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SRGRY3 > ANSTH - PHRMA > Flashcards

ANSTH - PHRMA Flashcards

1
Q

Time dependency of the drug

a. Pharmacokinetics
b. pharmacodyanmics
c. Potency
d. Efficacy

A

A

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2
Q

True about pharmacokinetics EXCEPT

a. time dependency of the drug
b. describes the relationship between the dose of a drug and its plasma or tissue concentration
c. relates to absorption, distribution, metabolism and elimination
d. What the drug does to the body

A

D.

it is the definition of pharmacodynamics

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3
Q

How the plasma concentration of a drug translates into its effect on the body. This is called

A

Pharmacodynamics

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4
Q

True about Pharmacokinetics

a. oral, IV and nasal or sublingual route are subject to first pass effect
b. Moecular size of drug, capillary permability, polarity and lipid solubility affec rate of entry of drug into tissues
c. Theoretical volume that would be necessary to contain the total amount of an administered drug at the same concentration that it is observed in the blood plasma is called volume of distribution
d. AOTA

A

A. nasal or sublingual bypass first pass effect

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5
Q

Drugs that interact with and activate receptors; they possess both affinity and efficacy. Full efficacy

A

Full agonist

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6
Q

Pharmacologic antagonist that competes with agonist for receptor binding site

A

Competitive inhibitor

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7
Q

Drugs that interact with receptors in such a way that they have affinity but NO efficacy

A

Competitive inhibitor

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8
Q

Act different sites of receptor molecules (does not compete), and activates it. Alter receptor function without occupying it.

A

Allosteric activator

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9
Q

Reverse effect and action of allosteric activator

A

Allosteric inhibitor

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10
Q

Mechanisms of Desensitization

A

Downregulation

Upregulation

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11
Q

short-term diminution of receptor response caused by frequent or continuous exposure to agonists

A

Tachyphylaxis

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12
Q

Which drug would be absorbed first?

a. Gas
b. Solid
c. Liquid

A

A

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13
Q

What is the bioavailability of an IV drug?

A

100%

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14
Q

This is the apparent volume of fluid into which the drug appears to distribute itself at a concentration equal to that in the plasma.

A

Volume of distribution

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15
Q

True about volume of distribution

a. high volume of distribution means it is concentrated in the vascular space
b. minimal volume of distribution means that the drug is mostly in the extravascular space
c. both
d. neither

A

D.

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16
Q

Defined as the percentage of the active drug in a drug product that enters the systemic circulation as a parent compound after the administration of that drug

A

Bioavailability

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17
Q

The rate of elimination by all routes normalied to the drug

concentration

A

Drug clearance

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18
Q

dose required to produce a given effect

A

Potency

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19
Q

Power to produce effect

A

Efficacy

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20
Q

Dose producing the desired effect in 50% of the general population

A

ED50

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21
Q

shiw relationship between the dose of the drug admnistered and the pharmacologic effect of the drug

A

Dose response curves

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22
Q

dose producing death in 50% of animals to which it is given

A

LD50

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23
Q

LD50/ED50

A

therapeutic dose

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24
Q

Dose that brings toxicity in 50% of humans

A

TD50

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25
Q

Types of anesthesi (3)

A

Local
Regional
Spinal

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26
Q

Triad of 3 major effects in anesthesia

A

UAM
Unconsciousness
Analgesia
Muscle relaxation

27
Q

IV agents that provude unconsciousness and amnesia EXCEPT

a. barbiturates
b. propofol
c. benzodiazepines
d. etomidate
e. succinylcholine

A

E; muscle relaxant

28
Q

Which drug is this?
MOA: inhibit excitatory synaptic transmission at the GABA receptor
Effect: rapid & smooth induction within 60 secs- wears off in 5 mins
S/E: hypotension, myocardial depression
Adv: anticonvulsants, protect brain during neurosurgery by cerebral metabolism

A

Barbiturates

29
Q

Which drug is this?
MOA: inhibit excitatory synaptic transmission at the GABA receptor
Effects: anxiolysis, amnesia (anterograde)
S/E: peripheral vasodilation, hypotension, minimal resp depression when used alone
Adv: anticonvulsant, rarely cause allergic reactions
Flumazenil- reverses BZD effects; antagonist

