Pharm Final Flashcards
(137 cards)
1
Q
Covert the different types of medication concentrations.
A
Kilogram→ gram→ milligram→ microgram & %= (%# x 10) / 100mL
2
Q
how many micrograms are in a milligram, or how many micrograms are in a gram?
A
1000mcgs=1mg
3
Q
a 4% medication, what does that mean to you?
How many milligrams per mL would that contain?
A
=4Gs/100mLs
=4Gs—>4000mgs
4
Q
What is the three-step process that I have instilled into your brains when solving a med math problem?
A
What are we solving for? Weight based? All units the same?
5
Q
administer a medication via an intramuscular injection.
A
90 degree angle; deltoid(up to 2mLs), Dorsal gluteal(butt (5 mLs or more) upper lateral side, vastus lateralus (5mLs or more), Rectus femoris (up to 5mL)
6
Q
Solve a med math problem to administer a medication bolus via either the IO route
A
find epiphysis/ growth plate of bone, 90 degree angle push needle till 1 line showing, then drill, aspirate at least with a 10mL (20mL preferred), (3-way-cockstop push & push method for kids), admin 2% lidocaine for pain
7
Q
Solve a med math problem that deals with administering a bolus of IV fluid over time.
A
TAV
Time, Admin Set , Volume
8
Q
Solve a med math problem that deals with administering a medicated IV/IO infusion.
A
CAD
Concentration , Admin Set , Dosage
9
Q
the “8 Rights” of medication administration.
A
PT, Dose, Doc, med, time, response, reason, route
10
Q
What is the difference between antiseptic and a disinfectant? When would we use one versus another?
A
Antiseptic = person
Disinfectant = tools
11
Q
what is medical asepsis
A
providing a medical environment that is free of pathogens
12
Q
What technique should be used if you ever must recap a needle?
A
Pick up cap on a surface alone with needle
13
Q
what are the 4 different general routes of medication administration:
A
Enteral, Parental, Pulmonary, Percutaneous
14
Q
Enteral med admin/=
A
GI; PO, NG/OG Tubes, SL, PR, Buccal
15
Q
Parenteral med admin/=
A
“needles”; IV, IO, ET, IM, Umbilical, Subcutaneous, Topical, IN
16
Q
Percutaneous med admin/=
A
per skin ;Sublingual, buccal, ocular, aural (ear),
17
Q
Pulmonary med admin/=
A
Inhaled (albuterol): musclnaric receptors on smooth M. of bronchioles
18
Q
What is the “first past effect” and during what type of medication administration would that apply?
A
Liver filtering the med/ & applies only to Enteral med/s
19
Q
what are the different types of oral medication forms:
A
tablets, capsules, enteric coated/time release, syrups (dissolved in sugary based), suspensions (water based), elixirs (meds mixed w/ alcohol based), lozenges (melt w/ heat)
20
Q
When would you use an OG tube versus an NG tube?
A
PT is unconscious
21
Q
How would you measure for the correct insertion depth of the different types of gastric tubes?
A
“?” measuring technique Confirm placement with air while listening to epigastric
22
Q
How would you administer medications to a patient utilizing their gastric tube?
A
Crush meds into 30mLs of warm water then admin w/ 50-100mLs warm flush after
23
Q
the different ways that we carry parenteral medications
A
glass ampules, single and multi-dose vials & pre-filled/loaded syringes
24
Q
What are the three different parts of a syringe?
A
(Tip, Barrel, plunger)Flashback chamber, Hub (base before needle), stylet =needle
25
Hypodermic needle is what/used for?
What are the different parts of a hypodermic needle?
hypodermic needle=hollow metal tube used w/ the syringe to admin/ med/s. It’s sharp enough to puncture tissues, blood vessels, or IV medication poorts
Parts: hilt & shaft. Hilt is a threaded plastic tube that screws securely onto the syringe’s distal adapter. shaft is a thin metal tube through which med/s can flow from the syringe into the site. A bevel at the shaft’s distal end accounts for its sharpness
26
intradermal medication administration:
what sites can you use:
What degree of insertion would you use?
