Pharm

Question 1

Ibuprofen

Drug Classification?

MOA?

Answer 1

Classification: NSAIDs, analgesic, antinflammatory, antipyretic

MOA: non-selective COX inhibitor; decreases production of protglandins (inflammatory mediators) and thromboxane

Question 2

Acetaminophen

Answer 2

MOA

analgesic -

pregnancy- B

neurotoxicity /headaches

Question 3

Amoxicillin

Answer 3

MOA

500 mg TID

inhibit cell wall syntheisis

broad spec

Pen V K 500mg x qid

Question 4

Clindamycin

Answer 4

MOA

Question 5

Midazolam Classification

paradoxical reaction-

Answer 5

Classification: Benzodiazepine/CNS depressant

(Versed)

Question 6

Midazolam Pharmacological effects

Answer 6

Effects: -sedative-hypnotic -anxiolytic -anterorgrade amnesic properties ( no retrograde) -Muscle relaxant -Anticonvulsant

Question 7

Midazolam: Duration of action Dosage T ½ life

Answer 7

Duration of Action: Rapid onset (0.5 - 2 mins) short duration of action Doseage 0.01 -0.1mg/kg T ½ life: 2 hours

Question 8

Midazolam Mechanism of Action?

Answer 8

MOA: increase activity of inhibitory NT GABA

Question 9

Midazolam: Metabolism? Elimination?

Answer 9

Metabolism: hepatic CYP Elimination: Kidney

Question 10

Midazolam: Contraindications Pregnancy category

Answer 10

Contraindications: narrow angle glaucoma, severe respiratory disease (COPD), heart failure, impaired hepatic/renal function Pregnancy: D

Question 11

Midazolam: reversal agent

Answer 11

Reversal drug: Flumazenil- competitive antagonist; 0.2mg q 60secs- lasts 20 mins - caution: resedation can occur

Question 12

Propofol MOA

Answer 12

MOA: poorly understood- modulates function of NT GABA and its receptors to produce anaesthesia (NO ANALGESIA)

Question 13

Fentanyl Indications:

Answer 13

Indications: IV induction, maintenance and recovery of general anaesthesia

Question 14

Fentanyl Drug Classification:

Answer 14

Analgesic: opioid agonist 100x potency of morphine

Question 15

Fentanyl Dose

Answer 15

Dose: 0.5 mcg/kg load; 0.01-0.04 mcg/kg/min maintenance

Question 16

Fentanyl MOA

Answer 16

• activation mu receptors and subsequent decrease of Ca influx and hyperpolarization of cell and inhibition of nerve activity

MME morphine mg equivalents- morphine is 1

Question 17

Fentanyl Pharmokinetics Onset Duration Metabolism Elimination T ½ life

Answer 17

Onset: 1-3 mins

Duration: 30-60 mins

Metabolism: hepatic cytochrome P450

T1/2: 7 hours

Question 18

Propofol Classification? Indication?

side effects

buring at site

Answer 18

Classification: IV anaesthetic, sedative/hypnotic Antiemetic properties

Indication: an induction and maintenance agent for general anaesthesia; may also be used as a sedative

Question 19

Propofol Pharmakinetics Onset/duration Metabolism Elimination T ½ like Dose

Answer 19

1. rapid induction (was 15-30 secs); short duration (5-10 mins); rapid recovery 2. Metabolism: hepatic - glucouronidation and CYP enzymes; 3. elimination: inactive metabolites excreted by kidneys T ½ life: 2-10 minutes Dose: 0.5 mg/kg over 3-5 mins???

