Pharmacotherapeutics (38-43)

Question 1

Most common fluid used within 48hrs post surgery

Answer 1

LR

Question 2

Good fluid for post resuscitation.

Answer 2

D5 1/2 NS

Question 3

Used commonly with hypovolemic hypernatremia.

Answer 3

1/2 NS

Question 4

The only fluid to be used with administration of blood products.

Answer 4

NS

Question 5

With acute and massive hemorrhage, give this colloid

Answer 5

Whole blood

Question 6

What is commonly give to raise hematocrit in chronic or acute bleeding, anemia, trauma, or an aortic dissection?

Answer 6

Packed RBC’s

Question 7

What are the 5 primary effects of general anesthesia?

Answer 7

Unconsciousness, amnesia, analgesia, inhibition of autonomic reflexes, and skeletal muscle relaxation

Question 8

T/F General anesthesia is usually a combination of inhaled and IV medications

Answer 8

TRUE

Question 9

Which is not a risk factor for general anesthesia? A) Smoking B) Sleep apnea C) Obesity D)HTN E) Sexiness

Answer 9

E) Sexiness. Nothing about being sexy makes you at increased risk during general anesthesia…oh wait…I take that back…all of them are risk factors;)

Question 10

T/F N/V is not common with general anesthesia.

Answer 10

FALSE. 20-30% That’s why you are allowed to eat anything pre-op

Question 11

A Bier block is a form of what?

Answer 11

Regional anesthesia

Question 12

What is a bier block used for?

Answer 12

Short operative procedures on extremities

Question 13

T/F A spinal is faster to take affect than an epidural

Answer 13

TRUE

Question 14

What S/E is really common, especially in women, after spinal anesthesia?

Answer 14

HA

Question 15

T/F A spinal offers longer pain control than an epidural.

Answer 15

FALSE. Spinal = Faster, Epidural = Longer

Question 16

What happens if you inject epinephrine into someones blood stream accidentally during a local anesthesia attempt by a rookie?

Answer 16

Sympathetic response…it’s effing epi people!!!

Question 17

What’s one thing to look out for when doing local anesthesia?

Answer 17

Unintentionally injecting into a vessel and causing cardiovascular issues and/or CNS problems (seizure)

Question 18

When might topical anesthetics cause systemic issues?

Answer 18

If it’s used on broken skin or mucus membranes

Question 19

Most common PCA medication used.

Answer 19

Morphine

Question 20

How much does morphine is usually infused in a PCA when the button is pressed? How long until it can be pressed again?

Answer 20

1-3mg. 6-8min

Question 21

The MOA of local anesthetics

Answer 21

Blocking sodium channels making it harder for nerve cells to reach action potential…LESS FIRING = LESS PAIN

Question 22

T/F Using local with epi is good because it causes the anesthesia to wear off faster

Answer 22

FALSE. It causes vasoconstriction in the area and making the anesthesia take longer to wear off.

Question 23

What do you ALWAYS want to do with the syringe prior to injecting with local anesthetic?

Answer 23

Aspirate to ensure you are not in a vessel!!!

Question 24

The highest potency and longest lasting local anesthetic

Answer 24

Bupivacaine

Question 25

Rapid onset medium duration local anesthetic

Answer 25

Lidocaine

Question 26

Rapid onset short duration local anesthetic

Answer 26

Chloroprocaine

Question 27

Moderate onset medium duration local anesthetic

Answer 27

Mepivacaine

Question 28

Slow onset local anesthetic

Answer 28

Bupivacaine

Question 29

You should use this local anesthetic with caution in myasthenia gravis

Answer 29

Chloroprocaine

Question 30

You should NOT use this local anesthetic during labor or obstetrical events

Answer 30

Mepivacaine

Question 31

This local anesthetic has cardiotoxicity potential

Answer 31

Bupivacaine

Question 32

A combo drug using _____ and _____ is used as a topical cream to numb skin prior to venipuncture, LP, lido injection, minor burn procedures, or vaccinations.

Answer 32

Lidocaine/prilocaine

Question 33

What might be an adverse effect associated with lidocaine/prilocaine cream use?

Answer 33

Methemoglobinemia (whatever the eff that is). Something to do with hemoglobin that can't carry O2 or something.

Question 34

Most common adverse reaction to morphine

Answer 34

Constipation

Question 35

T/F Morphine is a pure opiate

Answer 35

TRUE

Question 36

Brand name for hydromorphone

Answer 36

Dilaudid

Question 37

What is hydromorphone

Answer 37

Morphine and codeine

Question 38

Hydromorphone is ____x more potent than morphine

Answer 38

5x

Question 39

T/F You should NOT use hydromorphone with MAOI's

Answer 39

TRUE

Question 40

Tylenol with codeine is (more/less) potent than morphine

Answer 40

Less

Question 41

Tylenol with codeine is used for mild to moderate pain and is effective against what other symptom?

Answer 41

Cough

Question 42

Hydrocodone has a similar potency to what other drug?

Answer 42

Morphine

Question 43

What OTC medication would you want a person to discontinue taking with many of the opioid analgesics?

Answer 43

Acetaminophen as many of them contain it.

Question 44

Brand name of hydrocodone.

Answer 44

Vicodin

Question 45

Brand name for oxycodone

Answer 45

Percodan/percocet

Question 46

Percocet consists of what two drugs?

Answer 46

Oxycodone and acetaminophen

Question 47

What will happen if you crush sustained release tablets of oxycodone?

Answer 47

OD and death

Question 48

Meperidine's brand name is?

Answer 48

Demerol

Question 49

Meperidine is not recommended for long term pain care, why?

Answer 49

Due to its active metabolite toxic metabolites, normeperidine, which has neurotoxic properties

Question 50

You should not take meperidine within ____ days of taking an MAOI

Answer 50

14

Question 51

A pt has all the symptoms of a negative response to opioids plus anxiety, tremors, muscle twitches, and anticholinergic effects.

Answer 51

Meperidine use

Question 52

Oh no…his pupils are HUGE! But you're sure he took some opioids and not a benzo. What might he have taken?

Answer 52

Meperidine

Question 53

This drug is good and very commonly used for chronic pain

Answer 53

Methadone

Question 54

What opioid commonly used can cause Torsades as well as other ventricular cardiac arrhythmia's

Answer 54

Methadone

Question 55

One advantage to this opioid mediation in acute pain is the rapid onset and short duration of action making it good for the evaluation of pts pain level more often.

Answer 55

Fentanyl

Question 56

This opiate is 100x more potent than morphine.

Answer 56

Fentanyl

Question 57

Contraindications to topical anesthetics are...

Answer 57

Allergy to medication.