How much fluid can you administer using this route?
=Deposit med into the dermal layer of the skin
=Anywhere
= 10-15 degrees
= less than 1 mL
27
Subcutaneous medication admin/:
What sites can we use:
What degree of insertion would you use?
How much fluid can you administer using this route?
=Tissue Comp/: Loose connective tissue between skin and muscle.
= skin on the upper arms, thighs, abdomen (avoid tattoos & superficial important vessels & ligaments/tissues)
= 15 degrees
=No more than 1mL to avoid irritation/ possible abscess.
28
Intramuscular medication admin/:
What sites can you use?
What degree of insertion would you use?
How much fluid can you administer into the four ?
= deposit into muscle through muscle
= deltoid, Dorsal gluteal(butt) upper lateral side), vastus lateralis (back of thigh), Rectus femoris, PEDIS & stabilize
= straight on 90 degrees
;delt=2mL, butt & Vas Lat/ = 5 or more mLs, , Butt= up to 5mLs
29
what are the different types of percutaneous medication administration routes:
Sublingual, buccal, ocular, nasal, aural (ear), pulmonary, trans/subdermal
30
What medications could (but probably shouldn’t be) administered down an ET tube?
=(NAVEL) Narcan, Atropine, Vasopressin, Epi, Lidocaine
Vaso-irratators (really any med that isn't nutritional replacement)
31
Water is contained in what 3 compartments in the human body? What are the percentages?
60% of body weight is water 45%=intracellular & 15% extracellular (outside cell)
Interstitial 10.5%
Intravascular 4.5%
32
What is osmosis?
What is simple diffusion?
What is Facilitated Diffusion?
What is Active transport?
= water moving to high solute concentration from low
= molecules moving high to low
= Molecules moving with a helper EX metformin or insulin
= Molecules moving low to high concentration with use of ATP
33
different types of IV fluid:
Hypo/Iso/Hyper tonic, fluids, blood, crystalloids, & colloids,
34
What are the two most common types of isotonic crystalloid solutions that are used in the prehospital environment?
Lactate Ringer's & 0.9% sodium Chloride
35
If you were administering isotonic crystalloid solutions, how much would move out of the intravascular compartment within 1 hour?
2/3s would move out
36
What would occur to the cells in the body if admin/ a isotonic solution?
What'd occur to the cells in the body if admin/ a hypertonic solution?
What'd occur to the cells in the body if admin/ hypotonic solution?
= cells stay same
=cells shrink & can shrink to crenation
= Cells would swell up & can blow up
37
What is hydrostatic pressure in the vascular system & what creates it?
What is oncotic pressure in the vascular system and what creates it?
=Pressure from heart in blood vessels & forces water to cross the capillary membrane into the interstitial space.
=Pulling water back into the blood vessels by the presence of large proteins in the blood (pulling back in)
38
What IV sites are considered “peripheral IV” sites?
Arms, Feet, hands, Legs, External Jugular
39
What are central venous sites?
(IJ) intra jugular, subclavian, femoral, peripherally inserted central cath (PICC) line, Port-a-cath
40
What type of needle must be utilized to access a Port-a-Cath?
Huber needle --> slanted needle with hole laterally also
41
What is a Micro IV administer set & How many drops equals 1 mL?
60ggts
42
What are the different Macro IV administer sets?
20,15,12,10 gtts/min
43
What are the different types of needles used of intravenous therapy?
Butterfly, Teflon, Hallow, Huber, hyperdermic
44
When performing an IV stick, what degree of insertion would you use?
15-30 degrees
45
What size of IV catheter would you use to access an EJ?
16-18 gauge
46
What does the acronym “TKO” mean?
What does the acronym “KVO” mean?
(to keep open) = 20-25mLs/Hr
( keep vein open)= 20-25mLs/Hr
47
the different complications that can come from intravenous therapy.
Infiltration, pyrogenic reaction, air emboli, catheter shear, vein blowing, necrosis, thrombophlebitis, artery puncture, circulatory overload
48
Can you use a scalp vein for IV access, and if you can, what must you remember?
