pharmacology Flashcards

1
Q

How does gentamicin kill bacteria

A

concentration dependent

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2
Q

How does beta lactam kill bacteria

A

time dependent

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3
Q

What is volume distribution

A

Amount of drug available to the baby

Vd= Total amount of drug/ plasma conc x wt

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4
Q

Side Effects of ACE inhibitors on the Fetus

A

Oligohydramnios
Renal failure
Lung hypoplasia
Skull ossification defects

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5
Q

Side Effects of Beta Blockers on the fetus

A

Fetal bradycardia
Hypoglycemia
Possibly fetal growth restriction

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6
Q

Side effects of methimazole on the fetus

A

Choanal atresia
Esophageal atresia
Hypothyroidism
goiter
Cutis aplasia

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7
Q

First order vs Zero order kinetics

A

First order: certain percentage of the drug per unit time (proportional to the drug concentration)

Zero order: constant amount of drug regardless of concentration

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8
Q

First order vs Zero order kinetics, elimination time

A

First order: half life is independent of drug dosage, fraction constant

Zero order: dependent on dose- larger the more slow to clear, fraction not constant

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9
Q

Volume of distribution and half life

A

the larger the Vd the longer the half life

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10
Q

Peak concentration adjust by

A
  1. Infusion rate: longer lower
  2. Dose
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11
Q

Trough of a medication is dependent on

A

Interval of the drug administration

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12
Q

Ways milrinone improve cardiac output (3)

A
  1. increasing systolic contractility
  2. decreasing systemic vascular resistance (afterload)
  3. enhancing diastolic myocardial relaxation.

Facilitating diastolic relaxation: lusitropy.

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13
Q

MOA of medication to improve CO

A
  1. Increased heart rate (chronotropy)
  2. Increased myocardial contraction with greater shortening fraction (inotropy)
  3. Faster electrical conduction of cardiac contraction signals during systole (dromotropy)
  4. Increased myocardial relaxation during diastole (lusitropy)
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14
Q

How to give adenosine

A

Large IV/Central catheter IV push

  • 1/2 life: <1 min
  • dose: 0.1 mg/kg/dose
  • ECG running- diagnostic for focal atrial tachycardia (FAT) or AF
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15
Q

Ideal location of tip of UE or scalp PICC

A

T3-T5

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16
Q

Ideal location of tip of LE PICC

A

T8-T10

17
Q

Long Term Complication of chronic PGE use

A
  1. hyperostosis or cortical proliferation of the long bones
  2. intestinal and gastric mucosal hyperplasia resulting in gastric outlet obstruction and delayed gastric emptying.
18
Q

Common side effect of fentanyl

A

Chest wall rigidity

To prevent: slow administration (over 1 min)
To treat: Naloxone/ muscle relaxant (ie rocuronium?)

19
Q

Possible electrolyte abnormality secondary to amphotericin

A

Hypomagnesemia

20
Q

How does hypothermia change metabolism of medications

A
  • slow the kinetics of most enzymatic pathways involved in phase 1 and phase 2 metabolism.
  • Drugs that are eliminated largely unchanged through the kidneys (phase 3) are least affected

- buzz: antiseizure and sedation are mostly affected

Phase 1: biotransformation of a drug, usually by the cytochrome P450 enzymes found in the liver.
Phase 2: conjugation with other molecules, which facilitates its removal via the kidneys or intestine.
Phase 3: final common pathway of drug elimination largely via the kidneys

21
Q

What is the first line medication to treat systemic candidiasis

A

Amphotericin B

  • MOA: disrupts fungal wall synthesis by binding to sterols
  • If CNS: added second agent (flucytosine)
  • Fluconazole: wait for sensitivities due to concern for resistance