CA2 TYS Learning Pts + MC’s Drugs Flashcards
(T/F) Thiopentone is a long-acting GA
False
- barbiturate
- rapid induction & rapid recovery
(T/F) Nephrotoxicity is dependent on metabolism to fluoride
True
(T/F) Non-ionised metabolites from LA will bind to the voltage-sensitive sodium channel
False
- charged form of LA: most active, cannot readily exit Na+ channels
- uncharged form: impt for rapid penetration of lipid membranes
What happens:
- uncharged LA will get absorbed into the cell membrane of a nerve
- inside the cell, it becomes charged and binds/plugs the Na channel from inside
(T/F) Bupivacaine is most cardiotoxic
True
- most hydrophobic => most likely to penetrate lipid membrane
- thus, prolonged DOA
- CVS is most extensively affected by LAs
=> arteriolar dilation & depression of myocardial contractility => systemic hypotension (mean arterial pressure decrease)
=> arrhythmia
(T/F) Lidocaine used with adrenaline to reduce systemic absorption
True
(T/F) LAs cause toxicity in CNS & CVS
True
CVS (most extensively effected):
- arteriolar dilation & depress myocardial contractility => systemic hypotension
- arrhythmia
- indirect effects on autonomic nervous system
CNS:
- sleepy, lightheaded, restless, visual & auditory disturbances
- at higher conc: nystagmus, muscle twitching, seizures, coma
(T/F) Cocaine causes an increase in blood pressure
True (according to TYS)
- cuz it induces catecholamine secretion (activates sympathetic system)
(T/F) Cerebral blood flow and intracranial blood flow decreases from inhaled GAs
False
- CVS: decreased mean arterial pressure => increased cerebral blood flow due to lowered vascular resistance
- undesirable in px w high intracranial pressure
- use NO instead of halothane cuz its less likely to increase cerebral blood flow
(T/F) Nephrotoxicity dependent on extent of metabolism of F (for inhaled GAs)
True
(T/F) Rate of onset and recovery rate related to blood solubility for inhaled GAs
True
(T/F) MAC related to blood solubility, in inhaled GAs
True
MAC: minimum alveolar concentration
(T/F) In conscious sedation, px can still respond to verbal communication
True
(T/F) Prednisone is a prodrug
True
- prodrug of prednisolone
- like how cortisone is prodrug of cortisol
(T/F) small nerves are more sensitive to LA than large nerves
True
Which of the following is least likely to affect absorption of insulin?
1. Depth of injection
2. Concurrent acute infection
3. Concentration of insulin
4. Physical activity
5. Site of injection
Ans: concentration of insulin
(T/F) inhaled salmeterol increases CAMP levels in smooth muscle airway
True
- long acting slow onset B2 agonist
- increases cAMP => increase K+ conductance => decrease intracellular Ca2+ & MLCK => ASM relaxation
How long does Salmeterol last?
12h
- same for formoterol
- indacaterol lasts for 24 hrs
(T/F) salmeterol causes urinary retention
False
(T/F) Warfarin reduces Vit K pool
True
- warfarin issa vitamin k antagonist
- oral administration, slow onset
- crosses placenta, cannot use in pregnancy
- teratogen
(T/F) warfarin is a teratogen
True
- crosses placenta
- can cause fetal warfarin syndrome, birth defects, haemorrhagic fetus, abortion
(T/F) warfarin binds to factor 10a which prevents coagulation cascade
False
- it doesnt bind to factor 10a
- but takes away vit k which means 10a cannot be gamma carboxylated
(T/F) warfarin prevents gamma carboxylation of factor 10a
True
- vit K: essential cofactor in carboxylation of glutamate residues
- warfarin => causes vit k to be stuck in oxidised form by inhibiting the vit k reductase enzyme
- no vit k to enable gamma carboxylation of factor 10a
(T/F) Clopidogrel is used for arterial thrombosis
True
- tldr: inhibits ADP-induced platelet aggregation
Mefenamic acid issa
Selective cox2 inhibitor
- better for px w acid reflux and dyspepsia
List the non-selective cox inhibitors
- Naproxen
- Ibuprfen
- Diclofenac
What side effect is most common in midazolam?
Amnesia
Man in dental chair has a panic attack. What drug would you administer?
Oral/IV diazepam (benzodiazepine)
- long acting (1 day)
What is the emergency treatment for status epilepticus?
IV diazepam/lorazepam
(T/F) NO is a GA drug often used for labour pains
True
- used as analgesic
(T/F) lipid solubility of inhaled GA affects rate of onset
False
- solubility in blood affects the onset and recovery
(T/F) MAC is defined as the 50% of the immobilization in patients during skin incision
True
MAC: minimum arterial conc
(T/F) LA can be injected in epidural space for regional anaesthesia
True
(T/F) LA is most effective in small myelinated sensory nerves
True
- more effective in small nerves than in big nerves
(T/F) LA is administered w adrenaline to increase absorption
False
- slows down rate of absorption of systemic => allows greater uptake of anaesthetic by nerves => enhance effect of block
(T/F) LA works by inhibition of sodium channels
True
What happens:
- uncharged LA will get absorbed into the cell membrane of a nerve
- inside the cell, it becomes charged and binds/plugs the Na channel from inside
(T/F) LAs are less effective in inflamed tissues
True
(T/F) lidocaine is a long acting amide LA
False
- it is a medium acting amide LA
(T/F) ester LAs are easily broken down in plasma by cholinesterases
True
(T/F) Cocaine causes vasoconstriction
True
- unlike other LAs that cause arteriolar vasodilation
(T/F) naproxen is a cox 1 selective inhibitor
False
- non selective
Patient taking naproxen for pain, comes back w nausea and heartburn. What is the likely cause?
Cox 1 inhibition
(T/F) All NSAIDs cause bruising at anti-inflammatory and analgesic doses
False
(T/F) all NSAIDs cause water retention at anti-inflammatory and analgesic doses
True
(T/F) all NSAIDs impair wound healing at anti-inflammatory and analgesic doses
True
(T/F) all NSAIDs are contraindicated at third trimester of pregnancy at anti-inflammatory and analgesic doses
True
A 35 yr old px w asthma & history of wheezing n urticaria had naproxen. Intends to undergo a dental procedure & expected to have mild postoperative pain. Which analgesia is most suitable for this patient?
Paracetamol
(Not aspirin, ibuprofen, naproxen or morphine)