A

Benzodiazepines

30
Q

Which drug is this?
MOA: inhibit excitatory synaptic transmission at the GABA receptor
Effects: rapid induction
Adv: less reduction in blood pressure than thiopental & propofol, rapid awakening
Disadv: pain on injection, nausea & vomiting

A

Etomidate

31
Q

Which drug is this?
MOA: inhibits excitatory synaptic transmission at the GABA receptor
Effects: fast onset of sedation, short duration, rapid recovery (choice for ambulatory surgery)
Adv: low incidence of nausea and vomiting, bronchodilatory properties
S/E: hypotension, irritant pain on injection

A

Propofol

32
Q

Which drug is this?
MOA: inhibit excitatory synaptic transmission at the NMDA receptor
Effects: amnesia and analgesia
S/E: dissociative anesthetic, cataleptic state and hallucinations while regaining consciousness
Disadv: increase HR & BP (CI: CAD pxs); direct myocardial depression in catecholamine depleted pxs
Adv: useful in acutely hypovolemic pxs to maintain BP via sympathetic stim; asthmatic pxs- bronchodilation, less allergic reactions

A

Ketamine

33
Q

The following are used to provide analgesia EXCEPT

a. ketamine
b. morphine
c. propofol
d. ketorolac

A

C. propofol is for unconsciousness and amnesia.

Ketamine is both for unconsciousness and amnesia, and analgesia

34
Q

pure opioid antagonist; reverse opioid overdose (resp depression)

A

Naloxone/naltrexone

35
Q

Which drug is this?
MOA: act centrally on μ-receptors on the brain & SC
S/E: euphoria, sedation, constipation, resp depression

A

Opioid

36
Q

MOA: inhibit excitatory synaptic transmission at the NMDA receptor
Effects: potent analgesic, sedation & amnesia
Adv: supports respiration
Disadv: dysphoria

A

Ketamine

37
Q

Which drug is this?
MOA: reduces prostglandin formation via
inhibition of the COX enzyme (NSAID)
S/E: gastric bleeding, platelet dysfunction, hepatic and renal damage

A

Ketorolac

38
Q 
Which drug is this?
MOA: a2 adrenergic agonist
Effects: sedative & analgesic
Uses: sedation in ICU, adjunct to GA
S/E: hypotension and bradycardia
A

Dexmedetomidine

39
Q

Which drug is this?
MOA: centrally acting
Effects: analgesic & antipyretic
When used as part of post-op analgesic property, it reduces amount of opioid required  reduced opioid S/E (constipation, sedation, resp depression)

A

Acetaminophen

40
Q

True about neuromuscular blocking agents EXCEPT

a. No amnestic, hypnotic or analgesic properties
b. this is given prior to analgesia
c. act on neuromuscular junction
d. succinylcholine is a depolarizing NMB
e. NOTA

A

B. pxs must be properly anesthetized first before its administration

41
Q

Which drug is this?
Depolarizing NMB
MOA: binds to Ach receptors on the postjunctional membrane in the NMJ and causes depolarization of muscle fibers
Adv: Rapid onset (<60 secs) & rapid offset (5-8 mins)
DisAdv: Fasciculations causes post-op aches and pains; elevates serum K levels (CI in burns & trauma pxscardiac arrhytmias); increase in intraocular and intragastric pressure
Hydrolyzed by plasma cholinesterase or pseudocholinesterase
Can trigger malignant hyperthermia

A

Succinylcholine

42
Q

Examples of Non-depolarizing NMB (4)

A

Pancuronium
Vecuronium
Rocuronium
Mivacurium

43
Q

Non-depolarizing NMB with >1h duration of effect, no histamine release, disadvantage of Tachycardia;Slow onset; Long duration.

