Brainscape's Knowledge GenomeTM

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


See full index

Musculoskeletal > Pharm > Flashcards

Pharm Flashcards

1
Q

atracurium

A

non-depolarizing agent: isoquinolone

AE: histamine release, SEIZURE due to laudanosine

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

cisatracurium

A

non-depolarizing agent: isoquinolone
fewer AE than atracurium
HOFFMAN elimination: spontaneous breakdown (doesn’t change t1/2 in renal/hepatic problems)

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

D-tubocurarine

A

non-depolarizing agent: isoquinolone

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

pancuronium

A

non-depolarizing agent: steroid

AE: cardiac M receptor block

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

rocuronium

A

non-depolarizing agent: steroid
not as potent as other steroid derivatives
AE: slight cardiac M receptor block, allergic reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

vecuronium

A

non-depolarizing agent: steroid

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

succinylcholine

A

depolarizing agent
binds and opens nACh receptor and prevents repolarization after initial depolarization by preventing Na channel closure
SHORT duration
muscle contraction, then flaccid paralysis: twitches
AE: histamine release, stimulate cardiac M receptor, stimulate ganglia, MALIGNANT HYPERTHERMIA, HYPERKALEMIA (in injury), HTN, arrhythmia, brady or tachycardia, ANAPHYLAXIS, muscle pain
broken down by pseudocholinesterase
genetic variants of plasma cholinesterase: increase risk for long duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

endophonium

A

reversal agent
AChE inhibitor
give ATROPINE
shorter onset and duration than other AChE inhibitors

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

pyridostigmine

A

reversal agent
AChE inhibitor
give GLYCOPYRROLATE
longer onset and action

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

neostigmine

A

reversal agent
AChE inhibitor
give GLYCOPYRROLATE

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

sugammedex

A

reversal agent

capsule that prevents STEROIDAL NMB from accessing binding site on Ach nicotinic receptor

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

malignant hyperthermia

A

SUCCINYLCHONLINE
uncontrolled Ca release from SR
brown urine, rise in body temp, muscle rigidity
Tx: DANTROLENE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

glycopyrrolate

A

anticholinergic

give with AChE inhibitor to reduce consequences of off target activation

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

atropine

A

anticholinergic
non-sedating
give with endrophonium to reduce consequences of off target activation

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

scopolamine

A

anticholinergic

crosses BBB: sedating

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

duloxetine

A

serotonin-NE reuptake inhibitor (SER greater)
CYP metabolism; CYP2D6 inhibition
Tx: fibromyalgia
AE: increase HR and BP, SIADH (hyponatremia), suicidal ideation
CI: liver dysfunction, alcoholism, close angle glaucoma, MAOI

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

milnacipran

A

serotonin-NE reuptake inhibitor (NE greater)
Tx: fibromyalgia
AE: increase HR and BP, SIADH (hyponatremia), suicidal ideation
CI: liver dysfunction, alcoholism, closed angle glaucoma, MAOI,

18
Q

pregabalin

A

inhibit glutamate presynaptically (inhibit L-type Ca channels)
Tx: fibromyalgia (off label)
CI: reduce in renal dysfunction
AE: rebound, dependence, suicidal thoughts, depression, dizzy, sedation, blurred vision, xerostomia
monitor: serum creatinine

19
Q

amitriptyline

A

tricyclic antidepressant
Tx: fibromyalgia (off label)
AE: anticholinergic

20
Q

cyclobenzaprine

A

skeletal muscle relaxer
related to TCA, central action at brain stem
CYP metabolism
Tx: fibromyalgia (off label)
AE: anticholinergic (GI most significant)
CI: anticholinergics, 1st gen antihistamine, tricyclics (prolong QT)

21
Q

fluoxetine

A

SSRI (SER reuptake inhibitor)

Tx: fibromyalgia

22
Q

skeletal muscle relaxers

A

AE: sedation

23
Q

dantrolene

A

ryanodine receptor: block release of Ca from SR
Tx: spasticity, malignant hyperthermia
AE: thrombophlebitis (need slow infusion), liver, floppy child syndrome (C-section), muscle weakness
CI: Ca channel blocker
monitor: LFTs

24
Q

botulinum toxin (botox)

A

block fusion of vesicles with end of presynaptic terminal

Tx: spasticity

25
Q

baclofen

A

GABA(B) agonist: inhibitory signals or reduces excitatory glutamate pathways
inhibition of substance P: pain relief
AE: dependence
Tx: spasticity
AE: rebound neural activity results in seizure, confusion, hallucinations, increased spasticity (TAPER down), increase blood glucose; drowsy, dizzy, confusion
CI: adjust in diabetic agents, CNS toxicity in renal failure

26
Q

tizanidine

A 
skeletal muscle relaxer
pre-synaptic alpha 2 agonist
AE: decreased sympathetic outflow, liver, taper cessation, xerosomia, dizzy, sedation, hypotension
monitor: LFTs
Tx: spasticity
27
Q

methocarbamol

A

skeletal muscle relaxer
sedation, altered pain perception
AE: irritable, blurred vision, dizzy
CI: hepatic/renal dysfunction increases toxicity

28
Q

non-depolarizing agents

A

prevents any activation of muscle contraction by preventing opening of channel

29
Q

reversal agents

A

given post procedure to reverse residual effects of paralytic agents

30
Q

Nm

A

nicotinic M receptors
found on skeletal muscle
site of action of paralytics

31
Q

phase I NM blockade by succinylcholine

  1. EPP
  2. onset
  3. dose-dependence
  4. recovery
  5. TOF
  6. AchE inhibition
  7. muscle response
A 
EPP: -55mV
onset: immediate
dose-dependence: low
recovery: rapid
TOF: no fade
AchE inhibition: augments
muscle response: fasciculations, then flaccid paralysis
32
Q

phase II NM blockade by succinylcholine

  1. EPP
  2. onset
  3. dose-dependence
  4. recovery
  5. TOF
  6. AchE inhibition
  7. muscle response
A 
EPP: -80mV
onset: slow
dose-dependence: high
recovery: long
TOF: fade, PTP follows fade
AchE inhibition: reverses
muscle response: flaccid paralysis
33
Q

laudanosine

A

product of atracurium

causes seizures

34
Q

dibucaine test

A

enzyme inhibitor
identify genetic variants of plasma cholinesterase
important in succinylcholine use

35
Q

steroid derivatives

A

more potent

hepatic and renal elimination

36
Q

isoquinilone derivatives

A

spontaneous elimination

37
Q

effect of blocking/stimulating cardiac M receptor

A

block: tachycardia
stimulate: bradycardia

38
Q

effect of histamine release

A

hypotension

edema

39
Q

Off target actions of AchE inhibitors

A 
bradycardia bronchospasm
increased secretions
pupillary constriction 
increase peristalsis and bladder tone 
cerebral excitation
40
Q

therapeutic use of NMBs

A

IV
adjuvant to surgical anesthesia (no pain relier or amnesia)
short orthopedic procedures
endotracheal intubation

41
Q

What causes death with NMB overdose?

A

diaphragm paralysis

42
Q

carisoprodol

A

skeletal muscle relaxer
sedation and altered pain perception by CNS action on reticular activating system and spinal cord
CYP2C19 metabolism
AE: drowsy, dizzy, CNS, vision loss, mydriasis, orthostatic hypotension
CI: renal/hepatic dysfunction increases toxicity

Musculoskeletal (13 decks)

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