Yes you can, and remember can easily blow
49
When is it okay to perform an IO? (i.e. what type of patient/conditions)
Cardiac arrest, cant get IV, Critical PTs
50
What are the different parts of a bone? (ends, middle, etc..)
Epi/ Meta/ Dia/physis, medullary canal, red & yellow bone marrow
51
Where is red bone marrow found?
Epiphysis
52
Where is Yellow bone marrow found?
Diaphysis -> medullary canal
“Ye(ll)ow medu(ll)ary”
53
What is a more technical name for the growth plate of a bone?
Metaphysis
54
What sites can you use for the placement of an IO? (adult versus pediatric)
Proximal Tibia (~2 inches for stability)
Proximal Humorous (in peoples way)
Distal Tibia (easier for manual IO),
Sternal aka manubrium (for adults)
Distal femur (for kids)
55
What are some potential complications with IO access?
What are the contraindications for the placement of an IO?
=PE, Fat emboli, Infiltration, breaking bone
= Infection, previous attempt @ same site, Brittle bones, broken bones
56
What are the 3 most common types of central venous catheters that you will see in the prehospital environment?
PICC line, tunneled, med/ port
57
Accessing a central venous catheter, what's min/ syringe size that should be used?
10mL
use 20mL preferably
58
If a patient has their tunneled venous access device utilized for dialysis therapy, can we access it?
NO, b/c line have been used already
59
What are some techniques that you could use if you encounter difficulties while trying to aspirate fluid from a PICC line or tunneled venous line?
Roll & Shrug shoulders, Turn head side to side
60
What are the two main branches of the nervous system?
Central & Peripheral
61
The central nervous system (CNS) is made up of what structures?
Brain & Spinal Cord
62
What are the two subdivisions of the peripheral nervous system (PNS)?
Somatic & Autonomic
63
What are the 2 subdivisions of the autonomic NS (ANS)?
Sympathetic & Parasympathetic
64
What effects would you see if the sympathetic nervous system (SNS) was to take over?
"Fight or Flight"
increase HR & electricity, GI constriction, ect + tropic effects
65
What type of receptors are used by the sympathetic nervous system?
A1,A2, B1, B2
66
What is the main pre and post ganglionic neurotransmitter for the SNS?
Epinephrine
67
What part of the spinal cord does the SNS originate from?
Lumbar & Thoracic Spine
68
How do the nerves of the SNS differ from the PSNS?
shorter Pre & longer Post ganglions
69
What would you call a med/ that caused a direct increase in the SNS?
Sympathomimetic
70
What would you call a medication that directly blocked the SNS?
Sympatholytic
71
What effects would you see if the parasympathetic nervous system (PSNS) was to take over?
"Rest & Digest"
"calms down" bodies' organs
72
What type of receptors are used by the parasympathetic nervous system?
Nm (nicotinic muscle), Nn (nicotinic neuronal),
& Muscarinic = found in heart
73
What is the main pre and post ganglionic neurotransmitter for the PSNS?
Acetylcholine
74
hat part of the spinal cord does the PSNS originate from?
Cranial & Sacral Spine
75
How do the nerves of the PSNS differ from the SNS?
longer Pre & shorter Post Ganglion
76
What would you call a med/ that caused a direct increase in the PSNS?
Parasympathomimetic
77
What would you call a medication that directly blocked the PSNS?
Parasympatolytic
78
What is the difference between an agonist and an antagonist?
Agonist= Stimulates Antagonist= Inhibits
79
The very small area between two nerve cells is known as a?
Synapse
80
What is the difference between a positive and negative feedback loop?
