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Flashcards in Surgery: Drugs Deck (21):
1

mechanism of action: Plavix (clopidogrel)

irreversibly blocks P2Y12 component of ADP receptors on the platelet surface > prevents activation GPIIb/IIIa receptor > reducing platelet aggregation. platelets blocked by clopidogrel are affected for the remainder of their lifespan (~7-10 days).

2

dosing for morphine

IV: 2.5-5mg q4-6hrs opioid naive.
PO: 15-30mg q4hrs for immediate release.

3

drug interactions: morphine

may decrease antiplatelet effect of P2Y12 inhibitors

4

onset of action: morphine

PO (immediate release): ~30 min.
IV: 5 to 10 min

5

duration of action: morphine

Immediate-release (tablet, oral solution, injection): 3-5 hours
Extended-release capsule and tablet: 8-24 hours (formulation dependent)
Epidural or intrathecal (Single dose): Up to 24 hours
Suppository: 3-7 hours

6

time to peak (plasma): morphine

tablets, PO, epidural: 1 hour.
Extended release tablets: 3-4 hours
Suppository: 20-60 minutes
SubQ: 50-90 minutes
IM: 30-60 minutes
IV: 20 minutes

7

dosing of oxycodone

initial: (immediate release) 5-15mg q4-6 hrs, (extended release) 10mg q12 hrs.

8

onset of action: oxycodone

immediate release: 10-15 min

9

duration of action: oxycodone

immediate release: 3-6 hrs
extended release: up to 12 hrs

10

time to peak (plasma): oxycodone

immediate release: 1.2-1.9 hrs.
extended release: 4-5 hrs

11

dosing of acetaminophen (PO)

immediate-release:
regular strength: 650 mg q4-6 hrs; max 3250 mg QD
extra strength: 1000 mg q6 hrs; max 3000 mg QD. extended-release: 1300 mg q8 hrs; max 3900 mg QD.

12

dosing of acetaminophen (rectal)

650 mg q4-6 hrs; max 3900 mg QD

13

dosing of acetaminophen (IV)

<50 kg: 12.5 mg/kg q4 hrs or 15 mg/kg q6 hrs; maximum single dose: 15 mg/kg/dose (≤750 mg/dose); maximum daily dose: 75 mg/kg/day (≤3.75 g/day)

≥50 kg: 650 mg q4 hrs or 1,000 mg q6 hrs; maximum single dose: 1,000 mg/dose; maximum daily dose: 4 g/day

14

adverse reactions: acetaminophen

skin rash, nephrotoxicity (with chronic overdose), hypersensitivity rxn (rare)

15

onset of action: acetaminophen

PO: <1 hr.
IV: 5-10 min (analgesia), within 30 min (antipyretic)

16

duration of action: acetaminophen

PO/IV: (analgesia) 4-6 hrs.
IV: (antipyretic) ≥6 hrs

17

stool softeners (surfactants)

docusate sodium (colace), docusate calcium

18

bulk-forming laxatives

psyllium, methylcellulose, polycarbophil, wheat dextrin

19

osmotic agents

polyethylene glycol (miralax), lactulose, sorbitol, glycerin

20

stimulant laxatives

bisacodyl (dulcolax), senna (senokot)

21

dosing of docusate sodium (colace)

100mg BID