Reversal Agents - Quiz 8 Flashcards Preview

Spring 2020 - Pharmacology 1 > Reversal Agents - Quiz 8 > Flashcards

Flashcards in Reversal Agents - Quiz 8 Deck (56)
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1

What happens to the Heart with SNS Stimulation?

↑HR

↑Conduction Velocity

↑Automaticity

↑Contractility

2

What happens to the Heart with PNS Stimulation?

↓HR

↓Conduction Velocity

↓Contractility (Slight)

3

What happens to Bronchial Smooth Muscles with SNS Stimulation and PNS Stimulation?

SNS: Relaxation

PNS: Contraction

4

What happens to Sphincters w/ SNS & PNS Stimulation?

SNS: Contraction

PNS: Relaxation

5

What happens to the Uterus & Ureters w/ SNS & PNS Stimulation?

SNS: Contraction

PNS: Relaxation

6

How does SNS Stimulation affect the Liver?

Glycogenolysis & Gluconeogenesis

7

How does PNS Stimulation affect the Liver?

Glycogen Synthesis

8

What happens to the Pancreas w/ SNS & PNS Stimulation?

SNS: ↓B-Cell Secretion

PNS: ↑B-Cell Secretion

9

How are the Salivary & Sweat Glands affected by SNS & PNS Stimulation?

↑Secretions

(More Salivary Secretions w/ PNS)

10

How are all Arterioles affected by SNS & PNS Stimulation?

SNS: Constriction

PNS: Relaxation

(Beta SNS Stimulation of Coronary Arterioles = Relaxation)

11

Which Anticholinesterase Drug is classified as a Tertiary Amine?

Physostigmine

12

Which Anticholinesterase Drugs are classified as Quaternary Ammoniums?

Edrophonium

Neostigmine

Pyridostigmine

13

How does SNS & PNS Stimulation affect the Eyes?

SNS: Mydriasis

PNS: Miosis

14

How does Neostigmine, Pyridostigmine, & Physostigmine increase ACh Availability?

They get hydrolyzed by acetylcholinesterase, which then carbamylates and blocks the enzyme's ability to hydrolyze ACh

15

Which Reversal Agent forms magnetic/electrostatic bond that reversibly causes Acetylcholinesterase Inhibition?

Edrophonium

16

What happens if you give Reversal Agents without there being any NMBs?

Overflow of ACh = fasciculations/muscle twitches

Can look like a Phase I NMB Block

17

What is the Onset of Action for Edrophonium?

1-2 minutes

18

How does Neostigmine compare to Edrophonium?

More Profound & Potent than Edrophonium

Slower Onset: 7-11 Min

19

What is the Duration of Action for all of the Reversal Agents?

1-2 Hrs

20

What determines the Potency of Reversal Agents?

  • The NMB being reversed
  • Speed of Spont. Recovery
  • Depth of Block when Reversal given
  • End Point

21

Once anticholinergic enzymes are completely blocked by the reversal agent, how does re-dosing effect patient's recovery?

No benefits = keep patient sedated & intubated until spont recovery

22

What factors can slow down NMB Reversal?

Hypothermia

ABX

Acidosis

Hypokalemia

23

What are the Muscuranic Side effects of having Increased ACh from Reversal Agents?

Bradycardia

Salivation

Bronchoconstriction

Miosis

Hyperperistalsis

PONV

24

Which Reversal Agents have Marked & Prolonged Inhibition of Plasma Cholinesterase?

Neostigmine & Pyridostigmine

25

What can be mixed w/ Reversal Agents to minimize Muscuranic Side effects?

Anticholinergic Drugs w/ faster onset than Anticholinesterase

26

Which class of Anticholinesterase Drugs can cross the Blood Brain Barrier?

Tertiary Amines - Physostigmine

 

27

What can Physostigmine be used for as a Reversal other than for NMBs?

Central Anticholinergic Syndrome

Restlessness/Confusion

Opioids

Benzos

Ketamine

Antidepressants

28

What are some uses for Antiacetylcholinesterases outside of the OR?

Myasthenia Gravis

Glaucoma

Post-Op Pain/Shivering

Alzheimer's - Aricept, Razadyne, Exelon

Chronic Fatigue

29

What are treatments for Reversal Agent Overdose?

Atropine

Pralidoxime - Acetylcholinesterase Reactivator

Supportive Measures

30

What are the naturally occuring anticholingergic that are tertiary amines?

Atropine & Scopolamine