Pharm Flashcards
(34 cards)
Glycopyrrolate is classified as these 2 drug classes Drug Classes.
It binds to _______________ ______________. which inhibits the ____________ effects of ______________.
AntiCholinergic and AntiMuscarinic .
Binds to Muscarinic Receptors (M1,M2, M3), which inhibits the Parasympathetic effects of ACh.
Neostigmine Drug Classes (2).
It causes an increase in _______________ levels and can stimulate the _____________ _____________, causing _______________.
Parasympathomimetic & AcetylCHolinEsterase Inhibitor.
It causes an increase in ACh levels and can stimulate the Vagus Nerve causing Bradycardia.
Transplanted Hearts won’t respond to ? Why?
Glycopyrrolate and Atropine. Due to severed Vagus Nerve during Heart Tx Sx.
Glycopyrrolate blocks ___________ receptors in the Heart which prevents the ______________ effects of ______________ therefore preventing _____________.
Blocks M2 Receptors in the Heart which prevents the Parasympathetic effects of ACh therefore preventing Bradycardia.
Order of Induction Medication Administration
1) Amnestic/ Anxiolytic (Versed in Pre-Op)
2) Analgesic
3) Lidocaine
4) Hypnotic- Propofol (Wouldn’t give more than 1 vial)
5) NMBA
Weak Bases (LA and Opioids) : __________ Before _______
pK Before pH
Weak Acids (Barbiturates): ______ after _______
pK After pH
Support pt’s with decreased cortisol levels with ______ mg of ________ before administering Etomidate
15 mg Solu-cortef
Etomidate S/E:
(5)
Myoclonic movements (avoid in hx of Sz),
Cerebral Vasoconstrictor,
Decreases ICP,
Inhibition of Stress Response,
Rapid IV injection => apnea
Ketamine has cumulative effect due to Benzethonium Chloride (preservative) with
Fentanyl
Allergy to Neostigmine or morphine, has cross reactivity allergy to ___________ ___________ _________
• Quaternary ammonium NMBA’s; ex: Tubocurarine, Pancuronium, Vecuronium
DC 24 hours before Sx:
1) ACE inhibitors and ARBS
2) SGLT2 inhibitors
3) Sildenafil (unless taking for PHTN)
Which 5 medications must be avoided due to risk of Serotonin syndrome if patient is taking antidepressants (do not stop for sx)?
Norephinephrine, Ephedrine, Fentanyl, Tramadol, Meperidine (Demerol),
DC 4 weeks before surgery
1) If High-risk pt for post-op venous thrombosis - DC oral contraceptives
2) Post-menopausal HRT
DC 10-14 days before surgery
ASA - Cont in pts w/ prior PCI, high-grade ischemic heart disease or significant CVD
How long before before surgery DC P2Y12 inhibitors (clopidogrel, ticagrelor, prasugrel, ticlopidine)
Clopidogrel, ticagrelor… d/c 5-7 days
◦ Prasugrel… d/c 7-10 days
◦ Ticlopidine… d/c 10 days
◦ Do not d/c in drug-eluting stents until 6 months of dual antiplatelet therapy is completed*
◦ Continue in pt for cataract sx w/ topical or general anesthesia*
DC Warfarin before surgery
5 days
Continue in pt for cataract sx w/ topical or general anesthesia*
Gycopyrrolate reduces vagal tone by
blocking the Vagus nerve’s effects at Muscarinic receptors
Drugs that cause CYP450 Inhibition (=> Increased drug levels) and a longer BZD Duration
(5)
Fentanyl
Antifungals
CCBs
Cimetidine (Tagamet)
Erythromycin
FACCE
Medication given to Antagonize ventilators depression but not analgesia (ex: too much versed)
Physostigmine
Meds to treat Post op shivering :
Meperidine (Demerol) ( Mu and K Receptors)
Clonidine, Dexmedetomidine (Alpha 2 Agonists)
Physostigmine, Tramadol (Ultram)
Effect Site Equilibration is AKA
Onset of Action
DC on day of surgery
1) Diuretics (continue thiazides)
2) Non-Insulin Anti-diabetic meds (except SGLT2 Inhibitors= dc 24 hrs before sx)
3) Topical creams
BMI:
Imperial Formula
Metric Formula
