key terms final

Question 1

what do you use for antimicrobial prophylaxis in a clean orthopedic procedure?

Answer 1

none

Question 2

How do volatile anesthetics affect coronary blood flow?

Answer 2

Iso is a potent coronary vasodilator, may cause coronary steal
Other volatiles are weak coronary vasodilators

Question 3

What is the clinical use of phentoalamine?

Answer 3

nonselective Competitive alpha blocker used in acute hypertensive emergency, i.e. pheochromocytoma or autonimic nervous system hyperreflecxia

Question 4

What are the side effects of protamine?

Answer 4

Allergy
hypotension
Pulmonary hypertension

Question 5

What is the mechanism of action of ondansetron?

Answer 5

5Ht3 blocker

Question 6

What is used for antimicrobial prophylaxis in head and neck surgery in a pt with a cephalosporin allergy?

Answer 6

clinda (600-900)+ genta (1.5mg/kg)

Question 7

How is flumazenil metabolized?

Answer 7

100% hepatic

Question 8

What is the mechanism of action of coumadin?

Answer 8

Vitamin K antagonist causes defective vitamin K factors (2,7,9,10)

Question 9

Which opioid is associated with siezure?

Answer 9

merperidine

Question 10

Which beta blocker is used to treat glaucoma?

Answer 10

Timolol

Question 11

What is the potency of opioids from least potent to most?

Answer 11

(0.1)Merperidine<(500-1000)Sufentanyl

Question 12

How is metformin metabolized?

Answer 12

Cleared by kidneys 100% unchanged

Question 13

Which is the quickest acting opioid?

Answer 13

Remifentanyl–6-12 min duration

Question 14

Which drugs are examples of class IV?

Answer 14

Verapamil and Diltiazem

Question 15

Lidocaine is used to tx _______ arrhythmias

Answer 15

ventricular

Question 16

At what receptor occupancy does midazolam cause
anxiolysis
sedation
unconsciousness

Answer 16

anxiolysis: 20%
sedation 30-50%
uncosciousness: 60%

Question 17

What is the onset of edrophonium?

Answer 17

shortest of the anticholinesterase

Question 18

What is the mechanism of class IV antidysrhythmics?

Answer 18

Ca+ channel blockers

decrease action potential duration

Question 19

What is the effect of induction drugs on ICP?

Answer 19

decreased

Question 20

Which opioids should you not use in a pt with renal failure?

Answer 20

merperidine and morphine

Question 21

What is the order of volatile agents from lowest blood:gas coefficient to highest

Answer 21

Desflurane (.42)<Halothane

Question 22

What are examples of oral anticoagulants?

Answer 22

coumadin and pradaxa

Question 23

How much cardiac output goes to each of the tissue groups?

Answer 23

VRG-75%
Muscle-19%
Fat-6%

Question 24

What is the duration of action for regular insulin?

Answer 24

6-10 hours

Question 25

What is the mOA for Hirudin?

Answer 25

direct thrombin inhibitior: Supresses platelet function

Question 26

What is the order of most metabolized to least metabolized volatile anesthetics?

Answer 26

Halothane-20%>Sevo 2-5%>Iso .2%>Des 0

Question 27

HOw do NSAIDS work and what happens if you give a whole lot?

Answer 27

Inhibition of both cyclooxygenase without specificity | ceiling effect--exceeding recommended dose only adds to risk of toxicity

Question 28

What determines the rate local anesthetics are absorbed?

