Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm 2 > Drug Box 1 > Flashcards

Drug Box 1 Flashcards

1
Q

Versed Name (Generic and trade)

A

Midazolam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Versed Classification

A

Benzodiazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Versed contraindication

A

GLAUCOMA!!Pregnancy, lactation, CNS depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Versed dose and routes

A

Route - IM, IV, PO

Dose - (Adults) IV: 0.5-2 mg (usual total dose 2-5 mg) IM: 0.07-0.08 mg/kg (Nagelhout HB pg. 666-667)
Induction - 0.1-0.2 mg/kg IV (Nagelhout HB pg. 110)
preop kids- 0.5 mg/kg oral (20 mg max) (Nagelhout HB pg. 970), 0.07-0.1 mg/kg IM, 0.025-0.05 mg/kg IV (Nagelhout HB pg. 1199)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Versed MOA

A

(CNS depressant) MOA - binds to GABA receptor exerts its actions by modulating chloride channels (GABA receptor increases the frequency of chloride channel opening, resulting in postsynaptic membrane hyperpolarization and neuronal transmissions is inhibited)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Versed Elimination

A

Half-life 1.7-2.6 hours Renal and Hepatic elimination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Versed Onset

A

IV: 30-60 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Versed Peak

A

Peak - IV 2.8 - 5.6 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Versed Duration

A

IV: 15-80 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Versed misc.

A

Miscellaneous - Most common side effect is depression of ventilation caused by a decrease in hypoxic drive. Known for powerful amnestic effect and passes BBB. Cardiopulmonary bypass increases half-time dramatically.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Fentanyl name (generic and trade)

A

Trade name - (SUBLIMAZE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Fentanyl Classification

A

Classification - Opioid Agonist (Nagelhout Handbook, 650)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Fentanyl Contraindications

A

Contraindications - Reduce fentanyl doses in elderly or hypovolemic. Crosses the placental barrier, may produce depression of respiration in the neonate. Prolonged respiratory depression after cessation of transdermal patch use.
(Nagelhout Handbook, 650)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Fentanyl Dose and Route

A

Dose –
Analgesia: IV: 1 to 2 mcg/kg (Nagelhout Handbook, 650)
Induction: 50-100mcg (the norm per hammon) (attempt to blunt circulatory response to direct laryngoscopy or sudden changes in level of surgical stimulation (Flood, 232))

Epidural bolus:1 to 2 mcg/kg; infusion: 2 to 60 mcg/hr
Spinal bolus: 0.1 to 0.4 mcg/kg
Dosage form: injection: 0.05 mg/mL; transdermal patch: 100 mcg/hr. In conjunction with epidural administration: 1 to 2 mcg/kg. For infusion with epidural: 2 to 60 mcg/hr. In conjunction with spinal anesthesia: bolus dose of 0.1 to 0.4 mcg/kg.
(Nagelhout Handbook, 650)
Children 2-8 years old: 15-20mcg/kg (45 minutes before induction however, use of fentanyl in pediatrics shows an increase in PONV not influenced by prophylactic doses of droperidol)
Route - Transdermal, IV, IM, Epidural/Spinal, Transmucosal
(Nagelhout Handbook, 650)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Fentanyl MOA

A

Mechanism of Action - Opioids mimic the actions of enkephalins, endorphins, and dynorphins (endogenous ligands) by binding to opioid receptors, resulting in activation of pain-modulating (antinociceptive) systems.
Causes analgesia and anesthesia. (Flood, 218)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Fentanyl Elimination

A

Elimination - Excreted by the kidneys. Less than 10% unchanged in the urine. Metabolized by hepatic P450 enzymes with the metabolites having minimal activity. (Flood, 231)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Fentanyl Onset

A

Onset –
IV: within 30 seconds
IM: less than 8 minutes
Epidural/spinal: 4 to 10 minutes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Fentanyl Peak

A

Peak – 3.6 minutes (Flood, 32)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Fentanyl Duration

A

Duration –
IV: 30 to 60 minutes;
IM: 1 to 2 hours
Epidural/spinal: 4 to 8 hours.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Fentanyl Miscellaneous

A

Miscellaneous – Reversal Agent: (Narcan 0.2 to 0.4 mg IV). Large doses can be used as the sole anesthetic for surgery (Flood, 233).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Propofol name (generic and trade)

A

Diprivan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Propofol Classification

A

Classification: Sedative/Hypnotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Propofol Dose and rout

