Pharm

Question 1

First order kinetics

Answer 1

Constant fraction

1/2 life’s

Question 2

Weak acids

Answer 2

Cations Na, K

Propofol and barbs

Question 3

Weak bases

Answer 3

Anions Cl-

Locals, opioids

Question 4

Blood gas partition coefficients

Answer 4

Halothane- 2.5 This is saying 2.5:1 or 250:100 parts in
ISO- 1.46 Blood over gas.
Sevo- 0.65 He is doing nothing, most to least soluble
Des- 0.42
Nitrous- 0.46

Question 5

Vapor pressures

Answer 5

Sevo- 170
Enflurane- 175

ISO- 240
Halo- 243

Question 6

A1 agonist

Answer 6

Increases CA+ causes muscle contraction

Phenylephrine

Question 7

A2 agonist

Answer 7

Inhibits adenylate cyclase which limits exocytosis of norepinephrine, in the CNS produces sedation and reduced sympathetic outflow leading to peripheral dilation and decrease BP.
Clonadine

Question 8

Beta 1 agonist

Answer 8

Activate adenylate cyclase➡️ATP to cAMP➡️positive chrono, ino, dromotrophic effects.

Question 9

Beta 2 agonist

Answer 9

Activates adenylate cyclase and promotes smooth muscle relaxation, gluconeogenesis, and insulin release
Promotes:
Hyperglycemia, hypokalemia.

Question 10

Alpha 1 Antagonist

Answer 10

Prazosin

Question 11

Alpha 2 antagonist

Answer 11

Yohimbine, used to treat impotence

Question 12

Beta antagonist

Answer 12

“OLOL”
A-M= beta 1
N-z= beta 2. ( with beta 2 blockade K+ levels increase)

Question 13

What drug class inactivate acetylcholinesterase and plasma cholinesterase? Examples?

Answer 13

Cholinesterase inhibitors

Reversal agents

Question 14

Cholinesterase inhibitor used to diagnose myasthenia gravis

Answer 14

Edrophonium, short acting, electrostatic bonds.

Give up to 10mg, if increased weakness it cholinergic crisis, if symptoms improve implies its myasthenia gravis.

Question 15

Neostigmine and pyridiostigmine

Answer 15

Covalent bond, also direct agonist effect on nicotinic receptors

Question 16

Antilirium?

Answer 16

Physostigmine, tertiary amine, crosses BBB, used to treat anticholinergic toxicity caused by antimuscarinic overdose.

Question 17

Echothiopate

Answer 17

Cholinesterase inhibitor
Irreversible bond, used to treat glaucoma

Can cause prolong SUCCS and mivacurium blockade bc pseudo cholinesterase inhibition.

Question 18

Cholinergic syndrome/crisis

Answer 18

Physostigmine or organic insecticide can produce symptoms of excessive acetylcholine
Miosis, salivation, Brady, bronchoconstriction, confusion, seizure

Tx with atropine

Cholinergic crisis cause by ANTICHOLINEesterase drug.

Question 19

Class of drugs that combine with muscarinic receptors and prevent acetylcholine from attaching to receptors. Examples

Answer 19

Antimuscarinic- atropine, glyco, scopolamine.

Most Tachy- atropine
Least sedation- glyco

Question 20

Anticholinergic syndrome

Answer 20

Response to high dose atropine or scopolamine.
Tachy, excitation, agitation, dry and flush skin

Tx with physostigmine

Anticholinergic syndrome caused by an ANTIMUSCARINIC.

Question 21

Myasthenia gravis

Answer 21

Autoimmune Destruction of post synaptic acetylcholine receptors
Causing weakness, fatigue of skeletal muscle

Tx with Anticholinesterases, unknown response to succs, but very SENSITIVE to NDMB

Question 22

Myasthenic crisis

Answer 22

Acute exacerbation of myasthenia gravis

Question 23

Characteristics of muscle relaxants

Answer 23

100% ionized at PH
Highly protein bound
Do not cross BBB or Placenta
Trapped in renal tubule bc of ionization
All can be excreted in kidney if other routes unavailable

Question 24

Muscle relaxation and disease

Answer 24

Disease that cause increase in ACH RECEPTORS such as muscle denervation injury make the patient sensitive to SUCCS but bc more receptors require increase dose of NDMB.

Dsease like myasthenia decrease receptors so the opposite is true.

Question 25

Long acting NDMR

Answer 25

PGP- MD Pancuronium,gallamine, pipecuronium Metocurrarine, d-tubocurarine

Question 26

Intermediate acting NMB

Answer 26

Vec and roc

Question 27

Short acting

Answer 27

Miv Atra And cistatracurium

Question 28

Renal excretion primary route

Answer 28

All long acting | PGP-MD

Question 29

Biliary Excretion primary route

Answer 29

Vec and roc

Question 30

METAbolism primary route of elimination

Answer 30

Succs- pseudocholinesterase Mivacurium- plasma cholinesterase Atracurium- ester hydrolysis and hoffman Cistatracurium- Hoffman

Question 31

Relaxants with histamine release

Answer 31

``` DAMMS d-tubo Atra Mivacurium Metocurarine Succs ```

Question 32

Relaxants with Autonomic blockade

Answer 32

MD Metocurarine D-tubo

Question 33

Relaxants with bradycardia

Answer 33

Succs

Question 34

Relaxants with tachycardia

Answer 34

Reflex- MAD Metocurarine, atra, d-tubo Antimuscarinic- Pancuronium Gallamine

Question 35

Hypotension from NMB

Answer 35

Succs, d-tubocurarine, metocurarine

Question 36

Hypertension from NMB

Answer 36

Pancuronium and Gallamine

Question 37

Opioid receptors

Answer 37

Mu1- euphoria, pruitus, low abuse, supraspinal Mu2- resp depression, dependence, constipation, spinal analges Kappa- dysphoria, sedation, low abuse potential Delta- resp depression, dependance, constipation

Question 38

Opioid agonist/antagonist

Answer 38

Nubaine, stadol Work on kappa and delta

Question 39

Zero order kinetics

Answer 39

Constant amount (2mg per min) Alcohol, Asa, phenytoin