Meds Flashcards
(135 cards)
1
Q
Isoflurane boiling point
A
48.5 *C
2
Q
Isoflurane vapor pressure
A
238 mmHg
3
Q
Isoflurane Blood:Gas coefficient
A
1.4
4
Q
Isoflurane Oil:Gas coefficient
A
90.8
5
Q
Isoflurane MAC
A
1.15
6
Q
Isoflurane MAC-awake
A
0.49
7
Q
Isoflurane MAC-BAR
A
1.3
8
Q
Des fluorine molecular weight
A
168
9
Q
Desflurane boiling point
A
23.5 *C
10
Q
Desflurane vapor pressure
A
664 mmHg
11
Q
Desflurane blood:gas coefficient
A
0.42
12
Q
Desflurane oil:gas coefficient
A
18.7
13
Q
Desflurane MAC
A
6%
14
Q
Desflurane MAC-awake
A
2.5%
15
Q
Desflurane MAC-BAR
A
1.3%
16
Q
Sevoflurane molecular weight
A
200
17
Q
Sevoflurane boiling point
A
58.5 *C
18
Q
Sevoflurane vapor pressure
A
160 mmHg
19
Q
Sevoflurane blood:gas coefficient
A
0.69
20
Q
Sevoflurane oil:gas coefficient
A
47.2
21
Q
Sevoflurane MAC
A
1.7%
22
Q
Sevoflurane MAC-awake
A
0.62
23
Q
Sevoflurane MAC-BAR
A
2.2
24
Q
N2O Molecular Weight
A
44
25
N2O boiling point
-88 *C
26
N2O vapor pressure
39,000 mmHg
27
N2O blood:gas coefficient
0.47
28
N2O oil:gas coefficient
1.4
29
N2O MAC
104%
30
N2O MAC-Awake
0.68
31
Thiopental sodium (Pentothal) induction dose
3-5 mg/kg
32
Thiopental sodium (Pentothal) half life?
3-8 hours
33
Methohexital (brevital) induction dose
1-1.5 mg/kg
34
What receptor do barbiturates act on?
GABAa receptors
35
Etomidate induction dose?
0.2-0.3 mg/kg
36
What is a big draw back of etomidate?
Suppresses cortical adrenals leading to suppression of intrinsic steroid production.
37
What are some properties of Methohexital (Brevital)?
Ultra short acting, rapid redistribution, highly protein bound, very lipid soluble
38
If a drug is highly lipid soluble, will it have a faster or slower onset of action?
Faster
39
What is one downfall to Methohexital (brevital)?
Hangover effect
40
What type of drug is etomidate?
Non-barbiturate hypnotic
41
What are some properties of etomidate?
Highly lipid soluble, undergoes redistribution but rapid return to baseline
42
What side effect does etomidate have?
Can cause extra pyramidal movements due to the dis inhibitory effect on sub cortical structures - can cause myoclonus. Can also cause PONV
43
What type of drug is propofol?
2,6 diisoporopyl pheno
44
What are some properties of propofol?
Ultra short acting, rapidly cleared, highly lipid soluble
45
How is propofol metabolized?
Cytochrome P450 sx to 4-hydroxyl propofol (active) then glycerin ideation or sulfation. Clearance exceeds hepatic blood flow implying an extra hepatic mechanism that is not yet identified (pulmonary?)
46
What type of drug is ketamine?
Phencycidine (PCP) derivative
47
What are some properties of ketamine?
Slow onset, can be used for preemptive analgesia
48
Where does ketamine work?
Thalamus and limbic systems - no competitive antagonist at NMDA receptor.
49
What are some side effects of ketamine?
- Increased airway secretions
| - dissociative hypnotic, vivid dreams, hallucinations possible
50
What are some possible benefits of ketamine?
Increases CPP via increases in MAP, bronchodilator
51
What type of drug is dexmedetomidine (preceded)?
Selective A2 agonist
52
How does dexmedetomidine work?
Decreases presynaptic NE levels (central), hyper polarizes post synaptic neural membranes (peripheral)
53
What is the loading dose of precedex?
1 mcg/kg given over 30 minuets
54
What is the infusion dose for precedex?
0.2-0.7 mcg/kg/hr
55
Thiopental distribution half life
2-4 min
56
What is the elimination half life of thiopental?
10-12 minutes
57
What is the clearance for thiopental?
3.5 ml/kg/min
58
What is the volume of distribution for thiopental?
2.5 L/kg
59
What is the protein binding for thiopental?
80%
60
What is the distribution half life for Methohexital?
5-6 min
61
What is the elimination half life for Methohexital?
2-4 min
62
What is the clearance rate of Methohexital?
10 ml/kg/min
63
What is the volume of distribution for Methohexital?
2.3 L/kg
64
What is the protein binding for Methohexital?
85%
65
What is the distribution half life for diazepam?
10-15 min
66
What is the elimination half life for diazepam?
20-50 min
67
What is the clearance rate for diazepam?
0.3 ml/kg/min
68
What is the volume of distribution for diazepam?
0.8-1.3 L/kg
69
What is the protein binding for diazepam?
98%
70
What is the distribution half life of midazolam?
7-15 min
71
What is the elimination half life of midazolam?
2-4 min
72
What is the clearance rate of midazolam?
7-11 ml/kg/min
73
What is the volume of distribution of midazolam?