A

Route: IV
Induction: 1.5-2.5 mg/kg
Anesthesia maintenance: 100-300 mcg/kg/min
Subhypnotic: 10-15 mg (used as antiemetic or to treat neuropathic pain)
(Flood 5th edition page 162-164)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Propofol MOA

A

Increases GABA affinity for GABAa receptor. This decreases the rate of disassociation of the inhibitory neurotransmitter, GABA from the receptor and increases the duration of the GABA-activated opening of the chloride channel which leads to hyperpolarization of cell membranes (inhibition of the cell)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Propofol Elimination

A

Half time: 0.5-1.5 hours
Rapid metabolic clearance that exceeds hepatic blood flow. P450 –water soluble metabolites excreted by the kidneys. Less than 0.3% is unchanged in urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Propofol Onset

A

Dose Dependent, rapid onset, less than a minute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Propofol Peak

A

1 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Propofol Duration

A

15-45 min (depending on dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Propofol Misc

A

· Can cause pain at injection site
· Does NOT trigger malignant hyperthermia
· Strongly supports growth of E-coli & Pseudomonas aeruginosa. It is recommended that the contents of an unused ampule be discarded after 6 hours, and in the ICU the tubing and any unused portion be discarded after 12 hours
· No evidence of impaired elimination in patients with liver cirrhosis.
· Renal dysfunction does not influence the clearance of Propofol.
· Prolonged infusions may result in excretion of green urine reflecting the presence of phenols. This does not alter renal function.
· Propofol is associated with significant decreases in intraocular pressure that occur immediately after induction of anesthesia
· Can cause lactic acidosis in pediatric and adult patients with prolonged, high-dose infusions (Propofol infusion syndrome)
(Flood 5th edition pages 160-168)
Supply: 200mg/20ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Propofol Contraindication

A

Avoid in patients with known hypersensitivity to Propofol, its components or have a lipid metabolism disorder
· Do not use with patients who are sensitive to sodium metabisulfite –may cause anaphylactic symptoms
· Caution is advised in elderly, debilitated, and cardiac-compromised patients
· Controversy exists regarding whether Propofol should be avoided in patients who are allergic to eggs, soy, or peanuts.
(Nagelhout 5th edition page 109)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Rocuronium Name (generic and trade)

A

Zemuron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Rocuronium Classification

A

Nondepolarizing Neuromuscular blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Rocuronium Contraindication

A

Bromide hypersensitivity and Precaution in liver pts
Dose- 0.6-1.2mg/kg (Nagelhout, p. 692) RSI dose: 1.2mg/kg (Nagelhout, p. 692)
Fasciculation dose: 10% of full dose given before propofol dose when using succs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Rocuronium Dose and Route

A

Route - Intravenous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Rocuronium MOA

A

Binds to nicotinic acetylcholine receptors at the postsynaptic muscle membrane. Competitive antagonist of Ach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Rocuronium Elimination

A

Liver, Billary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Rocuronium Onset

A

1-3 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Rocuronium Peak

A

1.7 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Rocuronium Duration

A

30-120 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Rocuronium Misc

A

Rocuronium can be used in patients who are hemodynamically compromised due to the less or no histamines present in the drug (Flood, p.334)
-reversal agent is Sugammadex (Nagelhout, p.1155)
-Drug of choice in RSI when succinylcholine is contraindicated (Nagelhout, p. 693)
-Enhanced muscle relaxant properties with Des (in class)
Supply: 10mg/ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Succunylcholine Name (generic and trade)

A

Trade: (Anectine, Quelicin)

42
Q

Succunylcholine Classification

A

Classification: Depolarizing skeletal muscle relaxant

43
Q

Succunylcholine Contraindication

A

Succinylcholine should not be used for routine intubation in children younger the age of 12 because of reports of sudden cardiac arrest in children with undiagnosed Duchenne muscular dystrophy and with muscle disorders. Succinylcholine is contraindicated in patients with malignant hyperthermia, genetic variants of plasma cholinesterase or cholinesterase deficiencies, myopathies associated with elevated creatinine phosphokinase values, muscle disorders or muscular dystrophies, acute narrow-angle glaucoma, severe muscle trauma or muscle wasting, neurologic injury (i.e., paraplegia, quadriplegia, spinal cord injury, or cerebrovascular accident), hyperkalemia, severe sepsis, electrolyte imbalances, or third-degree burns over more than 25% total body surface due to potentially life threatening hyperkalemia. Repeated doses at short intervals (less than 5 minutes) are associated with bradycardia.

