Comprehensive Drugs

Question 1

muscle relaxant exhibiting vagolytic activity

Answer 1

pancuronium

Question 2

metabolism and fate of morphine

Answer 2

Metabolized via conjugation with glucuronic acid in the liver and the kidneys; major metabolite is morphine 6-glucaronide (active metabolite and more potent than morphine)

Question 3

causes of increased blood glucose levels - corticosteroid therapy

Answer 3

Glucocorticoids (esp. prednisolone and dexamethasone) oppose insulin action and stimulate gluconeogenesis, especially in the liver, resulting in a net increase in hepatic glucose output

Question 4

initial IV labetalol dose

Answer 4

5-10 mg (0.1-0.5 mg/kg)

Question 5

dobutamine infusion dose

Answer 5

0.5 - 20 mcg/kg/min

Question 6

What type of diuretic is furosemide?

Answer 6

loop (ascending)

Question 7

loading dose for amiodarone

Answer 7

300mg for cardiac arrest; 150mg for cardiac dysrhythmias

Question 8

infusion dose of insulin

Answer 8

0.5 -3 units/hour

Question 9

phenylepherine acts on which receptors?

Answer 9

alpha 1

Question 10

which vasoactive infusion drugs must be protected from light?

Answer 10

Sodium Nitroprusside, Nifidipine, and Nicardipine must be protected from light

Question 11

Why is there a risk of hypokalemia with HCTZ usage

Answer 11

Potassium will be wasted in the urine

Question 12

HCTZ, side effects

Answer 12

*Hypokalemic Hypochloremic Metabolic Alkalosis, orthostatic hypotension, dysrhythmias, hypoK+, hypovolemia, hyperglycemia, hyperuricemia, renal/hepatic failure

Question 13

Propofol TIVA infusion dose

Answer 13

TIVA: 100-200 mcg/kg/min

Question 14

meperidine side effects

Answer 14

Anti-muscarinic effects (atropine-like), tachycardia, seizures, itching, histamine release

Question 15

Which vasoactive drug exhibits tachyphylaxis on infusion?

Answer 15

SNP

Question 16

sympathomimetics with negligible effect on beta-2 adrenergic receptors

Answer 16

Norepi, Phenylephrine, Methoxamine

Question 17

epinephrine infusion, dosage rate

Answer 17

4-10 mcg/min

Question 18

droperidol contraindications

Answer 18

Increases QT interval, so contraindicated in patient’s with prolonged QT intervals already. Also contraindicated in parkinson’s disease.

Question 19

NTGs mechanism of action

Answer 19

increases NO release from tissues; NO upregulates cGMP = vasodilation

Question 20

propofol - reason for white appearance

Answer 20

Scattering of light from the very small (150nm) oil droplets

Question 21

time for infusion of vancomycin

Answer 21

at least 45 mins

Question 22

action of hydromorphone

Answer 22

μ-opiod agonist; 8x as potent as morphine

Question 23

SNP tachyphylaxis can be an early warning for what? How is it treated?

Answer 23

An early sign of cyanide toxicity; Treatment: stop the infusion, 100% O2, treat the acidosis with sodium bicarb…a sodium thiosulfate infusion will bind the excess cyanide…a sodium nitrite infusion will increase methemoglobin to bind more cyanide