12/28 Flashcards
Which antibiotic is the first line choice for acinetobacter and enterobacter pneumonias? What are the side effects of this antibiotic?
imipenem is the first choice for infections with acinetobacter and enterobacter. Side effects include seizures, GI distress, thrombophlebitis and skin rashes
What is the mechanism of action of atropine? What is atropine used for during surgical procedures? what is atropine used for post-surgically?
Atropine is a nonselective muscarinic antagonist
during surgical procedures atropine is used to suppress bronchial secretions
Post surgery, atropine is used to prevent the muscarinic effects of acetylcholinesterase inhibitors which reverse muscle paralysis at the end of the procedure.
What drug is used in an atropine overdose?
physostigmine because it can cross the BBB and it is an acetylcholinesterase inhibitor that increases ACh in the synapse, directly opposing atropine’s effect of blocking the ACh receptor
Which antipsychotic drug needs weekly WBC monitoring because of the risk of agranulocytosis? Which anti epileptic drug needs to WBC monitoring because of the risk of agranulocytosis?
antipsychotic = clozapine (atypical antipsychotic) antiepileptic = carbamazepine (causes blood dycrasias like aplastic anemia and agranulocytosis)
Neostigmine and physostigmine are both acetylcholinesterase inhibitors. Why is physostigmine used as the antidote for anticholinergic toxicity but neostigmine is not? What is neostigmine used for?
Physostigmine can cross the BBB but neostigmine cannot. Neostigmine is used for myasthenia gravis
Which anti epileptic medication is contraindicated in pregnancy because it can cause neural tube defects like spina bifida? What are other side effects of this drug?
valproic acid
Other side effects: GI distress, weight gain, rare but fatal hepatotoxicity, tremors
What etiology of meningoencephalitis is likely to cause a bloody CSF without a traumatic lumbar tap?
herpes simplex virus 1
What is the drug of choice to treat delirium tremens if the patient does NOT have liver dysfunction? If the patient does have liver dysfunction?
no liver dysfunction - chlordiazepoxide
liver dysfunction - lorazepam
Neuroleptic malignant syndrome is a adverse reaction to which class of drugs? Malignant hyperthermia is an adverse reaction to which class of drugs? Serotonin syndrome is an adverse reaction to which class of drugs?
NMS - dopamine blockers (antipsychotics)
MH - induction anesthetics
SS - SSRIs, MAOIs, meperidine, drugs that increase serotonin
What is the antidote to acetylcholinesterase inhibitor poisoning? What are the symptoms of AChE inhibitor poisoning?
atropine and pralidoxime (regenerates active AChE)
Symptoms - DUMBBELSS (diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal muscle and CNS, lacrimation, sweating and salivation
What class of drug should you give a patient with both hypertension and benign prostatic hyperplasia?
an alpha1 antagonist like prazosin/doxazosin because alpha1 blockers will vasodilate blood vessels and decreases muscle tone in the bladder, improving urinary outflow