Neg/= maintains/ brings back to homeostasis Pos/= Continues effects
81
Autoclave means?
clean/sanitize w/ heat
82
ET tube meds you can give:
(NAVEL) Narcan, Atropine, Vasopressors, Epi, Lidocaine
83
Chemical med name:
Generic med name:
Official med name:
Brand med name:
least common EX 7-chlor-1-3dihydro….
manufactured EX diazepam, (usually capitalized) EX Ibuprofen
name registered listed with USP EX Diazepam, USP
name by company followed by trademark/propriety EX Motrin Advil
84
Where meds come from:
plants, animals, minerals, synthetic (lab-made),
85
Harrison-Narcotic act (1914):
aimed a controlling the importation, manufacture, & sale of opium & coca plant & its derivatives
86
FDA & Cosmetic act (1938)
truth-in-labeling cause→ state whether prep has habit-forming drugs and its% “cosmetic makeup additive & %”
87
Durham-Humphrey amendments (1951)=
requires pharmacists to have either a prescription for certain meds
88
Kufauver-Harris amendment (1962)=
amendment to FDCA, → mandates pharmaceutical manufacturers to list complications “med have me hair”
89
Drug abuse (1970)=
classifies the drugs used in medicine into 5 different schedules
90
Schedule 1 med:
Schedule 2 med:
Schedule 3 med:
Schedule 4 med:
schedule 5 med:
=never give, highest abuse potential
=high abuse ~dependence accepted med indi/s (codeine, morphine)
=less abuse potential low dependence (acetaminophen)
=low abuse potential = benzos (diazepam, lorazepam)
=lowest abuse potential w/ lil bits of opioids often for cough/diarrhea
91
Phase 1 med studies:
Phase 2 med studies:
Phase 3 med studies:
Phase 4 med studies:
=meds/ pharmacokinetics, toxicity, safe dose (therapeutic dose) “make”
=test on limited pop/ “test”
= refined therapeutic dose; data on side effects ”refine”
= post-marketing analysis during conditional approval “sell”
92
FDA pregnancy category A:
FDA pregnancy category B:
FDA pregnancy category C:
FDA pregnancy category D:
FDA pregnancy category X:
=studied a lot and had not showed harmful effects to fetus/mom
=animals studies hadn't showed harm effects to animals but not humans
=animals studies pos/ prob/ w/ no studies on pregnant mother no good studies on animals/pregnant
= fetal risks have been demonstrated benefits could outweigh risks
=fetal risk demonstrated risk outweighs possible benefits to mother
93
Med Bioavailability:
Med Biotransformation:
Med Prodrug:
=how much the body breaks down the dose
=METABOLISM→ liver #1 ⅔ filter → means of body filtering med
=body has to break drug down for med to work as intended EX aspirin
94
Idiocrasy effect:
Cross tolerance effect:
Tachyphylaxis effect:
Cumulative effect:
Med antagonist effect:
Summation effect:
Synergism effect:
Potentiation effect:
Interference effect:
=individual reaction is unusually dif/ from what is commonly seen
= body builds up tolerance to 1 med thus, tolerance to another med
=rapid occurring tolerance to med
= when med admin/ in many doses thus increased effect, due to quantitative buildup of the drug in the blood
=effects of one med blocks the response to another drug
=2 meds that enhance each other
= 2 meds admin/ together that produces a greater response (“1+1=5”)
=when med enhances effects of another (promethazine + morphine)
=med directly effects the pharm/ of another “football” EX: non-selective beta blocker w/ albuterol so asthma worsts
95
Bioequivalence:
Assay:
Bioassay:
Efficacy:
Teratogenic med:
=relative therapeutic effectiveness of chemically equivalent med/s
= test done to determine the amount of purity of a given chemical
=test to ascertain a med/s in a biological model
= ability of med/ to cause a expected response
=medication that can kill/deform the fetus in the mother
96
What are the 2 main branches of NS:
Peripheral & central
97
SC the SNS originate from: Thoracic & Lumbar
Nerves of SNS differ from PSNS:
Med/ causing a direct increase in the SNS is:
Med/ directly blocking SNS is:
Parts of heart innervated by sympathetic nervous system:
= Thoracic & Lumbar
= Shorter Pre & Longer Post
= Sympathomimetic
= sympatholytic
= All of heart
98
Effects if (SNS) was to take over:
Receptors used by (SNS)
pre/post ganglion neurotransmitter for SNS: Pre & Post
Post w/ sweat glands:
= “Fight or Flight” Mydriasis
= Alpha 1,2 Beta 1,2,3
= ACh & NORepi
= ACh
99
Effects if (PSNS) was to take over:
What type of receptors are used by (PSNS):
Main pre/post ganglion neurotransmitter PSNS?
