secretions/bronchial secretions, bronchodilation, decreased tone/motility of lower esophageal sphincter, decreased bladder tone

25
Q

Scopolamine Dose

A

Patch = 1.5mg

26
Q

Scopolamine Pharmacokinetics

A 
Onset = 4 hours
DOA = 24 hours 
Metabolism = liver 
Elimination = renal and hepatic 
*crosses BBB
27
Q

Scopolamine Contraindications

A

Caution with CAD, pheochromocytoma, hyperthyroidism, and myasthenia gravis

28
Q

Scopolamine Considerations

A

Patch is most effective if placed 4 hours before induction
Pt education = patch can cause dry mouth, blurred vision, dilated pupils, can stay on for 24 hours, and after removal wash hands before touching eyes
Tachycardia, sedation, anticholinergic syndrome

29
Q

Neostigmine Class

A

Anticholinesterase

30
Q

Neostigmine Use

A

Reversal of non-depolarizing neuromuscular blockade

Other: glaucoma, paralytic ileus, atonic bladder, myasthenia gravis

31
Q

Neostigmine MOA

A

Antagonizes postsynaptic acetylcholinesterase at the NMJ, increasing the concentration of ACh in the synaptic cleft.
Excess ACh displaces nondepolarizing NMBAs bound to nicotinic receptors & binds to nicotinic receptors
Note: the excess ACh also binds to muscarinic receptors throughout the body

32
Q

Neostigmine Dose

A 
Dosing based on twitches on TOF 
1 twitch =  no reversal
2-3 twitches = 50 mcg/kg
4 twitches w/ fade = 40 mcg/kg
4 twitches w/o fade = 15-25 mcg/kg 
Often administered with an antimuscarinic (glycopyrrolate) 
       5mg MAX
33
Q

Neostigmine Pharmacokinetics

A

Onset: 5 - 15 minutes
DOA: 45 - 90 minutes
Metabolism: pseudocholinesterases (50%)
Elimination: kidneys (50% unchanged)

34
Q

Neostigmine Contraindications

A

Brady-arrhythmias & certain respiratory pathologies

35
Q

Neostigmine Considerations

A

May cause bradycardia (r/f asystole) when paired with antimuscarinic
Side effects: salivation, bronchoconstriction, peristalsis, miosis, enhanced gastric secretions

36
Q

Sugammadex Class

A

Selective relaxant binding agent

37
Q

Sugammadex Use

A

reversal of steroidal NMBAs

38
Q

Sugammadex MOA

A

Irreversibly encapsulates (binds to) steroidal NMBAs

39
Q

Sugammadex Dose

A 
Reversal of profound block: 
Post tetanic count <2: 16 mg/kg
Post tetanic count >2: 4 mg/kg 
TOF 0: use post tetanic
TOF 1: 4 mg/kg
TOF 2+: 2 mg/kg
40
Q

Sugammadex

A

Onset: 3 minutes
DOA: 15 min
Metabolism: NOT metabolized
Elimination: kidneys

41
Q

Sugammadex Contraindications

A

ESRD

Anaphylaxis

42
Q

Sugammadex Considerations

A

If paralysis desired after sugammadex administration, must use succinylcholine or a bezylisoquinolone (cis/atra)
Patients using hormonal contraceptives must use an additional, non-hormonal method of contraception for the next 7 days

Oral Boards J (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions