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NZATS Registration Exam study flash cards > Pharmacology + fluids > Flashcards

Pharmacology + fluids Flashcards

(100 cards)

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1
Q

What is the IM adrenalin dose for adults?

A

0.5mg [0.5ml of 1:1000]

Repeat every 5 minutes as needed

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2
Q

What is the IM adrenalin dose for children?

A

10mcg [0.01ml/kg] of 1:1000

[min dose 0.1ml]

[max dose 0.5ml]

Repeat every 5 minutes as needed

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3
Q

What drugs are given during bronchospasm?

A

Salbutamol inhaled 8-12 puffs

Salbutamol IV bolus 250mcg [100mcg/ml]

Magnesium

Adrenalin

ketamine

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4
Q

What drug do you give for an adult cardiac arrest?

A

Adrenalin 1mg IV and repeat every 2nd cycle [3-5 minutes]

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5
Q

How do you treat hyperkalaemia?

A

Sodium bicarbonate

Insulin actrapid

Calcium chloride

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6
Q

What is the paediatric dose of adrenaline for a cardiac arrest Asystole/PEA

A

Adrenaline 0.01mg/kg of the 0.1mg/ml concentration

Max dose 1mg

Repeat every 3-5 minutes

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7
Q

What is the intubation dose of propofol for adults?

A

1-2mg/kg

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8
Q

What is the intubation dose for suxamethonium IV?

A

2mg/kg

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9
Q

What is the intubation dose for suxamethonium IM?

A

4mg/kg

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10
Q

How much propofol do you give to break a laryngospasm event?

A

20% of an induction dose 0.25-0.5mg/kg

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11
Q

What is the immediate bolus dose of 20% intralipid during a local anaesthetic emergency event?

A

1.5mg/kg over 1 minute [100ml for 70kg]

If remains unstable Repeat 2 more doses at 5-minute intervals max

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12
Q

What is the infusion dose of 20% intralipid?

A

15ml/kg/hr [1000ml/hr for 70kg]

If remains unstable double infusion rate

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13
Q

Is propofol a substitute for intralipid?

A

No

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14
Q

How do you prepare the dantrolene?

A

20mg vial mixed with 60mls sterile water

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15
Q

What is the dose of dantrolene

A

2.5mg/kg [60kg = 8 vials]

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16
Q

How long after immediate treatment of dantrolene should you consider giving another repeat bolus?

A

10 minutes if still symptomatic

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17
Q

How does dantrolene work?

A

Dantrolene directly interferes with muscle contraction by decreasing calcium in muscle cells

preventing electrical impulses traveling to muscles and preventing muscle contractions

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18
Q

What complications can MH cause?

A

Acidosis – treat with hyperventilation, sodium bicarbonate

Arrhythmias

Disseminated intravascular coagulation [DIC] -abnormal blood clotting

Hyperkalaemia – high potassium levels in blood

Hyperthermia – cold fluids, ice

Hypotension – fluid bolus, vasopressor

Cardiovascular collapse and cardiac arrest

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19
Q

Plasmalyte is ______ compared to body water

A

Isotonic

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20
Q

Sodium chloride 0.9% is ______ compared to body water?

A

Isotonic

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21
Q

0.45% sodium chloride is ______ compared to body water?

A

Hypotonic

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22
Q

What is the adult blood volume per kg in mls?

A

70

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23
Q

What is the paediatric blood volume per kg in mls?

