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NNSOCM 2023 > PHARMA W6 > Flashcards

PHARMA W6 Flashcards

1
Q

5,5L is how many ml?

A

5500ml

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2
Q

4 mg mixed in 10 ml is how many mg/ml?

A

0,4 mg/ml

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3
Q

4,2g/ml is how many mg/ml

A

4200 mg/ml

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4
Q

What is the difference between generic and brand name?

A
  1. The generic name is the drug it self. (e.g. Fentanyl)
  2. The brand name is typically a catchy name invented by the company that produces it (E.g. Haldid)
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5
Q

What is the difference between systemic and local function of a drug?

A
  1. Systemic means the drug enters the bloodstream
  2. Local means the primary effect of the drug is at the area were it is dispersed
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6
Q

Enteral means?

A

Intake of a drug via the mouth and GI-tract

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7
Q

Parenteral means?

A

Administration of a drug into the blood stream

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8
Q

What are the 4 stages of pharmacokinetics

A

ADME
1. Absorbtion
2. Distribution
3. Metabolisation
4. Excretion

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9
Q

Pharmacokinetics means…

A

What the body does to the drugs

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10
Q

Pharmacodynamics means…

A

What the drug does to the body

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11
Q

What happens during absorption?

A

The body absorbs the drug from the GI-tract. If the drug is given IV it skips this part.

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12
Q

What is distribution in pharmacokinetics?

A

Transport of the drug to the cells of the body e.g. through the blood stream

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13
Q

Were does metabolisation of drugs primarily happen?

A

In the liver by enzymes

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14
Q

Were does excretion of drugs happen primarily?

A

In the kidneys, but also in lungs and in the liver (as bile)

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15
Q

Bioavailability means?

A

The percentage of drugs that reaches the circulation. It is depended upon administration method and wether it undergoes first pass metabolism

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16
Q

First pass metabolism means?

A

The blood from the GI-tract containing digested nutrients and drugs flows to the liver and gets degraded before entering the systemic blood stream

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17
Q

T 1/2 means?

A

The time it takes for a drug to half its concentration in the blood

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18
Q

If you administer a drug repeatedly what phase can you enter?

A

Plateuphase were a balance between drug intake and T 1/2 occurs

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19
Q

What interactions can occur with drugs?

A
  1. Drugs with other drugs
  2. Drugs with food/liquid (e.g. alcohol or grapefruit)
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20
Q

What is the primary consequence if you overdose a drug?

A
  1. Liver failure
  2. Multiorgan failure in consequence to the failing liver
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21
Q

How should you store drugs?

A
  1. Fridge 2-8 degrees
  2. Room temp 15-25 degrees
  3. No specific 3-30 degrees
  4. Dry and dark
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22
Q

What is Nicolau syndrome?

A

Necrosis of tissue usually caused by wrong injection of IM drugs e.g. due to a too short needle

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23
Q

Miosis means?

A

Small pinpoint pupils (contracted)

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24
Q

What do we use fluid for?

A

Resuscitation in:
1. Trauma
2. Crush
3. Burns
4. Dehydration

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25
Q

What are the elements of the lethal triad

A
  1. Coagulopathy
  2. Hypotmernia
  3. Metabolic acidosis
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26
Q

What is the goal urinary output in treatment of crush-injuries?

A

100-200 ml /hr

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27
Q

What is the optimal treatment for crush injuries prior to extraction/reperfusion of limb?

A

Administer 2000ml of NaCl IV.
Or place TQ above crush injury

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28
Q

What is the suggested treatment for crush-injuries post extraction/reperfusion of limb?

A
  1. Fluid therapy to urine output of 100-200ml/hr
  2. Calcium 10ml 10% IV/IO
  3. Ertapenem 1g IV/IO
  4. Analgesia
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29
Q

What is the treatment goal for fluid resuscitation in burn injuries?

A

Urine output of 30-50ml/hr

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30
Q

What are the clinical signs of dehydration?

A
  1. Low or absent urine output
  2. Skin turgor
  3. Dry mucous membranes
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31
Q

What is the treatment goal in fluid resuscitation for dehydration?