1-1.7 L/kg
74
What is the protein binding of midazolam?
94%
75
What is the distribution half life of etomidate?
2-4 min
76
What is the elimination half life of etomidate?
2-5 min
77
What is the clearance rate of etomidate?
22.5 ml/kg/min
78
What is the volume of distribution for etomidate?
2.4-4.5 L/kg
79
What is the protein binding of etomidate?
75%
80
What is the distribution half life of propofol?
2-4 min
81
What is the elimination half-life of propofol?
1-5 min
82
What is the clearance rate of propofol?
25 ml/kg/min
83
What is the volume of distribution of propofol?
2-6 L/kg
84
What is the protein binding for propofol?
98%
85
What is the distribution half-life if ketamine?
11-17 min
86
What is the elimination half-life of ketamine?
2-3 min
87
What is the clearance rate of ketamine?
14.5 ml/kg/min
88
What is the volume of distribution for ketamine?
2.5-3.5 L/kg
89
How much of ketamine is protein bound?
12%
90
What is the induction dose of thiopental?
2-4 mg/kg
91
What is the induction dose of Methohexital?
1-2 mg/kg
92
What is the induction dose of etomidate?
0.2-0.3 mg/kg
93
What is the induction dose for propofol?
1-2.5 mg/kg
94
What is the induction dose of ketamine?
0.1-0.2 mg/kg
95
What is the induction dose of midazolam?
0.1-0.2 mg/kg
96
Of the 3 bentos, what is the shortest acting?
Midazolam
97
Of the 3 benzos, which is the longest acting?
Diazepam
98
Of the 3 benzos, which is the intermediate acting?
Lorazepam
99
What are some key points of midazolam?
- highly lipid soluble
- Rapid onset
- short duration of action due to lipid solubility
- Rapid redistribution
- hepatic bio transformation
100
What receptor does midazolam act on to produce sedation?
GABA
101
Opioids act at which receptor?
Mu1 receptors
102
Are opioids act as agonists or antagonists at receptor to provide analgesia?
Agonists
103
What are the side effects at mu2 receptors?
- respiratory depression
- Brady cardia
- Dependence
- Illeus
104
What do analgesics do?
Provide pain relief, blunt autonomic response to stress, produce CNS depression
105
What are some properties of ketorolac?
- inhibits prostaglandins
- 30 Times more potent than morphine
- Antiplatelet effects
106
What type of drug is ketorolac?
NSAID
107
What type of drugs are nalbuphine and butorphanol? What do they do?
Mixed agonist/antagonist.
- Agonist at kappa
- antagonist at mu
108
What do opioids do to the CO2 curve?
Shifts it to the right - causes less response to increases in CO2
109
Which is a more reliable form of amnesia and anesthesia between opioids and benzos?
Benzos
110
What are some other opioid properties/side effects?
- increase PONV
| - decreased CBF and ICP
111
Histamine release is caused with which opioid?
Morphine
112
Which drug is 100 times as potent as morphine?
Fentanyl
113
Compared to morphine, does fentanyl have a faster or slower onset of action?
Faster because it's more lipid soluble
114
Compared to morphine does fentanyl have a longer or shorter duration of action?
Shorter
115
Between fentanyl and morphine, which has the narrower therapeutic index?
Morphine
116
What are some side effects of fentanyl?
Truncal rigidity and bradycardia
117
Which drug is 10 times as potent as fentanyl and why?
Sufentanil - higher affinity for receptor
118
Is Sufentanil more or less lipid soluble than fentanyl? What does this mean?
More lipid soluble - faster onset and shorter duration
119
Does sufentanil of fentanyl have a wider therapeutic index?
Sufentanil
120
What are side effects of sufentanil?
Bradycardia and truncal rigidity
121
Which drug is 1/5-1/10 the potency of fentanyl? Why?
Alfentanil - low affinity for receptor
122
What is the onset of action of alfentanil?
Very rapid (1-2 min)
123
How much of alfentanil is unionized? What does this mean?
90%, allows it to rapidly cross the BBB
124
What allows alfentanil to have 1/3 as quick of a duration of action compared to fentanyl?
Because of the rapid redistribution and hepatic clearance
125
What is the onset of action, peak and duration of ketorolac?
Onset - 45-60 min
Peak - 1-2 hours
Duration 4-6 hours
126
How is ketorolac metabolized?
Glucagon if acid conjugation in the liver
127
How much of ketorolac is protein bound?
99%
128
Where is ketorolac eliminated?
Kidneys
129
What does ketorolac do to platelets?
Inhibits platelet thromboxane production via inhibition of prostaglandin synthesis
130
What can ketorolac cause in those sensitive to ASA?
Severe bronchospasm.
131
Ketorolac can cause renal insufficiency, how?
Inhibits synthesis of renal prostaglandins
132
What can be done to help prevent renal impairment when giving ketorolac?
Adequate fluid resuscitation.
133
Ages 16-64, what is the dosing of ketorolac? Max dose?
30 mg IV, IM or PO q 6 hours, not to exceed 120 mg/24 hours and not to exceed 5 days
134
Ages greater than 64 ketorolac dosing? Max dose?
15 mg IM, IV, or PO q 6 hours, not to exceed 60 mg/day for 5 days
135
Isoflurane molecular weight
184.5