Where does PSNS originate on SC:
Nerves of PSNS differ from the SNS: Longer pre & shorter post
= “Feed & breed” miosis
= Muscararic 1 2& Nicotinic 1 2
= ACe for both
= Cranial Sacral
= Longer pre & shorter post
100
Med causing a direct increase in PSNS:
Med/ directly blocking the PSNS is:
Parts of heart innervated by PSNS:
Difference in agonist & antagonist:
= Parasympathomimetic
= Parasympatholytic
= AV & SA node
= Ag: stims & Ant: inhibits
101
if a agonist binds to a B1 receptor:
if a agonist binds to a B2 receptor:
if a agonist binds to an A1 receptor:
if a agonist binds to an A2 receptor:
if an agonist binds to muscarinic receptor:
= + /tropic effects
= Bronchodilation
= Vaso-consriction
= Keeps A1 in check
= Relaxes Smooth M.
102
Competitive antagonist:
Noncompetitive antagonist:
Irreversible antagonist:
= Finds & Fights for receptor
= won’t fight for receptor spot
= misshapes cell where receptor can’t bind from damage/misshaping
103
Small area between two nerve cells is known as a:
Pos/&Neg/ feedback loop:
= Synapse
= N= homeostasis P=Excessive
104
What is the RP & AP of a neuron:
The influx of what ion causes it to depolarize?
The efflux of what ion causes it to repolarize?
= RP -70mV AP -55mV
= Na
= K
105
Ectopic foci:
Phases 0 & 3 of AP:
= abnormal impulse then is propagated throughout the heart
= Depolarization & Repolarization
106
RP & AP of cardiac contractile cell:
RP to AP from:
Influx of ion causes it to depolarize?
Efflux of what ion causes it to repolarize?
= RP -90mV AP -85mV
= Ca & Na gap junction
= Na
= K
107
Phases 0, 1, 2, 3, 4 of CC: Phase0:
Phase1:
Phase2:
Phase3:
Phase4:
= depolarization Cell gap Junction rapid Na influx by an impulse gen/ed elsewhere in heart. Na then stops entering cell once inside +
= K slowly leaves cell slowly returning cell to normal negative charge
= “plateau” M contraction: Ca+ interrupts w/ influxing into cell. (M.s ussing Ca for contraction). This plateau phase slows repolarization
= Repolarization: cessation Ca influx & rapid K efflux
= Refractory & moving ions back to original seats for RP
108
Na/K pumps working ions move w/ each cycle:
Direction ions move:
= 3Na 2K
= Na out & K in
109
Renin-Angiotensin Aldosterone System (RAAS) work: 1st:
2.Liver is always releasing what in bloodstream
3. Kidney release what/by in response to hypoperfusion?
4. Liver makes what that mixes w/ kidney release?
5. Angiotensin1 becomes angiotensin2:
6. Angiotension2 then goes & stim/s Adrenal glands to:
What are the effects of angiotensin II? Vasoconstriction ultimately
= (JG cells) jugaxtugaler cells detect decreased blood Vol/press/
= Angiotensinogen released by liver
= Renin released by kidney
= Angiotensin + renin =angiotensin 1
= in the Lungs via releasing (ACE) Angiotensin- Converting Enzyme
= produce & release Alderosterone; Retain/absorbs more Na & water
= Vasoconstriction ultimately
110
Acid-Base balance perfect number:
What is the normal pH range:
Acid: Compensated & Uncomp/:
Alk:& Compensated & Uncomp/:
Respiratory Acid & Alka:
Metabolic Acid & Alka:
= 7.4
= 7.35-7.45
= within 7.35-7.4 & Uncomp/: <7.35
= within 7.4-7.45 Uncomp/: >7.45
= ETCO2 acid: <35 & Alk: >45
= ETCO2 35-45 pH and/or ABG >/< 22-26
111
Oxy Dissociation Curve:
Bohr Effect:
Haldane Effect:
= H-globin “Train” taking & dropping oxy
= Acidotic with R-shift of hemoglobin w/ decrease oxy affinity
= Alkalotic w/ L-shift Loves oxy in Lungs
112
Bohr Effect:
Influences by:
What does it do to hemoglobin:
= Acid> Hemoglobin droping oxy off in body
= + CO2, +temp, -pH+ BPG 2,3 in body
= -oxy affinity
113
Haldane Effect:
Influences by:
What does it do to the hemoglobin?
