PEMS 10 mins

Question 1

What is the T1/2 Ke0 of Remi?

Answer 1

1.3 mins

Peak effect 1.6 mins

Question 2

What is the Vd of Remi?

Answer 2

0.07 L/kg

confined in plasma

Question 3

What would be the dose of Remi required to achieve an effect site target concentration of 2ng/ml?

Answer 3

Bolus dose = desired conc x Vdc

= 2ng/ml x 5000 = 10000ng = 10microg

Usually higher than this to compensate for effect site distribution

Question 4

In diathermy, what is the function of an isolating capacitor?

Answer 4

Capacitor between patient’s plate and earth.

• Provides high resistance to low frequency current and prevent micro/macroshock
• Low resistance to high frequency diathermy current.

High frequency current has low tissue penetration.

Question 5

What is the pharmacological effect of echinacea?

Answer 5

improves immune system; stimulate macrophage and NK cells, modulate cytokines

Question 6

What is the risk of echinacea in peri-op context?

Answer 6

hepatotoxicity

Question 7

Which herbal medicine increases risk of bleeding?

Answer 7

garlic
ginger
ginseng

Question 8

What is the Pharm effect of ginseng?

Answer 8

mild sympathomimetic, can interact with MAO
Hypoglycaemic effect
inhibition of platelet aggregation

Question 9

What is the speed in which sound wave travels through the body?

Answer 9

1540m/s

Question 10

Which receptors do naloxone bind to?

Answer 10

all opioid receptors with greatest affinity to mu receptors

Question 11

oral bioavailability of naloxone?

Answer 11

20% due to significant first pass

Question 12

How is naloxone metabolised?

Answer 12

hepatic glucuronide conjugation

Question 13

Adverse effects of naloxone?

Answer 13

N/V
Increase SNS activity
HTN
pulmonary oedema

Question 14

Digoxin toxicity ECG changes

Answer 14

Frequent PVC
Sinus bradycardia
AV block
VT

Question 15

Normal ECG changes with digoxin

Answer 15

QT shortening
Inverted, biphasic T waves
Slight PR prolongation
Presence of U waves