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ITE > Drugs > Flashcards

Drugs Flashcards

1
Q

what benzo is metabolized exclusively through hepatic glucuronidation

A

lorazepam

good L aka GL= lorazzepam

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2
Q

phosphogene

A

chemical warefare agent that can cause severe pulmonary damage, treatment is supportive

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3
Q

interaction between non depolarizatizing neuro muscular blocking agents

A
  1. augmentation of antagonists affinity at receptor site
  2. central effects on alpha motor neurons and synapses
  3. inhibitiion of post synaptic nicotinic receptors

order of effect greatest to least:
des> sevo> iso> halogene > NO/propofol

think des is longer acting so has the strongest effect

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4
Q

mechanims of action of NO

A

breaks down GTP into GMP which is a smooth muscle dialator and anti inflammatory and inhibits platelet aggregation

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5
Q

what inhaled agent should be avoided in children w asthma

A

desflorane can cause increased airway reactivity and bronchospasms in children with ongoing pulm issues

** think if u give DES

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6
Q

what inhaled agent should be avoided in children w asthma

A

desflorane can cause increased airway reactivity and bronchospasms in children with ongoing pulm issues

** think if u give DES to asthma patient they may end up DED

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7
Q

protective mechanisms for spinal cord ischemic injury during aorta cross clamping include:

A

shunts
bypass
hypotherapy
spinal drain placement

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8
Q

drugs that prevent physiologic hypoxic pulmonary vasoconstriction

A
  1. nitroprusside
  2. nitroglycerine
  3. ACE
  4. ARB
  5. CCB
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9
Q

what drugs cause direct cerebral vasodilation

A 
nitroglycerine 
nitroprusside 
CCB
adenosine 
hydralazine
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10
Q

which drugs can potentiate the effects of neuromuscular blockades

A

aminoglycosides
tetracyclines
lincomycin
polymyxin

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11
Q

what drugs are associated w intense perineal itching

A

dexamethasone

fospropofol

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12
Q

long term use of barbituates causes what change to cytochrome p450

A

induces cyt p450 so will need higher doses of benzos etc. and other drugs metabolized by that enzyme

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13
Q

what drug works via the kappa opioid receptor

A

meperidine
1/10 as potent for analgesia as morphine
used for shivering

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14
Q

what drug works via the kappa opioid receptor

A

meperidine
1/10 as potent for analgesia as morphine
used for shivering

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15
Q

what drug is a glutamate antagonist

A

ketamine

NMDA is a subset of excitatory glutamate receptor

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16
Q

whats the concern with giving hydromorphone in renal insufficiency patients

A

all the mu opioid side effects will be metabolized by the liver so thats fine
but hydropmorphone via liver breaks down into H3G which is NEUROtoxic and removed by kidneys

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17
Q

what inhaled anesthetic can inhibit DNA synthesis in fetus

A

chronic NO expsosure can cause megaloblastic anemia

the rest of them are safe

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18
Q

what volatile gas blunts the baroreceptor reflex

A

isoflurane

think iso..static…no responding ….aka blunting baroreceptor

19
Q

what beta blocker is most likely to cause bronchoconstriction

A

labetalol

mixed receptor blocker….beta 2 blockade causes bronchoconstriction

20
Q

how does precedex effect evoked potential monitoring

A

precedex mimics non rem sleep–

so it will have little effect on evoked potential monitoring

21
Q

high altitude pulmonary edema is is from diffuse hypoxic pulmonary constriction.. what drugs will prevent HAPE

A

nifedipine and PDE-5 inhibitors

22
Q

hepatic metabolism of what gas causes inorganic fluoride production

A

Sevo

think sevo SEEPS into body (liver) and will give u the FLU (fluoride)

23
Q

what class of drugs can decrease clopedigrel’s efficacy

A

PPI

think PPI poop (make worse) on clopedigrel

24
Q

what is doxapram and when is it used clinically

A

respiratory stimulant, stmulates chemoreceptors on carotid body
used in hypercapnic respiratory failure in COPD patients with supplemental oxygen

25
Q

what receptors does epinephrine hit

A

alpha 1 causing vaso constriction

but also beta receptor agonist causing vasodilation in coronary vesse;s (think beta agonism is why its used for bronchospasm)

26
Q

what is the MOA of cilostazol

A

PDE3 inhibitor aka increases cAMP leading to vasodialtion

its also a anti platelet ?

27
Q

what opioids re metqabolized by liver

A

fentanyl aka good option for renal patients

hydrocodone —> H3G, if this accumulates its neuro excitatory

28
Q

what is isproterenol MoA

A

nonselective beta agonist
can be used for heart block or bradycardia

remember b1 is for the heart

29
Q

morphine and atracurium release what that means asthma exacerbation a possbilit y

A

histamine

30
Q

what volatile anesthetics potentiates neuromuscular the most

A

desflurane

think DES = DEATH

bad for asthmatics
will be the one to prolongate NMDA the most.. think MOST death the longest

31
Q

how is the drug effect of succinhylcholine mostly terminated

A

there is some psuedocholinesterase activity but the termination of the drug effect is mostly through succ passive diffusion out of the neuromuscular junction

32
Q

how is the drug effect of succinhylcholine mostly terminated

A

there is some psuedocholinesterase activity but the termination of the drug effect is mostly through succ passive diffusion out of the neuromuscular junction

33
Q

what is the initial dose vs the dose after acute rxn for dantrolene treating MH

A

intitially do 2.5 mg/kg every 5 ish minutes

think MH has 2 letters + give every 5 min so dose is 2.5

then 1 mg/kg every 4-6 hours or 0.25 mg/kg/hr infusion for 24 hours

34
Q

how does milirione effect preload

A

decreases preload

because of venodilation

but overall improved
CO and SV

35
Q

when stopping an irresversible antiplatlet drug how many platelts are replenished in 24 hours

A

10%-14% every 24 hours

so can take 7-10 days to replenish the whole pool

36
Q

what drug is ppx for organophosphate poisoning

A

pyridostigmine must be taken 30 min prior to organophosphase exposire, it prevents organophospahtes from binding to the AcHase it will bind to

the first line treatment is atropine then pralidoxime is the definite treatment

37
Q

what are risk factors for bradycardia when giving succ

A

repeat succ doses

young age

38
Q

which inhaled anesthetic decreases BP mainly by decreasing cardiac output

A

halothane

39
Q

what drug increases ICP

A

ketamine

40
Q

oral dose of versed in peds patients

A

0.5 mg/kg

41
Q

how doe hypercalcemia afffect roc

A

causes antagonism of roc so u will need higher doses

42
Q

what drugs decrease IOP

A

benzos
barbituates
volatile anesthetics

43
Q

common complications of spinal anesthesia

A

think unopposied parasympathetic

post dural puncture headache 
increased ventilatory response to hypercapnia 
vasodilation 
increased GI activity 
hypothermia/vasodilation 
transient hearing loss
44
Q

mechanisms by which mag causes hypotension

A

calcium antagonism in vascular smooth muscle

more NO production

ITE (7 decks)

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