= Alk> Hemoglobin Loves oxy in Lungs
= -CO2, -temp, +pH -BPG 2,3, in Lungs,
= +oxy affinity
114
he (CNS) is made up of what structures: Brain & SC
2 subdivisions of (PNS): Autonomic & Somatic
2 subdivisions of (ANS):
= Brain & SC
= Autonomic & Somatic
= Sympathetic & parasympathetic
115
Effects if (SNS) was to take over:
Receptors used by (SNS)
pre/post ganglion neurotransmitter for SNS:
Post w/ sweat glands:
= “Fight or Flight” Mydriasis
= Alpha 1,2 Beta 1,2,3
= ACh & Norepi
= ACe
116
Parasympathetic touches 4 cranial nerves:
= 3,7,9,10
117
(H2CO3)Carbonic acid (HCO3)bicarbonate system:
Starts & to:
Lungs to/:
H2CO3:
HCO3:
= Fastest buffer system " Teeter-totter"
= CO2 + H2O <> H2CO3 <> H + HCO3 to lungs
= HCO3 + H <> H2CO3 <> CO2 + H2O to body/exhaled
= Carbonic acid
= Bicarbonate
118
Arterial Blood Gas(ABG):
ABG Acid:
ABG Alk:
= 22-26 HCO3 (like pH)
= <22
= >26
119
pH: 7.4-7.45, CO2: >45, HCO3: 22-26:
pH: 7.4-7.45, CO2: <35, HCO3: 22-26:
= Compensated Respiratory Acidosis
= Compensated Respiratory ALkalosis
120
pH: 7.35-7.4, CO2:35-45, HCO3: <22:
pH: 7.4-7.45, CO2: 35-45, HCO3: >26:
= Compensated Metabolic ACidosis
= Compensated Metabolic ALkalosis
121
pH:>7.45, CO2:35-45, HCO3: >26:
pH: <7.35, CO2 = 35-45, HCO3 = <22:
= Uncompensated Metabolic ALkalosis
= Uncompensated Metabolic ACidosis
122
pH = <7.35, CO2 = >45, HCO3 = 22-26:
pH = >7.45, CO2: <35, HCO3: 22-26:
= Uncompensated Respiratory ACidosis
= Uncompensated Respiratory ALkalosis
123
Different buffer systems in body & how they work: Mid:
Slowest:
Quickest:
= Protein buffer system> Carbaminohemoglobin: Amino acid chains pick up CO2
= Phosphate system: Loop-diuretics effects kidneys nephrons to loosen retention of water & release it
= Carbonic acid-bicarbonate buffer system (relies on lungs) “See-Saw” CO2 + H2O <> H2CO3 <> H + HCO3
124
“Natural Pacemaker” of heart & firing rate:
“Gate-Keeper” of heart & firing rate:
Purkinje System inherent firing rate:
Electrical impulses get from right to L-Atrium via:
= SA Node 60-100
= AV Node 40-60
= 15-40
= Backman’s Bundle
125
Equation for cardiac output:
Heart & SV volumes:
Equation for BP:
How can you make a + & - effect on it?