A

Urine output of 0,5ml/kg/hr

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32
Q

What solution should you always flush IV/IO with?

A

NaCl 0,9%

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33
Q

Pain in the joints, skin, muscles or bones are called

A

Somatic pain

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34
Q

Pain from organs are called

A

Visceral pain

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35
Q

Were are nociceptors found

A

Everywhere in the body basically

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36
Q

What is effective pain relief?

A
  1. Decline of 2 points on NRS
  2. 30% decrease in pain score
  3. Patient feels relief
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37
Q

What happens if you combine NSAID’S?

A

You risk having more side-effects

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38
Q

What are the contraindications for NSAIDS?

A
  1. Gastric ulcers
  2. Gastric bleeding (blood in vomit or faces)
  3. Allergy/hypersensivity
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39
Q

NSAIDS effect what enzymes?

A

COX 1 and COX 2

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40
Q

What does NSAID do to COX1?

A

Inhibits COX1’s function in coagulation causing bleedings to be hard to stop

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41
Q

What does NSAID do to COX2?

A

Inhibits COX2’s function in the inflammatory process

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42
Q

What is the dosage of NSAID per NNSOCM?

A
  1. 400mg capsule 3 times a day
  2. 600 mg capsule 2 times a day
    Max dose of 1200mg/day
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43
Q

What is the pharmacodynamic function of paracetamol?

A

Works antipyretic and analgesic (precise function unknown)

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44
Q

What is the antidote for paracetamol overdose?

A

Acetylcysteine IV

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45
Q

What is the dosage of tablet paracetamol per NNSOCM

A

2 capsules of 500g 3-4 times a day
Max dose of 4g/day

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46
Q

What is the pharmacodynamic function of an opioid?

A
  1. Binds to opioid receptors in CNS
  2. Blocks transmission of pain signals to the brain
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47
Q

What are the 7 symptoms of opiod intake/overdose?

A
  1. Sedation
  2. Respiratory depression
  3. Bradycardia
  4. Hypotension
  5. Obstipation
  6. Nausea/vomiting
  7. Miosis (contracted pin-point pupils)
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48
Q

When is opiod drugs indicated?

A

In severe pain if no contraindications

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49
Q

What are the contraindications for Morphine?

A
  1. GCS <12
  2. Hemodynamical instability
  3. Respiratory depression (bradypnea)
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50
Q

What is the dosage of Morphine per NNSOCM?

A

5mg IV “slow push” over 5 mins.
Repeatable every 30 minutes

51
Q

How fast does Morphine work when administered IV, IM or SC?

A
  1. IV after 20 min
  2. IM after 30-60 min
  3. SC after 50-90 min
52
Q

What is true for Fentanyl vs Morphine

A
  1. Fentanyl is 100 times stronger than morphine
  2. Fentanyl can pass the blood/brain barrier faster
53
Q

How fast does fentanyl work when administered IV?

A

After 2-3 min

54
Q

How long will the effect of Morphine last?

A

Approx 5 hrs

55
Q

How long will the effect of fentanyl last?

A

Approx 30-60 min

56
Q

What is the dosage of fentanyl lozenge per NNSOCM?

A

PO 800micg lollipop
Repeatable after 15 mins

57
Q

What is the initial dosage of fentanyl IV?

A

1 micg/kg

58
Q

What are the contraindications for fentanyl?

A
  1. Respiratory depression (bradypnea)
  2. Cyanosis
  3. AVPU=(PU)
  4. Ileus (intestines not moving/working properly)
59
Q

What is the antidote for opiods?

A

Nalaxone

60
Q

What is the pharmacodynamic function of naloxone?

A

Has higher affinity than opioids so it pushes opioids of the receptors and occupies the receptors, causing the opioids to be inactive for a while

61
Q

What is true for the relationship between T1/2 for naloxone and opioids?

A

Nalaxone has shorter T/12 causing opioids to regain its function at the receptor after a while. Reassess and repeat injection of naloxone if needed

62
Q

What is the dosage of nalaxone per NNSOCM?

