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Pharmacology Exam 4 > Different cases > Flashcards

Different cases Flashcards

1
Q

What is the MOA for caffeine?

A

nonselective inhibition of adenosine receptors and phosphodiesterase resulting in accumulation of cAMP and calcium with effects of smooth muscle relaxation and/or muscle/cardiac/CNS excitation. Also B1 and B2 adrenergic stim from catecholamine release

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2
Q

When are the primary uses of caffeine?

A

cath lab to stim tachy and ID origin
supplement
post dural puncture headache.

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3
Q

What are the doses of caffeine?

A

250mg at start/throughout/end of case as supplement.

For post dural puncture it is 1-2 doses of 500mg

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4
Q

What is the MOA of octreotide?

A

potent inhibitor of growth hormone, glucagon, and insulin. Decreases splachnic blood flow and inhibits release of serotonin, gastrin, vasoactive intestinal peptide, motilin, secretin, and pancreatic polypeptide

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5
Q

What are the uses of octreotide?

A

acromegaly, treating symptoms of metastatic carcinoid tumors, vasoactive intestinal peptide tumors (treat diarrhea)

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6
Q

What’s the toxic dose of octreotide?

A

there isnt one. no side effects either.

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7
Q

What are the doses of octreotide?

A

small procedure: 100mcg sq preop then 50-100mcg throughout the case.
major surgery 100-200mcg sq preop, possibly gtt or 500-1000mcg boluses iv

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8
Q

What is the MOA of Flolan?

A

direct vasodilation of pulm arteries and systemic arterial vascular beds, inhibits platelet aggregation

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9
Q

What is Flolan used for?

A

primary pulm htn

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10
Q

What are some considerations for flolan?

A

Don’t abruptly stop: short 1/2 life and can cause complications/death
Admin in dedicated iv with 0.22 micron filter
C/I with CHF (decrased LV function) b/c cant keep up with right heart

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11
Q

What is the MOA of methylene blue?

A

inhibits nitric oxide cGMP pathway by inhibiting guanylate cyclase in endothelium and reduces nitric relaxation of vessels.

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12
Q

What is Methylene blue used for?

A

to improve hypotension, hypoxia, and methemoglobinemia. increases MAP and SVR while decreasing pressor requirements. Also used as dye to check anastomosis in urology.

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13
Q

When is indocyanine green used?

A

when surgeon under microscope looking at vasculature

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14
Q

What is the dose of IC green?

A

0.5mg/kg over 6-10 sec

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15
Q

What can you expect after admin IC green?

A

transient drop in pulse ox sats

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16
Q

What is Onyx glue used for?

A

embolization on AVM and aneurysms,

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17
Q

What does the onyx glue do?

A

non-adhesive liquid embolic agent made of ethylene-vinyl copolymer, dimethyl sulfoxide and tantalum to show contrast under fluoro: after delivery material transforms into solid polymer

18
Q

What are the side effects of onyx glue?

A

PAINFUL, can cause bad breath and skin odor.

19
Q

What does a tocalytic do and what are examples?

A

stop uterine contractions: magnesium and endometh…

20
Q

How does oxytocin/pitocin work?

A

oxy receptors in uterus, increase cAMP and intracellular Ca

21
Q

What does methergine act on?

A

D1 antagonist

22
Q

What does carboprost (hemabate) act on?

A

prostacyclin

23
Q

When is carboprost C/I?

A

asthma and HTN due to bronchoconstriction

24
Q

Is txa 1st line in maternal hemorrhage kit?

A

No.

25
Q

When is methergine C/I?

A

HTN/preeclampsia, HAART

26
Q

When can you use inhaled TxA?

A

to treat airway bleeding after CT-guided mass ablation. need atomizer and filters so need RT to help

27
Q

How is thymoglobulin administered to kidney transplant patients?

A

through 0.22 micron filter via CENTRAL ACCESS

28
Q

How is Campath (alemtuzumab) admin, and what for?

A

SQ injection, for induction med of standard risk recipients

29
Q

How is Basiliximab (simulect) admin?

A

IV, central not required

30
Q

What chemo meds are given in HIPEC?

A

mitomycin, cisplatin

31
Q

Describe HIPEC.

A

Hyperthermic Intraperitoneal Chemotherapy; not curative, mainly palliative. put chemo in belly and shaken x90 min. used for intestinal, uterine, abdominal cavity CA.

32
Q

What are anesthetic considerations in HIPEC.

A

treat acidosis, chemo precautions, keep temp <38.5 b/c chemo is heated, so use ice packs and all the things

33
Q

What is the primary toxicity of cisplatin?

A

ototoxicity/nephrotoxicity

34
Q

When/why do you use sodium thiosulfate?

A

gtt when they infuse chemo and through end of case, given by anesthesia to mitigate chemo toxicity

35
Q

What is the MOA of sodium thiosulfate?

A

neutralizing agent for cisplatin (thought to be done in kidney

36
Q

What is the concentration of dex in kids?

A

dilute to 4 mcg/mL

37
Q

What can be used for ear tubes?

A

nasal fentanyl 2mcg/kg and dex

38
Q

What can you premed kids with?

A

midazolam, ketamine, tylenol (beware of sugar if on ketogenic diet can’t use)

39
Q

When can you premed kids?

A

2-6yo

40
Q

What can’t mitochondrial disorders have?

A

propofol

41
Q

Why do you need to be cautions in succ with kids?

A

potential for undiagnosed muscular dystrophy but still often used in laryngospasm

Pharmacology Exam 4 (7 decks)

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