tutoring pharm

Question 1

A patient arrives in your emergency room with ataxia and a little respiratory depression. The patient is too somnolent to speak clearly. You check his medical history and see he has a history of anxiety and alcoholism. His last note says he came in for a refill for his chlordiazepoxide. You suspect an OD. What drug do you need to call in?

Answer 1

Flumazenil

Question 2

what is Flumazenil

Answer 2

BZs-R antagonist (GABA(A) channel)

Can precipitate withdrawal -> sleep disturbance, depression, rebound anxiety, seizure.

Question 3

what is Chlordiazepoxide

Answer 3

is a BZ - Increases frequency of opening of the GABA(A) channel and it acts to hyperpolarize the neuron

Question 4

An alcoholic patient arrives in your emergency room for the 5th time this month. He appears very inebriated. The patient exhibits emotional labiality, slurred speech, weird eye movements and ataxia. The patient has not eaten anything, but does make sure to get his nutritional calories from his alcohol. You need to give him glucose and a vitamin. What vitamin does he need and do you give glucose first or the vitamin first?

Answer 4

–thiamine (vitamin B1)
–you must give thiamine 1st then give glucose to prevent further ATP depletion of highly aerobic tissues (heart and break).
Also, could worsen W-K syndrome if the patient had it.

Question 5

Wernicke symtopms

Answer 5

ataxia, nystagmus/ophthalmoplegia, confusion

Question 6

Korsakoff psychosis symptoms

Answer 6

confabulation, personality change and memory loss (anterograde or retrograde)

Question 7

Patient comes into the ER with euphoria, respiratory depression and pinpoint pupils. You suspect an OD. You see the arm of the patient and see track marks. What drug would do you give the patient to treat the OD? What symptoms are looking for after you give this particular drug?

Answer 7

–Naloxone (short acting mu-R antagonist )
Side Effects: Precipitates immediate, severe withdrawal; shorter in duration than a normal withdrawal
feeling nervous, restless, or irritable;
body aches;
dizziness, weakness;
diarrhea, stomach pain, mild nausea;
fever, chills, goosebumps; or sneezing, runny nose.

Question 8

Ethosuximide - targets the ___ which is current treatment for absent seizures

Answer 8

T type calcium channels