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pharm1 S.Horvath > GI > Flashcards

GI Flashcards

(70 cards)

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1
Q

early PONV

A

2-6h

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2
Q

late PONV

A

6-24h

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3
Q

delated PONV

A

> 24h post op

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4
Q

post discharge n/v

A

> 24h post dc

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5
Q

one risk factor %

A

20%

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6
Q

two risk factors %

A

40

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7
Q

three risk factors %

A

60

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8
Q

four risk factors %

A

80

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9
Q

post discharge NV risk factors

A

female, <50yo, hx of PONV, opiates in PACU, nausea in PACU

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10
Q

risk factors for children - procedure length

A

> 30min

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11
Q

risk factors for children - age

A

> 3 years

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12
Q

strabismus surgery is a risk factor for

A

children

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13
Q

child risk factor - history

A

history of PONV or PONV in relatives

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14
Q

who to pretreat?

A

moderate to high risk pt’s (3 or more risks)

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15
Q

which drug should you give before induction

A

dexamethasone

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16
Q

which drug do you give the evening before surgery or 4h prior to awakening

A

scop patch

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17
Q

which drug do you give 1-3 hours prior to surgery

A

aprepitant

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18
Q

impact trial

A

zofran+droperiodl vs dex…. both equally effective

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19
Q

which drugs are 5HT3 Antagonists

A

ondansetron, granisetron, dolasetron, palonosetron

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20
Q

what percent of gen pop experiences vomiting

A

30%

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21
Q

what percent of gen pop experiences nausea

A

50

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22
Q

top 3 PONC factors

A

female, history of PONV, non-smoker

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23
Q

GA has a __x higher risk of PONV than regional

A

9

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24
Q

every 30 min you increase PONV risk by

A

60%

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25
___ of patients experience PONV post discharge
1/3
26
which med has a long onset and long duration
dexmethasone
27
neurokinen receptor antagonist
aprepitant
28
5HT3 receptor is primarily located in
GI tract
29
5HT3 receptor ___ afferents
vagal, chemosenstive center
30
how are 5ht3's metablolized
liver. CYP3A4 450
31
Which 5HT3 is a prodrug
dolasetron
32
whats zofrans half life
4h
33
whats zofrans onset
15min IV, 30min PO
34
side effects of 5Ht3's
constipation, diarrhea, nausea, dizziness
35
whats a prolonged QTc
450 milliseconds and above
36
what is 5HT3's mechanism
antagonism
37
dexamethasone MOA
unknown, thought to be prostaglandin antagoinist, endorphin release.
38
side effects dex
impaired wound healing/infection, increased glucose, htn, edema, AMS
39
onset of dexamethasone
4-6h
40
half life of dexamethasone
35-54 h
41
what kind of drug is droperidol
anti-dopaminergic (D2)
42
droperiodl mildly works as
antihistamine, antiserotonergic
43
droperiold's main receptor is D2 but also works in the
chemoreceptor trigger zone
44
black box warning for droperiol
QT prolongation at doses >5mg
45
side effects of droperiol
dysphoria, hypotension, EPS
46
droperidol metabolism
hepatic
47
droperidol half life
2.3
48
dopamine in the brain - balance between
movement disorders like parkinson's and psychosis
49
which drugs are phenothiazines
promethazine (phenergan) and prochlorpromazine.
50
what is the MOA for phenothiazines
d2 receptor antagonist
51
how is phenothiazines metabolized
hepatic
52
what is the half life of phenothiazines
4-8h
53
issue with phenothiazines
highly sedating , EPS
54
what kind of drug is dimenhydrinate
h1 antagonist
55
what cranial nerve is associated with inner ear feeling - both cholinergic tracts and histimanergic tracts.
c8
56
which drug is also used to treat motion sickness
dimenhydrinate
57
BP effects of h1 antagonists like dimenhyrinate
may see htn since its anti-histamine
58
scopolamine is an ___ med
anticholinergic
59
when should you place scop patch
either prior to surgery or 4 hours prior to awakening
60
side effects of scop patch
blurred vision, dilated pupil on the same side patch is applied, constipation, urinary retention
61
what kind of drug is aprepitant (Emend)
neurokinin 1 receptor antagonist
62
where in the neuro system does aprepitatnt work
brain steam and dorsal vagal complex
63
what is the injectable form of Aprepitant called
fosaprepitant
64
substance P is blocked by
neurokinin 1 receptor antagonist (aprepitant )
65
aprepitant is reserved for
end of life, HIV, cancer, very serious GI upset, super expensive
66
what is substance p
hormonal type compound that is released in injury, trauma.
67
aprepitant side effects
few. generally pretty safe
68
aprepitant
cyp3A4 substrate and weak inhibitor
69
aprepitant half life
9-13h
70
aprepitant protein binding
highly

pharm1 S.Horvath (18 decks)

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