44
Q

Succunylcholine Dose and Route

A

Route: IV, IM
Adults: intravenous: 1 to 1.5 mg/kg
Children: intravenous: 1 to 2 mg/kg; intramuscular: 2 to 4 mg.kg
Dosage forms: injection: 20 mg/mL; powder for infusion: 500 mg (mix in 500 mL for 1 mg/mL solution.

45
Q

Succunylcholine MOA

A

Partial agonist against the nicotinic acetylcholine receptor (nAChR) and depolarizes (opens) the ion channels. This opening requires the binding of only one molecule of SCh to the α subunit. The other α subunit can be occupied by either acetylcholine or SCh. Because SCh is not hydrolyzed by acetylcholinesterase, the channel remains open for a longer period of time than would be produced by acetylcholine, resulting in a depolarizing block (sustained depolarization prevents propagation of an action potential)

46
Q

Succunylcholine Elimination

A

plasma cholinesterase

47
Q

Succunylcholine Onset

A

Onset: 30 to 60 secs

48
Q

Succunylcholine Peak

A

Peak: 2 minutes (Nagelhout)

49
Q

Succunylcholine Duration

A

Duration:5 to 10 minutes

50
Q

Succunylcholine Misc

A

Pretreat with atropine because of the incidence of bradycardia.

51
Q

Morphine name (generic and trade)

A

Astramorph PF, AVINza, Infumorph,

Duramoph PF, Embeda, Kadin

52
Q

Morphine Classification

A

Classification: opioid agonist

53
Q

Morphine Contraindication

A

hypersensitivity to morphine, acute/severe asthma, ↑ICP, pregnancy, severe respiratory depression, paralytic ileus, pruritus (Flood p. 228)

54
Q

Morphine Dose and Route

A 
Route: PO, IV, IM, Rectal, Epidural
Doses:
Nagelhout, p. 1036)
(Barash, p. 515, 1231)
Adult Analgesia (given 60 min prior to end of procedure): 0.15-0.2 mg/kg
PACU Analgesia: 2 mg bolus q5-10 min

Intraop Anes peds: 50-100mcg/kg

PostOp peds: 50mcg/kg

Single dose Epidural: 2-5mg

Epidural Bolus adult: 3-5 mg bolus

Infusion Epidural: 0.1-1mg/hr

55
Q

Morphine MOA

A

Mu1 and Mu2 agonist, ↑ threshold to pain and modifies the perception of noxious stimulation, poor lipid solubility, K+ channel opening and inhibition of Ca++ channel causing inhibition of ascending pathway

56
Q

Morphine Elimination

A

Liver

57
Q

Morphine Onset

A 
PO
60 min
IM
30-60 min
IV
20 min
58
Q

Morphine Peak

A

po 60 min
im 30-60 min
iv 30-60 min

59
Q

Morphine Duration

A

4-5 hrs

60
Q

Vecuronium Name (generic and trade)

A

Norcuron

61
Q

Vecuronium Classification

A

Nondepolarizing/ Steroidal Compound) Monoquarternary neuromuscular blocker

62
Q

Vecuronium Contraindications

A

Contraindications - caution use in patients with decreased liver and kidney function, anaphylaxis (Flood p. 331)

63
Q

Vecuronium Dose and Route

A

Route - IV

Dose - Intubating Dose: 0.1 mg/ kg (Flood p. 329)

64
Q

Vecuronium MOA

A

Binds to nicotinic acetylcholine receptors at the postsynaptic muscle membrane

65
Q

Vecuronium Elimination

A

Primarily eliminated by the liver and excreted in bile (renal - 30% of administered dose) (Flood p. 331)

66
Q

Vecuronium Onset

A

Onset - within 3 minutes (Nagelhout p. 154)

67
Q

Vecuronium Peak

A

Peak - 2.4 min (Flood p. 329)

68
Q

Vecuronium Duration

A

Duration- intermediate: 20-50 min (Flood p. 328)

69
Q

Vecuronium Misc

A

Molecular instability in solution (prepared as a lyophilized powder), less potent than pancuronium, duration of block is dependent on liver function, 80% of blocking potency is from the metabolite 3-OH and long term administration can have lingering effects because of this metabolite, No histamine release so it is more appropriate for those that are hemodynamically unstable (Flood p. 334), reversed by Sugammadex

70
Q

Cisatricurium name (generic and trade)

A

Nimbex

71
Q

Cisatricurium Classification

A

Benzylisoquinoli-nium non-depolarizing Neuromuscular Blocking Drug

72
Q

Cisatricurium Contraindication

A

Use caution in patients with neuromuscular diseases (myasthenia gravis, Guillian-Barre, etc). Hyperthermia may potentiate/increase duration/intensity of paralysis.