A

80

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24
Q

True or false – hypotonic fluids might be used to treat diabetic ketoacidosis

A

True

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25
True or false – Hypertonic fluids are not used in treatment of oedema
False
26
True or false – Albumin must be given through a blood pump set?
False
27
Fresh frozen plasma is used to treat coagulopathies and what other purpose?
increase circulating volume
28
Untreated haemorrhage or dehydration could lead to which of the 4H’s and 4T’s
Hypovolaemia
29
True or false – platelets are stored in the fridge
False
30
What is the micron size range for a blood filter?
170-200
31
Who is the universal blood donor?
O Negative
32
Who is the universal blood recipient?
AB positive
33
Who is the universal plasma donor?
AB
34
Who is the universal plasma recipient?
O
35
In normal use, how many units of blood should be given through a blood filter?
4
36
true or false – in a massive transfusion, it is acceptable to give more units than 4 through a filter
True
37
Can rhesus positive blood be given to rhesus negative patients?
No
38
What blood products should not be given in the same line as RBC’s
Platelets
39
A haemolytic transfusion reaction causes destruction of what?
Haemoglobin
40
What is the adult cardiac arrest adrenaline dose? Include units
1mg
41
What is the adult anapahylaxis IM adrenaline dose? Include units
0.5mg
42
What is the paediatric cardiac arrest adrenaline dose? mcg/kg
10 mcg/kg
43
What is the paediatric amiodarone cardiac arrest dose? mg/kg
5 mg/kg
44
What is the intralipid bolus dose in ml/kg?
1.5ml/kg
45
Which medication can be given to reduce metabolic acidosis in malignant hyperthermia?
Sodium Bicarbonate Insulin - acrapid Calcium Choride
46
Which blood test is used to confirm anaphylaxis after the incident?
Tryptase
47
When should tryptase be taken after an anaphylaxis event? A - Immediately and after 24 hours B- 1 hour, 4 hours and 24 hours C - Immediately, 2 hours and 6 hours D - When I can be bothered doing a blood gas
B
48
MTP box 1 contains what? A) 4 RBC, 4 FFP B) 2 RBC, 2 FFP C) 4 RBC, 4 FFP, 3 Cryo D) 4 RBC, 4 FFP, 1 Platelets
B
49
MTP box 2 contains what? A - 4 RBC, 4 FFP, 3 Cryo B - 2 RBC, 2 FFP C - 4 RBC, 4 FFP, 1 Platelets D - 4 RBC, 4 FFP
A
50
MTP box 3 contains what? A 2 RBC, 2 FFP B 4 RBC, 4 FFP, 1 Platelets C 4 RBC, 4 FFP, 3 Cryo D 4 RBC, 4 FFP, 1 Cryo
B 4 RBC, 4 FFP, 1 Platelets
51
Which boxes are repeated in an MTP? A - 1 & 2 B - 3 & 4 C - 1 & 4 D - 2 & 4
B
52
What are the 4 H’s related to an emergency?
Hypovolemia, Hypoglycaemia/Hyperkalaemia, Hypo/Hyperthermia, Hypoxia
53
What are the 4 T’s related to an emergency?
Tension pneumothorax, Tamponade, Thrombosis, Toxins
54
What does MAC stand for?
Minimum alveolar concentration
55
Five common causes of anaphylaxis?
Latex Colloid Antibiotics Muscle relaxant Chlorhexidine Patient blue sugamadex -[likelihood appears to be dose-related]
56
What are 5 symptoms of anaphylaxis?
Difficult/noisy breathing Wheeze/Persistent cough Swelling of the face and tongue Swelling/tightness in the throat Difficulty talking Persistent dizziness/ loss of consciousness Abdominal pain and vomiting Hives, welt and body redness/rash Hypotension Tachycardia
57
What are the signs and symptoms of Local Anaesthetic Toxicity?
Tingling on the lips and fingers, metallic taste, ringing in the ears, confusion, and dizziness Convulsions and loss of consciousness Hypotension, bradycardia, and respiratory arrest
58
What are the early signs and symaptoms of Malignant hyperthermia?
Prolonged muscle spasm after Suxamethonium Tachycardia Tachypnoea in a spontaneous breathing patient Increased CO2 Cardiac arrhythmias
59
What are the Developing Signs and Symptoms of Malignant hyperthermia?
Rapid increase in temperature (0.5 degrees every 15 minutes) Respiratory and metabolic acidosis Hyperkalaemia Profuse sweating Decrease SpO2 Mottled skin Cardiac instability Muscular rigidity
60
What does TACO stand for and what is it?
Transfusion Associated Circulatory Overload Pulmonary oedema primarily caused by volume excess Symptoms = acute respiratory distress, cough, pink sputum, decreased SpO2, nausea, pulmonary oedema, raised CVP.
61
What does TRALI stand for and what is it?
Transfusion Related Acute Lung Injury Repaid onset of excess fluid in the lungs. Symptoms = acute respiratory distress, fever, bilateral infiltrates on chest
62
What is Acute Haemolytic Transfusion Reaction AHTR
A life-threatening reaction to receiving a blood transfusion that results from the rapid destruction of donor red blood cells by host antibodies (Can be delayed)
