Pharm 1

Question 1

As part of the ERAS program, how does giving a patient a carbohydrate-rich drink 2 hours before surgery help?

Answer 1

It increases insulin sensitivity which decreases post op insulin resistance?

Question 2

How is surgery and general anesthesia associated with blood glucose?

Answer 2

Hyperglycemia

Also - higher catecholamine, cortisol, and glucagon levels

Question 3

What is the recommended MAC for surgical incision?

Answer 3

1.3

1.0 is where 50% of the population will move to surgical stimulation.

1.3 is where 95% will not move

Question 4

What type of pharmacokinetics is phase 2 reactions?

Answer 4

Conjugation

Question 5

What type of metabolism does morphine undergo?

Answer 5

Phase 2 - Conjugation

Turns into M3G and M6G

Then excreted in the urine

Question 6

M3G or M6G, which causes respiratory depression?

Answer 6

M6G

Question 7

High dose oxytocin leads to what electrolyte abnormality?

Answer 7

Hyponatremia - due to retaining water

Question 8

What is the reversal agent for Idarucizumab?

Answer 8

Dabigatran

Question 9

What is the reversal agent for apixaban?

Answer 9

Andexanet alfa (factor 10a inhibitor)

Question 10

How is chloroprocaine metabolized?

Answer 10

Plasma cholinesterase

Question 11

How is remifentanil metabolized?

Answer 11

Nonspecific tissue and plasma esterases

Question 12

What are the best treatments for opioid induced pruritus?

Answer 12

Opioid antagonists such as

Naloxone
Naltexone
Nalbuphine

Question 13

How does metoclopramide effect the pyloric sphincter? GI motility? Esophageal sphincter ?

Answer 13

Relaxes pyloric

Increases GI motility

Constricts esophageal

Question 14

How does lipid solubility effect the bioavailability of a drug?

Answer 14

The more lipid soluble, the more bioavailable

Question 15

How does molecular weight effect the bioavailability of a drug?

Answer 15

The smaller the weight, the more bioavailable

Question 16

How does blood circulation effect the bioavailability of a drug?

Answer 16

The more blood circulation, the more bioavailable

Question 17

How does a prodrug effect the bioavailability of a drug?

Answer 17

It decreases it

Question 18

How does a low first pass effect, effect the bioavailability of a drug?

Answer 18

It will have more bioavailability

Question 19

Bioavailability route chart; most? least?

Question 20

If the sevo vaporizer is filled with iso and is set at 2%, will there be a higher percentage delivered or lower?

Answer 20

Higher - at 2%, 3.4% iso would be delivered

Question 21

Drug receptor affinity and efficacy are determined by its.

Answer 21

Stereochemistry

Question 22

What is the antidote for anticholinergic syndrome or overdose?

Answer 22

Physostigmine

Question 23

What is used to treat cyanide toxicity?

Answer 23

Vitamin B12

Question 24

What is used to treat nerve gas?

Answer 24

Atropine

Question 25

What is used to as prophalaxysis for nerve gas?

Answer 25

Pyridostigmine

Question 26

How do nerve agents attack the body?

Answer 26

Inhibition of acetylcholinesterase

Question 27

What may be the first sign of a pneumothorax ?

Answer 27

Increased airway peak pressures

Question 28

Why is inhalational induction more rapid in infants than in adults?

Answer 28

They have a greater fraction of cardiac output to the vessel rich organ group

Question 29

Where do Non dihydropyridines work? Which phase?

Answer 29

Target L-type calcium channel Phase 0