Pharmacology Flashcards
(47 cards)
DOC for reversal of respiratory depression
Naloxone
How does Naloxone reverse effects of opioid toxicity?
Competitive antagonist at miu- opioid receptors
Opioid overdose symptoms
Triad- Respiratory depression, coma and pin point pupils (miosis)
Hypotension, bradycardia
Hypothermia
Shallow breathing
Naloxone reverses all effects except
sedation
Usage of Naloxone in neonates?
Used to reverse neonatal asphyxia d/t opioid usage
Meperidine (Pethidine)
a. Class
b. Uses
c. Advantage to Morphine
d. Effect on fetus
e. Excitatory syndrome
a. mu-opioid receptor agonist
b. Strong analgesic effect; also used in post-anesthetic shivering
c. Penetrates CNS better at lower systemic concentration than morphine so constipation, urinary retention and nausea is less frequent
d. Crosses placenta and cause respiratory depression in fetus
e. People who are tolerant to depressive effects of meperidine, large doses repeated at small intervals can cause Excitatory syndrome which includes- hallucinations, tremors, muscle twitches etc.
Atropine side effects
- Dry mouth, delirium, decreased bowel movements, dry warm skin
- Hypotension
- Accomodation paralysis, dilated pupils (blurring of vision)
- Tachycardia
- Urinary retention
- Respiratory depression
- Anhydrosis, Ataxia, Acute congestive glaucoma
Mnemonic: Dhatura
Also, convulsions and circulatory collapse d/t repiratory failure
Death occurs d/t respiratory paralysis
Atropine
a. class
b. MOA
c. Uses
a. Anticholinergic
b. Competitive, reversible inhibition of postsynaptic muscarinic acetycholine receptors
c. OP poisoning/ Muscarinic poisoning; bradycardia; to reduce salivary secretions; as mydriatic-cycloplegic
Buprenorphine
a. Class
b. Use
a. partial miu agonist and antagonist at kappa and delta receptors
b. As analgesic and in management of opioid dependence
Drug used for metastatic trastuzumab resistant Her 2 positive breast cancer
Lapatinib + Capecitabine
Lapatinib is an inhibitor of
EGFR
HER2 tyrosine kinases
Lapatinib is metabolised by
CYP3A4
Treatment of post-menopausal women with hormone receptor positive metastatic breast cancer that overexpresses HER2
Lapatinib + aromatase inhibitor Letrozole
Adverse effects of Lapatinib
- Acneiform rash
- Diarrhoea
- Cramping
- Exacerbation of GER
- Cardiac toxicity (less than trastuzumab)
- Dose dependent prolongation of QT interval
- Hepatotoxicity
Transtuzumab
a. class
b. MOA
c. Use
a. monoclonal antibody
b. inhibits HER2 receptor
c. Treatment of HER2 positive breast cancer
Vismodegib
a. inhibits?
b. Used to treat?
a. Hedgehog pathway
b. Metastatic and locally advanced BCCs
Vemurafenib
a. Inhibits?
b. Used in?
a. BRAF
b. metastatic melanoma and thyroid cancers with BRAF V600E mutation
Erlotinib
a. class
b. First line treatment for
a. protein kinase antagonists
b. non small cell lung carcinoma with EGFR deletion of axon 19 or L858R mutation
Nomogram used for Vancomycin dosing is
Matzke nomogram
Dosing intervals in Matzke nomogram
0.5 - 12 days on a continuum of CLcr (Creatinine clearance) values from 0 to 120ml/min
Matzke nomogram was created to
determine initial empiric dose and interval of IV Vancomycin in hospitalised patients who are not receiving hemodialysis
Nomogram doesnt apply to
- critically ill
- cystic fibrosis
- liver failure/ ascites
- acutely post transplant
- burns > 20 percent
- rapidly changing renal function
- pregnant women
- extremes of weight
Nomogram used to asses potential hepatotoxicity after single acute ingestion of Acetaminophen
Rumack- Matthew nomogram
Therapeutic range of lithium
0.8-1.2 mEq/L