Answer 28

``` dosage site of injection drug tissue binding local blood flow addition of a vasocontrictor ```

Question 29

What is the mechanism of action of histamine antagonists?

Answer 29

Antagonize histamine receptor/ do not decrease amount of histamine (except H3)

Question 30

What is the pH of thiopental?

Answer 30

10.5

Question 31

What is the side effect of sulfonylureas?

Answer 31

hypoglycemia

Question 32

Which local anesthetics cause methemoglobinemia?

Answer 32

prilocaine and benzocaine

Question 33

What is the concentration for epi added to local anesthetics?

Answer 33

1:200000 aka 5mcg/ml

Question 34

What does NPH stand for ?

Answer 34

neutral protamine hagedorn

Question 35

What is the toxic dose of lidocaine without epi? | with?

Answer 35

without 5mg/kg | with 7mg/kg

Question 36

What is the treatment for methemoglobinemia?

Answer 36

methylene blue 1-2 mg

Question 37

What is Im dose for induction with ketamine?

Answer 37

4-8mg/kg

Question 38

what are contraindications for droperidol?

Answer 38

prolonged QT and parkinsons

Question 39

What is toxic doses of bupivicaine w/ and w/out epi?

Answer 39

without 2.5mg/kg | with 3mg/kg

Question 40

What is the gold standard K+ sparing diuretic?

Answer 40

triamterene | amiloride was the other one listed as an example

Question 41

What does VRE stand for?

Answer 41

Vancomycin resistant enterococcus

Question 42

What does MRSA stand for

Answer 42

methicillin resistant staphylococcus aureus

Question 43

What is the intubating dose for cisatracurium?

Answer 43

.1mg/kg (-.15mg/kg)

Question 44

What do you give for Anticholinergic overdose?

Answer 44

physostygmine

Question 45

What infusion rates of epi are associated with alpha1? beta1? beta2?

Answer 45

Alpha1 1-2 mcg/min Beta1 4mcg/min Beta2 10-20 mcg/min

Question 46

In the 2006 medical letter guidelines which antibiotic is indicated for bowel procedures?

Answer 46

cefoxitin

Question 47

What do you give to treat biliary colic from opioids?

Answer 47

glucagon 2mg iv

Question 48

Which opioid receptor do enkalphalins bind to?

Answer 48

delta

Question 49

Which opioid receptor do dynorphins bind to?

Answer 49

kappa

Question 50

Which opioid receptor is associated with feeling of dysphoria?

Answer 50

kappa--where agonist/antagonist work

Question 51

which opioid has atropine like effects?

Answer 51

merperidine

Question 52

Which diurectic is prescribed for IOP?

Answer 52

acetazolamide--carbonic anhydrase inhibitior

Question 53

how is esmolol metabolized?

Answer 53

plasma choliesterase

Question 54

what is ped dosage of ondansetron?

Answer 54

0.1mg/kg

Question 55

what is papaverin used for?

Answer 55

used by vascular surgeons not really us anastamoses (verapamil is derived from papavirine)

Question 56

what drug is contraindicated in porphyria>?

Answer 56

thiopental

Question 57

Which diuretic is prescribed for essential hyperetension?

Answer 57

hydrochlorothiazide (HCTZ)

Question 58

Which antibiotic is given for prophylaxis in a C section?

Answer 58

ancef | clinda and genta also listed

Question 59

How are opiods metabolized? whats the exception?

Answer 59

all hepatic except Remi-plasma and tissue esterases

Question 60

which ca++ channel blocker provides the best vasodilation?

Answer 60

Nicardipine

Question 61

which Ca++ channel blocker is used for cerebral vasospasm?

Answer 61

Nimodipine

Question 62

At what dose of SNP do you start sseing CN accumulation?

Answer 62

>2mcg/kg/min | (regular dose is 0.3-10 mcg/kg/min

Question 63

what is ratio of beta:alpha in labetalol?

Answer 63

oral 3:1 | IV 7:1

Question 64

name 2 alpha 2 agonists

Answer 64

clonidine alpha2:1 200:1 | dexametetomidine

Question 65

which antacid does not cause acid rebound?

Answer 65

MgOH

Question 66

which nsaid is used to close a PDA?

Answer 66

indomethecin

Question 67

what are the effects of Beta 2 agonist?

Answer 67

vasodilation Increased glucose secretion gluconeogenesis ad glycogenolysis are inhibited

Question 68

How do volatile anesthetics affect cerebral blood flow?

Answer 68

all increase

Question 69

Which inhaled agent causes bone marrow supression?

Answer 69

NO

Question 70

What is the formula for uptake?

Answer 70

solubility x CO x (Pa-Pv)

Question 71

which induction agent causes adrenocorticoid supression?

Answer 71

etomidate | other sides: myoclonus, hiccups, increased PONV

Question 72

which H2 blocker inhibits cytochrome p450 nand may delay lido metabolism

Answer 72

cimetidine (tagamet)

Question 73

what are side effects of neuraxial opioid adminitstration?

Answer 73

respiratory depression, urinary retention, and itching/pruritis