A

0,2mg IV every 5 mins until desired effect (normal respiration regained)
Max dose 0,8mg

63
Q

What is the side-effects of naloxone?

A
  1. Nausea/vomiting
  2. Sweating
  3. Dizziness
  4. Headache
  5. Tachycardia
64
Q

What is the medical treatment for nausea caused by opioids?

A

Odensetron IV

65
Q

What is the dosage of odansetron per NNSOCM?

A

4-8mg IV

66
Q

How do you prep Ertapenem for IV use?

A
  1. Add 10 ml of NaCl to the powder
  2. Stir
  3. Put the 10ml into a 100ml NaCl bag
67
Q

What are common side effects of most antibiotics?

A
  1. Stomach complaints
  2. Diarrea
  3. Nausea
  4. Headache
68
Q

What are the 5 ways of preventing infection?

A
  1. Hygiene
  2. Protection
  3. Avoid contact
  4. Boil water and heat food
  5. Vaccinations
69
Q

What type of pathogen are antibiotics effective against?

A

Bacterias

70
Q

How does antibiotics work?

A

They attack/inhibit different structures of the bacteria-cell. e.g. some of the enzymes inside the bacteria causing it to die

71
Q

What are the cons and pros with broad spectrum antibiotics?

A

Cons: Attacks also “friendly” bacteria in the body
Pros: If we don’t know what bacteria has infected a person, broad spectrum will attack most bacteria

72
Q

What are the pros and cons with narrow spectrum antibiotics?

A

Pros: Only attacks the specific bacteria
Cons: We need to know which bacteria to attack

73
Q

What can happen if antibiotics are overused or used when not necessary?

A

The bacteria in the body might become resistant to the treatment we have. Then antibiotics cannot treat possible infections of that bacteria in the future

74
Q

Name a multi resistant bacteria?

A

MRSA
Multi resistant streptococcus arius

75
Q

Name the most common antibiotics per NNSOCM?

A
  1. Ertapenem
  2. Moxifloxacine
76
Q

What is the indications for Ertapenem IV?

A

Prophylactic treatment of penetrating battle field trauma

77
Q

What is the dosage of Ertapenem IV per NNSOCM?

A

1g / day in 3-14 days

78
Q

Name some of the side effects of Ertapenem

A
  1. Diarrhea
  2. Nausia/vomiting
  3. Headache
  4. Thrombophlebitis
  5. Rash
  6. Itching
79
Q

How long can you store Ertapenem when diluted into solution?

A

6 hours

80
Q

What are the indications for moxifloxacine

A
  1. Penetrating eye injury
  2. Complicated skin/intra abdominal infections
  3. Pneumonia, bronchitis, sinusitis
81
Q

What is the dosage for moxifloxacine per NNSOCM?

A

400mg PO pr day over 5-10 days

82
Q

What 2 things can S-ketamine be used for?

A
  1. Sedation
  2. Analgesia
83
Q

What is the initial dosage of S-ketamine when used as anesthetic per NNSOCM?

A

20-25 mg IV or 50 mg IN

84
Q

What is the preferred dosage for S-Ketamine when titrating

A

10 mg

85
Q

How do you create a solution of S-ketamine with the concentration of 10mg/ml

A

Draw up 2 ml of S-ketamine into 3ml of NaCl.
The total is now 50mg S-ketamine in 5 ml (or 10mg/ml)
Now you can give 1ml containing 10mg

86
Q

What is the dosage of S-Ketamine when used as sedative?

A

1mg/kg initial dose. Maintained by 0,5mg/kg after 15-20 min.
or
0,5-3mg/kg/hr when used as a drip

87
Q

What are the side-effects of S-Ketamine?

A
  1. Tachycardia
  2. Hypertension
  3. Hallucinations
  4. Respiratory depression
88
Q

What other drug can be nice to use together with S-Ketamine to calm the patient down?

A

Midazolam 2,5mg IV

89
Q

Adrenalin is the treatment for…?

A

Anaphylaxis

90
Q

What is the dosage for adrenalin in anaphylactic shock per NNSOCM?