A

Pancuronium

44
Q

Non-depolarizing NMB with <1 h effect, No CV effects, disadvantage of intermediate onset

A

Vecuronium

45
Q

Non-depolarizing NMB with <1h effect, fast onset, short duration and histamine release

A

Mivacurium

46
Q

Non-depolarizing NMB, <1h effect, fast onset, No CV effects

A

Rocuronium

47
Q

True about non-depolarizing NMB EXCEPT

a. irreversibly binds to post synaptic terminal in the NMJ and prevents Ach from depolarizing the muscle
b. No fasciculations
c. both
d. neither

A

A. it is reversible

48
Q

This is a Measure of anesthetic potency. It is the ED50 of an inhaled agent The higher the the value, the less potent the agent is

A

MAC (Minimum alveolar concentration)

49
Q

Most potent inhalational agent among the list:

a. halothane
b. NO
c. Enflurane
d. Desflurane
e. Sevoflurane

A

A

50
Q

Which drug is this?
MAC 105%, provides analgesia with minimal cardiac and respiratory depression. Disadvantage of sympathetic stimulation, expansion of closed airspace.

A

NO

51
Q

Which inhilational agent is this?
MAC of 0.75, effective in low concentration, minimal airway irritability, inexpensive. Disadvantage of cardiac depression and arrhythmia; hepatic necrosis; slow elimination

A

Halothane

52
Q

Which inhalational agent is this?

MAC is 1.68, Muscle relaxation, no effect on cardiac rate and rhythm; disadvantage of strong smell and seizures

A

Enflurane

53
Q

Which inhalational agent is this?

MAC 6 rapid induction and emergence, disadvantage is coughing and high cost

A

Desflurane

54
Q

Which inhalational drug is this?

MAC is 1.15, advantage is muscle relaxation, no effect on cardiac rate and rhythm. Disadvantage is strong smell

A

Isoflurane

55
Q

Which inhalational drug?

1.71 MAC, rapid induction and emergence, pleasant smell; ideal for mask induction; disadvantage is high cost and liver metabolism

A

Sevoflurane

56
Q

True about local anesthetics EXCEPT

a. amide local anesthetics have amide linkage between a benzene ring and a hydrocarbon chain that in turn, is attached to a tertiary amine
b. Lidocaine, bupivacaine and procaine are examples
c. Metabolized in the liver
d. NOTA
e. AOTA

A

B. procaine is an ester.

Lidocaine
Bupivacaine
Mepivacaine
Prilocaine
Ropivacaine
57
Q

True about local anesthetics

a. Cocaine, procain, cchlorprocaine, tetracaine, benzocaine, and prilocaine are esters
b. esters are hydrolysed by plasma cholinesterase
c. esters have allergic potential
d. AOTA
e. NOTA

A

A. Prilocaine is an amide

58
Q

The ff are metabolized in plasma EXCEPT

a. procaine
b. Chloroprocaine
c. Prilocaine
d. Tetracaine
e. NOTA

A

C; amides are metabolized in the liver.

All the other 3 are esters and are metabolized in plasma.

59
Q

The ff are metabolized in the liver and lung

a. Prilocaine
b. lidocaine
c. mepivacaine
d. bupivacaine
e. Ropivacaine

A

Only prilocaine is metabolized in the liver and lung

A.

60
Q

What is the MOA of local anesthetics

A

Reversible block of the transmission of neural impulses when placed on or near a nerve membrane by stabilizing sodium channels in theirclosed state, preventing action potentials from propagating along the nerve

61
Q

True about local anesthetic toxicity EXCEPT

a. CNS toxicity occurs earlier than Cardiovascular system toxicity
b. Restlessness -> slurred speech-> tinnitus-> seizures-> unconsciousness
c. mgt of CNS toxicity is benzidiazepine/thiopental for seizures, and airway mgt
d. NOTA

A

B

restlessness
tinnitus
slurred speech
seizures
unconsciousness
62
Q

True about Cardiovascular system toxicity in local anesthetic

a. hypotension-> increased P-R intervals -> bradycardia-> cardiac arrest
b. Bupivacaine is very cardiotoxic
c. Lidocaine toxic dose is 5 mg/kg
d. NOTA
e. AOTA

A

E

63
Q

Calculate the volume of 0.5% bupivacaine needed to administer 3mg/kg to a 50kg person.

A

30mL

SRGRY3 (44 decks)

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