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Flashcards in key terms final Deck (73)
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1
Q

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

A

none

2
Q

How do volatile anesthetics affect coronary blood flow?

A

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

3
Q

What is the clinical use of phentoalamine?

A

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

4
Q

What are the side effects of protamine?

A

Allergy
hypotension
Pulmonary hypertension

5
Q

What is the mechanism of action of ondansetron?

A

5Ht3 blocker

6
Q

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

A

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

7
Q

How is flumazenil metabolized?

A

100% hepatic

8
Q

What is the mechanism of action of coumadin?

A

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

9
Q

Which opioid is associated with siezure?

A

merperidine

10
Q

Which beta blocker is used to treat glaucoma?

A

Timolol

11
Q

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

A

(0.1)Merperidine<(500-1000)Sufentanyl

12
Q

How is metformin metabolized?

A

Cleared by kidneys 100% unchanged

13
Q

Which is the quickest acting opioid?

A

Remifentanyl–6-12 min duration

14
Q

Which drugs are examples of class IV?

A

Verapamil and Diltiazem

15
Q

Lidocaine is used to tx _______ arrhythmias

A

ventricular

16
Q

At what receptor occupancy does midazolam cause
anxiolysis
sedation
unconsciousness

A

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

17
Q

What is the onset of edrophonium?

A

shortest of the anticholinesterase

18
Q

What is the mechanism of class IV antidysrhythmics?

A

Ca+ channel blockers

decrease action potential duration

19
Q

What is the effect of induction drugs on ICP?

A

decreased

20
Q

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

A

merperidine and morphine

21
Q

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

A

Desflurane (.42)<Halothane

22
Q

What are examples of oral anticoagulants?

A

coumadin and pradaxa

23
Q

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

A

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

24
Q

What is the duration of action for regular insulin?

A

6-10 hours

25
Q

What is the mOA for Hirudin?

A

direct thrombin inhibitior: Supresses platelet function

26
Q

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

A

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

27
Q

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

A

Inhibition of both cyclooxygenase without specificity

ceiling effect–exceeding recommended dose only adds to risk of toxicity

28
Q

What determines the rate local anesthetics are absorbed?

A
dosage
site of injection
drug tissue binding
local blood flow
addition of a vasocontrictor
29
Q

What is the mechanism of action of histamine antagonists?

A

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

30
Q

What is the pH of thiopental?

A

10.5

31
Q

What is the side effect of sulfonylureas?

A

hypoglycemia

32
Q

Which local anesthetics cause methemoglobinemia?

A

prilocaine and benzocaine

33
Q

What is the concentration for epi added to local anesthetics?

A

1:200000 aka 5mcg/ml

34
Q

What does NPH stand for ?

A

neutral protamine hagedorn

35
Q

What is the toxic dose of lidocaine without epi?

with?

A

without 5mg/kg

with 7mg/kg

36
Q

What is the treatment for methemoglobinemia?

A

methylene blue 1-2 mg

37
Q

What is Im dose for induction with ketamine?

A

4-8mg/kg

38
Q

what are contraindications for droperidol?

A

prolonged QT and parkinsons

39
Q

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

A

without 2.5mg/kg

with 3mg/kg

40
Q

What is the gold standard K+ sparing diuretic?

A

triamterene

amiloride was the other one listed as an example

41
Q

What does VRE stand for?

A

Vancomycin resistant enterococcus

42
Q

What does MRSA stand for

A

methicillin resistant staphylococcus aureus

43
Q

What is the intubating dose for cisatracurium?

A

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

44
Q

What do you give for Anticholinergic overdose?

A

physostygmine

45
Q

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

A

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

46
Q

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

A

cefoxitin

47
Q

What do you give to treat biliary colic from opioids?

A

glucagon 2mg iv

48
Q

Which opioid receptor do enkalphalins bind to?

A

delta

49
Q

Which opioid receptor do dynorphins bind to?

A

kappa

50
Q

Which opioid receptor is associated with feeling of dysphoria?

A

kappa–where agonist/antagonist work

51
Q

which opioid has atropine like effects?

A

merperidine

52
Q

Which diurectic is prescribed for IOP?

A

acetazolamide–carbonic anhydrase inhibitior

53
Q

how is esmolol metabolized?

A

plasma choliesterase

54
Q

what is ped dosage of ondansetron?

A

0.1mg/kg

55
Q

what is papaverin used for?

A

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

56
Q

what drug is contraindicated in porphyria>?

A

thiopental

57
Q

Which diuretic is prescribed for essential hyperetension?

A

hydrochlorothiazide (HCTZ)

58
Q

Which antibiotic is given for prophylaxis in a C section?

A

ancef

clinda and genta also listed

59
Q

How are opiods metabolized? whats the exception?

A

all hepatic except Remi-plasma and tissue esterases

60
Q

which ca++ channel blocker provides the best vasodilation?

A

Nicardipine

61
Q

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

A

Nimodipine

62
Q

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

A

> 2mcg/kg/min

(regular dose is 0.3-10 mcg/kg/min

63
Q

what is ratio of beta:alpha in labetalol?

A

oral 3:1

IV 7:1

64
Q

name 2 alpha 2 agonists

A

clonidine alpha2:1 200:1

dexametetomidine

65
Q

which antacid does not cause acid rebound?

A

MgOH

66
Q

which nsaid is used to close a PDA?

A

indomethecin

67
Q

what are the effects of Beta 2 agonist?

A

vasodilation
Increased glucose secretion
gluconeogenesis ad glycogenolysis are inhibited

68
Q

How do volatile anesthetics affect cerebral blood flow?

A

all increase

69
Q

Which inhaled agent causes bone marrow supression?

A

NO

70
Q

What is the formula for uptake?

A

solubility x CO x (Pa-Pv)

71
Q

which induction agent causes adrenocorticoid supression?

A

etomidate

other sides: myoclonus, hiccups, increased PONV

72
Q

which H2 blocker inhibits cytochrome p450 nand may delay lido metabolism

A

cimetidine (tagamet)

73
Q

what are side effects of neuraxial opioid adminitstration?

A

respiratory depression, urinary retention, and itching/pruritis