Question 20

Propofol Pregnancy Classification negative effects/contraindications

Answer 20

Pregnancy category: B Disadvantages: Myocardial depression and vasodilation and hypotension, respiratory depression

Question 21

Pseudoephedrine

Brand name:

Drug Class

Schedule

Uses:

Preganancy Category

Answer 21

Pseudoephedrine hydrochloride/sulphate

Sudafed

Drug Class: α->>and β-adrenergic receptor agonist

Schedule: OTC

Uses: decongestant

Preganancy Category: C

Question 22

Pseudoephedrine

MOA

Answer 22

Pseudoephedrine

MOA: sympathomimetic that directly stimulates α-adrenergic>> and β-adrenergic receptors in the mucosa of respiratory tract producing vasoconstriction (α-adrenergic), and relaxing bronchial smooth muscle (β-adrenergic)

-produces vasoconstriction of respiratory tract mucosa; shrinks nasal mucous membranes; reduces edema and nasla cogestion

Question 23

Pseudoephedrine

Route

Absorption

Metabolism

Elimination

Answer 23

Pseuodoephedrine Parmacokinetics

Route: PO

Absorption: GI track (no 1st pass metabolism)

Distribution:

Metabolism: primarily liver

Elimination: kidneys (urine)

Protein binding: doesn’t biind to plasma proteins in concentration range between 50-2000 ng/ml

Question 24

Pseudoephedrine

Dosage: adult/pediatric Max dose:

Onset:

duration:

t_1/2 life:

Answer 24

Dose

• adult: 60 mg q4-6h; max: 240 mg/day
• extended dose 120mg q 12h
• child: 30 mgq 6h; max: 120mg/day

Onset: 15-30 mins

Duration: 4-6 hrs; 8-12 hrs

t_1/2: 9-16 hr (child: 3h)

Question 25

Pseudoephedrine Contrindications Cautions Dental Concerns

Answer 25

**Contraindications:** pregnancy and breast-feeding CAD severe HT MAO inhibitors (MAO breaksdown NE, Epi- inhibiting this) **Caution:** -cardiac (tachycardia/palpations); hyperthyroidism, DM **Dental Concerns:** - dysrythmia (hydrocarbon inhalation anaesthetics) - Increased CNS, cardiovascular effects (sympathomimetic)

Question 26

Oxymetazoline (Oxymetazoline hydrochloride ) Brand name: Drug Class Schedule Uses: Preganancy Category

Answer 26

Brand name: Afrin Drug Class: α-adrenergic receptor agonist, sympathomimetic amine Schedule: OTC Uses: decongestant; vasoconstriction resulting in decreased blood flow and decreased nasal congestion Preganancy Category: C

Question 27

Oxymetazoline hydrochloride (Afrin) MOA

Answer 27

MOA- α-adrenergic receptors agonist -acts directly on the arterioles of the nasal mucosa by binding to α-adrenergic receptors n arterioles producing vasoconstriction (diated nasal vessels cause nasal congestion)

Question 28

Oxymetazoline Route Absorption Metabolism Elimination

Answer 28

Route: intranasal spray (topical) Absorption: nasal mucosa Metabolism: kidney 30%; feca; 10% Elimination: unchanged 30% kidneys/ 10% feces

Question 29

Oxymetazoline Dosage: adult/pediatric Max dose: Onset: duration: t1/2 life:

Answer 29

Dosage: * adult: 2-3 drops/sprays (0.05% nasal solution) ea nostril q 12 hrs * pediatric: 2-4 drops/sprays (0.025% nasal solution) ea nostril q 12 hrs up to 3d * max dose- do not exceed 2 doses in 24hours Onset: 10 min duration: 7+ hrs t1/2 life: 5-8 hrs

Question 30

Oxymetazoline and conjunctivitis Dose

Answer 30

1-2 drops (0.025% opthalmic solution) ea eye q 6 hrs up to 3-4 d

Question 31

Oxymetazoline Contrindications Cautions Dental Concerns

Answer 31

Contrindications: narrow-angle glaucoma; hypersensitivity to oxymetazoline Cautions: Child \<6; DM; HT; CVD; HyprThy; glaucoma rebound congestion; long term ischemia Dental Concerns: increased risk HT: tricyclic antidepressants (TCAs)