= CO= SV x HR
= usually squeezes 70mLs & heart holds 100-110mL
= BP=(SV X HR) X SVR
= Meds: diuretics, vaso-constructors
126
Vaughn Williams Classification System:
Class I meds:
Class II meds:
Down regulation:
Never mix what w/ what b/c:
Class III meds:
Class IV meds:
Miscellaneous meds:
= Antiarrhythmic med classes by pharmacodynamics
= Sodium channel blockers
= Beta-Blockers
= takes away/blocks CA cells channels:
= Never mix Ca blocker w/ Beta blockers→ stops heart
= Potassium channel blockers "phase 3 K"
= Calcium channel blockers
= Miscellaneous EX Adenosine→ dif/ & adenosine receptors
127
Capnography waveform:
What is Phase I called:
What is Phase II called:
What is Phase II called:
What is Phase IV called:
= Measured at end of phase 3
= Baseline
= Upstroke
= Plateau
= Inspiratory Downstroke
128
(Capno/ waves) Shark fin:
Tachypnea:
Bradypnea:
Curare's Cleft:
= Bronchoconstriction
= thin wave width, small baselines, hypocapnia if severe
= thick wave width, Big baselines, Hypercapnia if severe
= Dip in phase 3 from diaphragm/PT waking up
129
hormone is secreted by the Alpha Cells:
What effect would this have on PT’s BGL:
What hormone is secreted by the Beta Cells:
What effect would this have on PT’s BGL:
What is the purpose of insulin in the body:
= Glucagon
= Raise BGL
= Insulin
= Lower BGL
= Facilitates & lower BGL
130
Main inhibitory neurotransmitter:
Main excitatory neurotransmitter:
Neurotransmitter for reward & motivation:
Neurotransmitter Which plays a role in stress response:
Neurotransmitter for Mood & helps w/ sleep & digestive regulation:
= GABA
= Glutamate
= Dopamine
= Epinephrine
= Serotonin
131
How is “Therapeutic Index” established for a particular med/:
Med studies 4 phases:
Phase 1:
Phase 2:
Phase 3:
Phase 4:
= Ratio of med’s lethal dose to its effective dose “sweet spot” determined w/ phase 1 of med study
= med: pharma/kin/, toxicity, safe (therapeutic) dose, PT volunteers
= tested on limited population
= refined therapeutic dose; collects data on side effects
= post-marketing analysis during conditional approval
132
Non-depolarizing neuromuscular blocking agent:
Depolarizing neuromuscular blocking agent:
Common med & Contraindicated use w/:
= Blocks/shuts down brain & muscle paralyzing PT 60-90mins
= Blocks/shuts down brain & muscle paralyzing PT 5-15mins
= Succinylcholine: Hyperkalemia, Burns, Crush Injury, +ICP, Trauma
133
Beta-Blocker:
Cardio-Selective Beta-Blockers:–
Non-selective Beta-blockers:
= blocks β adrenergic receptors
= Atenolol, Esmolol, Metoprolol
= Propranolol, Nadolol, Labetalol, Sotalol.
134
Alpha Adrenergic antagonists Meds:
α2 Agonists:
α1 Antagonist: Minipress
= Inhibits the release of NorEpi into the synapse thus decreases HR(CHronotropy) & electrical impulse speed (Inotropy)
= Clonidine (Catapres)
= Minipress
135
(Vaughn-Williams Antiarrhythmics) Procainamide & Lidocaine:
Aminodrone:
“lol” Labetalol:
Aminodrone:
Diltiazem:
Adenosine & Digoxin:
= Class I: Na Channel Blockers:
= Class 3: K+ Channel Blockers (“phase 3 repolar”):
= class 2 beta blockers
= class 4 Ca blockers
= miscellaneous
136
Pulse pressure: SBP-DBP
MAP form steps: step 1:
Step 2:
Step 3:
Step 4:
CPP Cerebral Perfusion form:
= Pulse pressure: SBP-DBP
=1. BP120/80
= 2. SBP-DBP =40
=3. PP 40/3 + 30
=4. back to PP 40= 93
= (MAP-ICP) + 10
137
plant for Digoxin:
plant for Atropine:
= foxglove
= nightshide