A

0,3-0,5mg IM repeatable every 5 minutes

91
Q

What are the side effects of adrenaline?

A
  1. Tachycardia
  2. Sweating
  3. Arrythmias
  4. Anxiety
  5. Tremor (shivering)
92
Q

What is the indication for TXA?

A

Massive traumatic bleeding

93
Q

What is the dosage of TXA per NNSOCM?

A

2g over 2 minutes

94
Q

What are the contraindications for TXA?

A

Bleeding that existed over 3 hours

95
Q

What is the pharmacodynamic function of TXA?

A

Inhibits fibrinolysis (plasminogen) which lets the blood clots stay longer in place

96
Q

What are the side effects of TXA?

A
  1. Nausea, vomiting
  2. Diarrea
97
Q

Can/should you administer TXA in the same IV infusion line as penicillin?

A

No

98
Q

Can/should you administer TXA directly into the IV?

A

Yes

99
Q

Can/should you administer TXA in the same IV infusion line as blood products?

A

No

100
Q

What is the indication for Midazolam?

A
  1. Agitation/anxiety
  2. Seizure
  3. Treatment of S-ketamine side effects
101
Q

What type of drug is midazolam?

A

Benzodiazepine

102
Q

What are the contraindications for midazolam?

A

Do not use with opioids unless to treat seizures

103
Q

What is the dosage of midazolam per NNSOCM?

A

Agitation/anxiety: 5mg IV repeat if necessary
S-ketamine side effects: 2,5mg IV single dose
Seizure: 10mg IM/IN or 5mg IV/IO repeat after 5 mins
Max dosage 20 mg

104
Q

What are the side effects of midazolam?

A
  1. Sedation
  2. Confusion
  3. Slurred speech
105
Q

What is the dosage of paracetamol IV?

A

1g every 6h

106
Q

What is the indication for Calcium gluconate 10%?

A
  1. Crush syndrome
  2. Blood transfusion
107
Q

What is the contraindication for Calcium gluconate 10%?

A

Hypercalcemia

108
Q

What is the dosage of calcium gluconate 10% per NNSOCM?

A

Crush injury: 10ml in case of arrhythmias/CPR
Blood transfusion: 10ml after 1. infusion and after each 4.th

109
Q

What are the side effects of calcium gluconate 10%?

A
  1. Hyper/hypotension
  2. Bradycardia
  3. Arrhythmia
  4. Nausea
  5. Blush (redness in face)
110
Q

Citrizine is a type of

A

Antihistamine

111
Q

What are the indications for citrizine

A
  1. Allergic rhinitis
  2. Pollen allergy
  3. Hives
112
Q

What are the dosage of citrizine per NNSOCM?

A

10mg tablet a day

113
Q

What are the contraindications for citrizine?

A

None relevant

114
Q

What are the side effects of citrizine?

A
  1. Abdominal complaints
  2. Sleepiness
  3. Dry mouth
  4. headache
115
Q

What should you be cautious about after having taken citrizine?

A

It may impair the ability to react fast

116
Q

Dexamethasone is a type of…

A

Corticosteroid

117
Q

What are the indications for dexamethasone?

A
  1. HACE/AMS
  2. Anaphylaxis
  3. Asthma
118
Q

What are the dosage of dexamethasone in anaphylaxis per NNSOCM?

A

8mg IV/IO/IM

119
Q

What are the side effects of dexamethasone?

A
  1. Abdominal complaints
  2. Nausea, vomiting
  3. Diarrea
  4. Obstipation
120
Q

What are the pharmacodynamics of dexamethasone?

A

It lowers the sensitivity of the body’s inflammatory response

121
Q

What is odansetron?

A

Anti-emetic

122
Q

What is a scopoderm patch good at preventing

A

Motion sickness

123
Q

What are the pharmacodynamics of scopolamine?

A

Blocks M1 receptor of the vestibulocochlear nerves.

124
Q

What are the pharmacodynamics of odansetron?

A

Block serotonin nerotransmitter release

NNSOCM 2023 (16 decks)

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