Adjuncts 2: anticonvulsants, antihistamine, antimicrobials, antiemetics, H2 blockers, diuretics Flashcards Preview

Anesthesia Pharm Oral Exam > Adjuncts 2: anticonvulsants, antihistamine, antimicrobials, antiemetics, H2 blockers, diuretics > Flashcards

Flashcards in Adjuncts 2: anticonvulsants, antihistamine, antimicrobials, antiemetics, H2 blockers, diuretics Deck (14):
1

Phenytoin: class

Antiepileptic
Class Ib antiarrythmic

2

Phenytoin: MoA

Decreases neuronal excitability and inhibits neurotransmission by ↓ sodium and calcium ion transport across neuronal cell membranes.

3

Phenytoin: PK

Onset = rapid
90% PB
0.7L/kg
E1/2t = 20 hrs + must maintain within tight serum level parameters

4

Phenytoin: metabolism

Hepatic microsomal enzymes to inactive metabolites.

2% unchanged in urine

5

Phenytoin: AE

Hypotension, bradycardia, arrhythmias, CV collapse
Pain/thrombophlebitis
CNS toxicity
Hepatotoxicity
Stevens Johnson syndrome

6

Phenytoin: CI

Pregnancy unless benefits outweigh risks.
Porphyria
Hepatic dysfunction
Bradycardia
AV block

7

Phenytoin: dosing

10-25mg/kg @ 50mg/min

Dysrhymias: 50 - 100 mg IV every 15mins to a max of 10 - 15 mg/kg

8

Diphenhydramine: class

First generation H1 receptor antagonist

9

Diphenhydramine: MoA

Competes with histamine to antagonizes H1 receptors on target cells in GI tract, blood vessels, and resp tract

10

Diphenhydramine: PK

Onset: rapid
DoA: 4 - 6 hrs
E1/2t: 2 - 8 hrs
Vd: high
78% PB

11

Diphenhydramine: metabolism

Hepatic metabolism, first pass effect
Eliminated in urine
Inhibits CYP2D6

12

Diphenhydramine: AE

Somnolence, nervousness, paradoxical excitement in peds, euphoria, confusion

Delayed emergence if given at end of case!

Hypotension, tachycardia, palpitations

Thickening of bronchial secretions

Urinary retention, epigastric distress, constipation, N/V/D, anorexia, weight gain

13

Diphenhydramine: CI

Driving or operating heavy machinery
Premature infants, neonates, nursing moms,
Hypersensitivity

14

Diphenhydramine: dosing

10-50mg IV q6-8 hrs

Max 400mg/day