63
ESBL
Extended Spectrum Beta-Lactamase
64
HELLP
Haemolysis Elevated Liver Enzyme and Low Platelets
65
MRSA
Methicillin Resistant Staphylococcus Aureus
66
What is the triad of anaesthesia
Amnesia Analgesia Muscle relaxation
67
What are some examples of colloid substances?
RBC Albumin FFP
68
Name some crystalloid fluids
Heartmans Sodium Chloride Plasmalyte Dextrose saline manitol
69
Do crystalloids have high or low cell permeability?
High
70
Do colloids have high or low cell permeability
Low
71
What temperature is FFP stored at?
-30’C
72
What temperature is RBC stored at?
2- 6'C
73
What are the signs and symptoms of a blood transfusion reaction?
Increased temperature Hypotension Tachycardia Anaphylaxis Elevated ventilation pressure
74
List fractionated blood products available;
Plasma Cryoprecipitate Platelets Immunoglobins Albumin Irradiated and leuko depleted red blood cells
75
What are leukocytes and what is their main purpose?
White blood cells Main immune system cell
76
Name a depolarising muscle relaxant;
Suxamethonium
77
Name non-depolarising muscle relaxants;
Rocuronium Vecuronium Atricurium
78
What are the 5 R’s of drug administration?
Right drug Right patient Right dose Right route Right time
79
What are some induction agents?
Propofol Thiopentone Etomidate
80
What medications can provide analgesia?
Fentanyl Alfentanil Remifentanil Morphine Paracetamol Parecoxib
81
What are some antiemetics?
Ondansetron Dexamethasone
82
Define a half-life regarding medications;
It is the time taken for half of the drug to be broken down by biological processing
83
Define agonist;
Is a chemical that binds to a receptor on a cell to cause activation thus causing a response
84
Define antagonist;
A chemical substance that binds to and blocks the activation of receptors on cells preventing a biological response
85
Define toxicity;
Chemicals or drug concentrations are at such high levels in the body that they can damage organs and tissues
86
Define bioavailability;
The rate and extent to which the rate a drug is absorbed and reaches circulation IV administration has a bioavilability of 100%
87
What items can contain chlorhexidine in operating theatres?
Skin antiseptic wipes Hand gels and hand wash solutions Surgical skin disinfectants Pre-surgery wash sponges and wipes Lubricant preparations Central venous lines Surgical dressings and mesh Mouth wash
88
Outline the guidelines for fluid maintenance relating to body weight in paediatric anaesthesia;
0-10kg = 4ml/kg/hr 10-20kg = 2ml/kg/hr >20kg = 1ml/kg/hr 4-2-1 rule
89
Do children require higher weight-adjusted doses of most medications compared to adults?
Yes Children have higher rates of metabolism and elimination than adults which means they require a higher weight-adjusted dose of medication
90
Define pharmacodynamics;
The study of the molecular, biochemical and physiologic effects and actions on the body
91
Define pharmacokinetics;
The study of how the body interacts with administered substances for the entire duration of exposure
92
Discuss 3rd spacing in relation to fluid shifts during a major laparotomy;
3rd spacing describes the movement of bodily fluid from the blood into the spaces between the cells This can lead to problems such as oedema, reduced cardiac output and hypotension 3rd space fluid shifts are calculated as 4-6ml/kg/hr which can be compensated with fluids
93
What muscle relaxant produces a rise in ICP and is commonly avoided for neurosurgical patients?
Suxamethonium
94
What are 3 contraindications for suxamethonium
Neurosurgery due to increase in intracranial pressure is not ideal Muscular disorders MH history
95
What are the side effects of suxamethonium?
Bradycardia Hypotension Increased intracranial / Intraocular pressure MH Post operative muscle pain
96
why should GTN spray be available in an obstetric theatre?
GTN is a smooth muscle relaxant and vasodilator
97
What medication is commonly given for preeclampsia?
Magnesium sulfate
98
why is oxytocin given in an obstetric case and what is the infusion dose?
Oxytocin prevents excessive postpartum bleeding by helping the uterus contract. The medication works immediately when given IV 40IU Oxytocin in a 500 ml saline bag running at 125 ml/hr for 4 hours
99
List two drugs used for gastric emptying;
Ranitdine Metoclopromide sodium Citrate
100
What type of rhythm, and what dose and when during the CPR is amiodarone given?
VF / VT - 300mg IV after 3rd cycle

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