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Drugs Flashcards

1
Q

Anthracycline antibiotic that works by intercalating DNA:

A

Doxorubicin

Causes reversible cardio toxicity

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2
Q

SE of vincristine?

A

Peripheral neuropathy

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3
Q

SE of cyclophosphamide?

A

Hemorrhagic cystitis

SIADH

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4
Q

SE of cisplatin?

A

Neurotoxicity
Nephrotoxicity
Ototoxicity

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5
Q

How is milrinone cleared?

A

Really excreted

Avoid in renal impaired pts

Phosphodiasterase inhibitor III at low doses; non-selective at higher doses

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6
Q

How does dopamine work?

A

Low doses (1-3 mg/kg/min)—-> increases renal blood flow, maintain diruesis thru D1/D2 renal vasculature stimulation

Moderate doses (5-10 mg/kg/min)—->increases CO and contractility thru B-stimulation

Higher doses (>10 mg/kg/min)—->stimulates peripheral a-receptors causing peripheral vasoconstriction

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7
Q

How does norepinephrine work?

A

A/b

At lower doses; b predominates—> increased HR and contractility

A higher doses; a predominates—-> increased peripheral vasoconstriction, blood pressure

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8
Q

How does epinephrine work?

A

A/b

At low doses; B1 causes increased HR and contractility, B2 peripheral vasodilation

At higher doses; alpha pre-dominates leading to increased SVR and blood pressure

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9
Q

What determines arterial oxygen content?

A

CaO2= (Hgb x 1.34 x SaO2) + (PaO2 x 0.003)

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10
Q

Milrinone and pulm HTN?

A

Milrinone is a phosphodiesterase III inhibitor

Also leads to pulmonary vasodilation by preventing breakdown of cAMP

Useful in pts with chronic pulm HTN

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11
Q

Depolarizing neuromuscular agent?

A

Succinylcholine

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12
Q

Alvimopam?

A

U-opioid receptor antagonist

Shown to decrease Ileus post-bowel surgery

Contra-indicated in pts who have received opioid in prior 7 days before sx 2/2 risk of MI and GI SE

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13
Q

Warfarin dose change after gastric bypass?

A

Should be decreased by 25%

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14
Q

Benzo reversal agent?

A

Flumazenil

Can cause seizures

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15
Q

SE of flumazenil?

A

Tachycarrhythmias
Seizures
Dry mouth
Palpitations

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16
Q

SE of benzocaine is methehmoglobinemia, what’s the tx?

A

Supportive care and methylene blue in severe cases

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17
Q

In pts with open angle glaucoma which neuromuscular blocking agent is avoided?

A

Succinylcholine

Leads to rise in intra-ocular pressure

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18
Q

MOA of promethazine?

A

Antiemetic that inhibits dopamine receptors

SE is tardive dyskinesia; treated with Benadryl

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19
Q

MOA of furosemide?

A

Inhibits the Na-K-Cl co-transporter in the ascending limb of the loop of Henle

20
Q

B-blocker overdose treatment?

A

Glucagon—-> increases myocardial contractility

21
Q

Tx of benzo overdose?

A

Flumazenil

Competitively inhibits GABA receptor

22
Q

Tx of acetaminophen overdose?

A

NAC

Replenishes glutathione

23
Q

MC symptom of local anesthetic systemic toxicity?

A

Diziness, lightheadedness

24
Q

MOA of benzos?

A

Increase frequency of Cl-channel opening—-> facilitating GABA action

25
Q

Nicotinic Ach receptor agonist used for paralysis during intubation:

A

Succinylcholine

Rapid onset; short duration of action

It’s a depolarizing muscular blocker

26
Q

Drug used in cancer chemotherapy, its an athracyclin antibiotic that works by intercalating DNA:

A

Doxorubicin (Adriamycin)

27
Q

SE of cyclophosphamide?

A

Hemorrhagic cystitis
SIADH

28
Q

SE of cisplatin?

A

Nephrotoxicity
Neurotoxicity
Ototoxicity

29
Q

Management of symptomatic bradyarrhythmia?

A

Can do atropine 1 mg IV every 3-5 mins for max dose of 3 mg

If that doesn’t work can do transcutaneous pacing

If that doesn’t work can consider transvenous pacing

30
Q

Milrinone MOA and use in pulmonary hypertension?

A

Phosphodiasterase III inhibitor ; used as a contractility agent in pts in cardiogenic shock

Also have vasodilatory properties in the pulmonary vasculature; which can lower pulmonary HTN

31
Q

How does dopamine work?

A

At low does; 1-3 ug/kg/min; increase renal blood flow and maintains diuresis by acting on DA1/DA1 receptors

Moderate doses; 3-5 ug/kg/min; stimulates cardiac b-receptors; increases contractility

32
Q

Alvimopam; is a u-opioid receptor antagonist used in ERAS protocols; but its use it contraindicated in pts that have received opioids >7 days, why?

A

Causes increased risk of MI and GI side effects

33
Q

Reversal agent for benzo overdose?

A

Flumazenil

34
Q

SE of flumazenil?

A

Can lower seizure threshold

Tachyarrhythmias, palpitations, dry mouth

35
Q

MOA of lasix?

A

Loop diuretic
Inhibits luminal Na-K-2Cl transporter in thick ascending limb of loop of Henle

36
Q

SE of lasix?

A

Tinnitus
Hearing loss
Vertigo
H/A

37
Q

Promethazine?

A

Antiemetic that inhibits dopamine receptors

SE causes tardive dyskinesia

38
Q

What neuromuscular relaxant during anesthesia avoided in open angle glaucoma?

A

Succ

Increases intra-ocular pressure; can lead to closed angle glaucoma

39
Q

Rapid reversal of rocuronium,?

A

Sugammadex

40
Q

Neostigmine?

A

Achetylcholinesterase inhibitor used for reversal of rocuronium

Has SE of bradycardia (atropine or glycopyrolate are usually given together to counteract these SE)

Sugammadex preferred

41
Q

Bevacizumab;

A

Monoclonal antibody that binds VEGF

Most commonly used anti-angiogenic agent

20 day half-life

Should wait 7-14 days between small surgical procedures and initiation of bevacizumab

42
Q

How do benzos work?

A

Bing to GABA-A receptor, which increases receptors affinity for GABA which is an inhibitory neurotransmitter

43
Q

Dabigatran;

A

Direct thrombin inhibitor

Binds thrombin

Reversal; idaricizumab; 5 g IV given in two separate 50 ml bolus infusion

44
Q

Reversal of apixaban and rivaraxoban?

A

Andexat Alfa/

45
Q

Bezlotuxumab?

A

Monoclonal antibody that’s used in refractory c diff

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