73
Q

Cisatricurium Dose and Route

A

Route: IV push or IV infusion
4.) Dose: Intubation: 0.1-0.2mg/kg Peds Intubation: 150mcg/kg, Maintenance: 0.01-0.02 mg/kg Infusion: 1-2mcg/kg/min

74
Q

Cisatricurium MOA

A

Nondepolarizing neuromuscular blockers compete with acetylcholine for the active binding sites at the postsynaptic nicotinic acetylcholine receptor (also called competitive antagonists) , and therefore, disallowing depolarization to occur

75
Q

Cisatricurium Elimination

A

Hepatic

76
Q

Cisatricurium Onest

A

2-4min

77
Q

Cisatricurium Peak

A

3-5 mins

78
Q

Cisatricurium Duration

A

20-50 min

79
Q

Cisatricurium Misc

A

: Does not cause histamine release. Does not affect HR or BP, nor does it produce autonomic effects Morgan & Mikhail, p. 221) Good for renal patients
Supply: 20mg/10ml

80
Q

Lidocaine name (generic and trade)

A

Name: Lidocaine (Xylocaine)phe

81
Q

Lidocaine Classification

A

Class 1b antiarrhythmic agent (membrane stabilizing and mild NA channels effects) and a local anesthetic.

82
Q

Lidocaine Contraindications

A

Do Not give this drug when PVCs occur with bradycardia or escape rhythm. May cause Seizures, Restlessness, vertigo, tinnitus, and difficulty focusing.

83
Q

Lidocaine Dose and Route

A

Route: IV, IM, SQ, Topical, Epidural, Spinal. (Flood pg. 284,277)
Dose: 1-2 mg/kg bolus 1.5mg/kg/hr should not exceed 300mg/hr. Epidural 50-300mg max dose. Local 300mg max dose. Transdermal: 3 patches within a 24hr timeframe. (Flood, pg.277,284,299)

84
Q

Lidocaine MOA

A

It is amide, binds to specific sites in voltage gated sodium channels blocking sodium current reducing excitability of neuronal, cardiac, CNS.

85
Q

Lidocaine Elimination

A

Hepatic

86
Q

Lidocaine Onset

A

45-90 mins

87
Q

Lidocaine Peak

A

10-20 mins

88
Q

Lidocaine Duration

A

30 mins- 4 hrs

89
Q

Lidocaine Misc

A

May be given in conjunction with epinephrine to help increase potency and decrease systemic effects. Helps with laryngeal spasms. Also blunts the gag reflex.

90
Q

Etomidate Name (generic and trade)

A

Amidate

91
Q

Etomidate Classification

A

Central nervous system agent; nonbarbiturate hypnotic without analgesic activity

92
Q

Etomidate Contraindications

A

Causes Adrenal Suppression→inhibition of cortisol, avoid in sepsis & hemorrhage (need cortisol)

93
Q

Etomidate Dose and Route

A

Route IV

Dose-0.2-0.4mg/kg (Flood pg 169)

94
Q

Etomidate MOA

A
  • (Gaba- mimetic) Binds to GABAA receptors→increase inhibitory neurotransmitter effect.
95
Q

Etomidate Elimination

A

Elimination - ester hydrolysis is the primary mode of metabolism in the liver and plasma

96
Q

Etomidate Onset

A

Onset- 30seconds-60 seconds

97
Q

Etomidate Peak

A

Peak- within 1 minute

98
Q

Etomidate Duration

A

5-15 mins

99
Q

Etomidate Misc

A

Miscellaneous- pain on injection (Flood pg 168-170)
Reference: book-FLOOD pg. 168-171.
Supply: 20mg/10ml

100
Q

Morphine Misc

A

↓ dose with ESRD, monitor for delayed onset respiratory depression, Narcan 2 mg up to 10 mg, PO morphine has significant first-pass metabolism in the liver dropping the bioavailabilty of it to 25% (1 mg IV morphine ~ 4 mg PO), Less than 0.1% of IV enters the CNS (Flood p. 226-228)

Pharm 2 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions