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Drugs Flashcards

(44 cards)

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1
Q

what benzo is metabolized exclusively through hepatic glucuronidation

A

lorazepam

good L aka GL= lorazzepam

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2
Q

phosphogene

A

chemical warefare agent that can cause severe pulmonary damage, treatment is supportive

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3
Q

interaction between non depolarizatizing neuro muscular blocking agents

A
  1. augmentation of antagonists affinity at receptor site
  2. central effects on alpha motor neurons and synapses
  3. inhibitiion of post synaptic nicotinic receptors

order of effect greatest to least:
des> sevo> iso> halogene > NO/propofol

think des is longer acting so has the strongest effect

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4
Q

mechanims of action of NO

A

breaks down GTP into GMP which is a smooth muscle dialator and anti inflammatory and inhibits platelet aggregation

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5
Q

what inhaled agent should be avoided in children w asthma

A

desflorane can cause increased airway reactivity and bronchospasms in children with ongoing pulm issues

** think if u give DES

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6
Q

what inhaled agent should be avoided in children w asthma

A

desflorane can cause increased airway reactivity and bronchospasms in children with ongoing pulm issues

** think if u give DES to asthma patient they may end up DED

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7
Q

protective mechanisms for spinal cord ischemic injury during aorta cross clamping include:

A

shunts
bypass
hypotherapy
spinal drain placement

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8
Q

drugs that prevent physiologic hypoxic pulmonary vasoconstriction

A
  1. nitroprusside
  2. nitroglycerine
  3. ACE
  4. ARB
  5. CCB
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9
Q

what drugs cause direct cerebral vasodilation

A 
nitroglycerine 
nitroprusside 
CCB
adenosine 
hydralazine
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10
Q

which drugs can potentiate the effects of neuromuscular blockades

A

aminoglycosides
tetracyclines
lincomycin
polymyxin

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11
Q

what drugs are associated w intense perineal itching

A

dexamethasone

fospropofol

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12
Q

long term use of barbituates causes what change to cytochrome p450

A

induces cyt p450 so will need higher doses of benzos etc. and other drugs metabolized by that enzyme

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13
Q

what drug works via the kappa opioid receptor

A

meperidine
1/10 as potent for analgesia as morphine
used for shivering

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14
Q

what drug works via the kappa opioid receptor

A

meperidine
1/10 as potent for analgesia as morphine
used for shivering

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15
Q

what drug is a glutamate antagonist

A

ketamine

NMDA is a subset of excitatory glutamate receptor

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16
Q

whats the concern with giving hydromorphone in renal insufficiency patients

A

all the mu opioid side effects will be metabolized by the liver so thats fine
but hydropmorphone via liver breaks down into H3G which is NEUROtoxic and removed by kidneys

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17
Q

what inhaled anesthetic can inhibit DNA synthesis in fetus

A

chronic NO expsosure can cause megaloblastic anemia

the rest of them are safe

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18
Q

what volatile gas blunts the baroreceptor reflex

Study These Flashcards
A

isoflurane

think iso..static…no responding ….aka blunting baroreceptor

19
Q

what beta blocker is most likely to cause bronchoconstriction

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A

labetalol

mixed receptor blocker….beta 2 blockade causes bronchoconstriction

20
Q

how does precedex effect evoked potential monitoring

Study These Flashcards
A

precedex mimics non rem sleep–

so it will have little effect on evoked potential monitoring

21
Q

high altitude pulmonary edema is is from diffuse hypoxic pulmonary constriction.. what drugs will prevent HAPE

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A

nifedipine and PDE-5 inhibitors

22
Q

hepatic metabolism of what gas causes inorganic fluoride production

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A

Sevo

think sevo SEEPS into body (liver) and will give u the FLU (fluoride)

23
Q

what class of drugs can decrease clopedigrel’s efficacy

Study These Flashcards
A

PPI

think PPI poop (make worse) on clopedigrel

24
Q

what is doxapram and when is it used clinically

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A

respiratory stimulant, stmulates chemoreceptors on carotid body
used in hypercapnic respiratory failure in COPD patients with supplemental oxygen

25
what receptors does epinephrine hit
alpha 1 causing vaso constriction but also beta receptor agonist causing vasodilation in coronary vesse;s (think beta agonism is why its used for bronchospasm)
26
what is the MOA of cilostazol
PDE3 inhibitor aka increases cAMP leading to vasodialtion | its also a anti platelet ?
27
what opioids re metqabolized by liver
fentanyl aka good option for renal patients | hydrocodone ---> H3G, if this accumulates its neuro excitatory
28
what is isproterenol MoA
nonselective beta agonist can be used for heart block or bradycardia remember b1 is for the heart
29
morphine and atracurium release what that means asthma exacerbation a possbilit y
histamine
30
what volatile anesthetics potentiates neuromuscular the most
desflurane think DES = DEATH bad for asthmatics will be the one to prolongate NMDA the most.. think MOST death the longest
31
how is the drug effect of succinhylcholine mostly terminated
there is some psuedocholinesterase activity but the termination of the drug effect is mostly through succ passive diffusion out of the neuromuscular junction
32
how is the drug effect of succinhylcholine mostly terminated
there is some psuedocholinesterase activity but the termination of the drug effect is mostly through succ passive diffusion out of the neuromuscular junction
33
what is the initial dose vs the dose after acute rxn for dantrolene treating MH
intitially do 2.5 mg/kg every 5 ish minutes think MH has 2 letters + give every 5 min so dose is 2.5 then 1 mg/kg every 4-6 hours or 0.25 mg/kg/hr infusion for 24 hours
34
how does milirione effect preload
decreases preload because of venodilation but overall improved CO and SV
35
when stopping an irresversible antiplatlet drug how many platelts are replenished in 24 hours
10%-14% every 24 hours so can take 7-10 days to replenish the whole pool
36
what drug is ppx for organophosphate poisoning
pyridostigmine must be taken 30 min prior to organophosphase exposire, it prevents organophospahtes from binding to the AcHase it will bind to the first line treatment is atropine then pralidoxime is the definite treatment
37
what are risk factors for bradycardia when giving succ
repeat succ doses | young age
38
which inhaled anesthetic decreases BP mainly by decreasing cardiac output
halothane
39
what drug increases ICP
ketamine
40
oral dose of versed in peds patients
0.5 mg/kg
41
how doe hypercalcemia afffect roc
causes antagonism of roc so u will need higher doses
42
what drugs decrease IOP
benzos barbituates volatile anesthetics
43
common complications of spinal anesthesia
think unopposied parasympathetic ``` post dural puncture headache increased ventilatory response to hypercapnia vasodilation increased GI activity hypothermia/vasodilation transient hearing loss ```
44
mechanisms by which mag causes hypotension
calcium antagonism in vascular smooth muscle | more NO production

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