Drugs

Question 1

Whats our Adult dosage for Adenosine in SVT?

Answer 1

1st = 6mg
after 2 mins
2nd = 12mg
after 2 mins
3rd = 12mg

Question 2

Contraindications for Adenosine?

Answer 2

Second or Third AV block without pace-maker or sick sinus

Question 3

MoA of Adenosine

Answer 3

Agonism of Adenosine receptors A1 and A2 reducing conduction time.
Increases potassium efflux and inhibiting calcium influx through channels in the nerve cells –> hyperpolarization of cell

Question 4

Whats our Paediatric dosage for Adenosine in SVT?

Answer 4

1st = 100mcg/kg
after 2 mins
2nd = 200mcg/kg
after 2 mins
3rd = 300mcg/kg

Question 5

Caution for Adenosine?

Answer 5

Reactive airway disease as it may cause 30mins of bronchoconstriction

Question 6

MoA of Amiodarone

Answer 6

Block potassium efflux –> prolongs the absolute refractory period

Question 7

Contraindications for Aspirin?

Answer 7

Severe Bleeding
Reyes Syndrome

Question 8

Onset of Aspirin?

Answer 8

10 mins

Question 9

MoA of Aspirin

Answer 9

Inhibits COX-1 enzyme which blocks the production of Thromboxane A2 which is needed for platelet aggregation

Question 10

Atropine Dosages?

Answer 10

Atropine 600mcg
Repeat PRN
If ineffective after 1.2 mg try other methods ie adrenaline/pacing
Max 3mg

Question 11

MoA Atropine

Answer 11

Competitively binds to and inhibits muscarinic acetylcholine receptors.
M1, M2, M3, M4, M5

Question 12

How do we mix Benzylpenicillin?

Answer 12

1.2g with 3.2mL water

Question 13

MoA of Benzylpenicillin?

Answer 13

Inhibits the last stage of bacterial cell wall synthesis leading to lysis

Question 14

Which bacterial does Benzylpenicillin target?

Answer 14

Gram positic cocci
Narrow spectrum antibiotic

Question 15

Precuations for Carbetocin?

Answer 15

Pre-eclampsia
Migraine
Asthma

Question 16

Duration of Action of Carbetocin?

Answer 16

Sustained uterine contraction for 11 mins
Rhythmic contractions for 120 mins

Question 17

MoA of Carbetocin?

Answer 17

Binds to oxytocin receptors on the smooth musculature of the uterus

Question 18

Duration of Action of Clonazepam?

Answer 18

Onset of action 15 mins
Duration 6-12 hours

Question 19

What do we use Clonazepam for?

Answer 19

Palliative care anxiety
Delirium in combination with haloperidol

Question 20

Cophenylcaine constituents?

Answer 20

5% Lidocaine
0.5% Phenylephrine

Question 21

Cophenylcaine Onset of action?

Answer 21

1-2 minutes for onset
Duration of 1 hour

Question 22

Cophenylcaine MoA?

Answer 22

Phenylephrine: Alpha-1 adrenergic agonist causing vasocosntriction
Lidocaine: Bings to internal sodium channels preventing the post synaptic neuron from depolarising

Question 23

Contraindications for Droperidol

Answer 23

Neuroleptic Malignant Syndrome
Parkinsons
Phaechromocytoma
Pregnancy
Long QT

Question 24

Onset of Action of Droperidol

Answer 24

Onset 10-15 minutes
Duration 3-4 hours

Question 25

Adverse reactions to Droperidol?

Answer 25

Hypotension Respiratory Depression Extrapyramidal events

Question 26

Droperidol MoA?

Answer 26

Multitude of effects

Question 27

Onset of Action Fentanyl

Answer 27

2-5mins Duration 30-60mins

Question 28

Fentanyl MoA

Answer 28

Binds to opiate receptors, especially Mu --> decreases influx of calcium ions --> hyper-polarization of nerves --> decrease activity

Question 29

MoA of Fexofenadine?

Answer 29

Agonist of the H1 receptor preventing activation and de-granulation of mast cells.

Question 30

MoA Glucagon?

Answer 30

Activation of hepatic glucagon receptors stimulating glycogenolysis and release of glucagon

Question 31

MoA GTN?

Answer 31

GTN --> NO --> cGMP increase leading to further vasodilation

Question 32

MoA Haloperidol?

Answer 32

Antagonist of Dopamine (D2) both in the mesocortical system and CTZ

Question 33

Onset of Action of Hydrocortisone?

Answer 33

10 mins Duration 6-12 hours

Question 34

What do we use Hyoscine Butylbromide for?

Answer 34

Delirium and Anxiety Nausea and vomiting along with bowel obstruction Augmented Sedation with benzodiazapine

Question 35

MoA of Hysocine Butylbromide

Answer 35

M3 receptor antagonist resulting in decreasing colonic contraction Reduces spasms Blocks transmission of neural impulses in the parasympathetic ganglia

Question 36

MoA Ibuprofen

Answer 36

COX1 and COX2 inhibition leading to prostaglandin reduction and in turn pain, inflammation and fever

Question 37

MoA Ipratropium

Answer 37

Muscarinic antagonist -->inhibit parasympathetic drive -->decrease bronchial secretion and constriction

Question 38

Adverse effects of Ketamine

Answer 38

Dysphoria and emergence Apnoea N/V Tachycardia and hypertension Laryngospasm Hypersalivation

Question 39

MoA Ketamine

Answer 39

NMDA antagonist Delta type Opiod binder, Kappa agonist, Mu binder Monoaminergic Muscarinic binder Calcium gated ion channels

Question 40

Levetiracetam MoA?

Answer 40

Increases function of synaptic vesicle protein --> increased release of neurotransmitters

Question 41

Onset of action of Lorazepam?

Answer 41

15 minutes Duration 6-8 hours

Question 42

Adverse effects of Lorazapam?

Answer 42

Vertigo Disorientation Paradoxical excitation

Question 43

MoA Lorazapam?

Answer 43

Binds to GABA-A --> increases flow of chloride ions into the cell --> hyperpolarization

Question 44

MoA Magnesium Sulphate?

Answer 44

Vasodilation: Calcium antagonist --> decreases intracellular calcium -->decreases myosin contractility --> decreases spasm Anticonvulsant: Decreases acetylcholine released at the motor end plate --> prevents seizures

Question 45

Contraindications of Metaraminol?

Answer 45

Heart block due to reflex bradycardia Heart failure due to high afterload

Question 46

MoA Metaraminol?

Answer 46

Alpha-1 Adrenergic

Question 47

When do we use metoclompramide?

Answer 47

N/V Poor gastric emptying Nausea due to constipation

Question 48

Contraindications for metoclopramide?

Answer 48

Intestinal obstruction Parkinsons disease

Question 49

MoA Metoclopramide?

Answer 49

Nausea: Inhibits D2 and Serotonin 5-HT3 in CTZ Prokinetic: releases ach allowing increased lower oesophageal sphincter and gastric tone --> gastric emptying

Question 50

Naloxone onset of action?

Answer 50

IV and IN: 1-2 mins IM: 2-5 mins

Question 51

Naloxone MoA

Answer 51

Competitive inhibitor of the u-opiod receptor

Question 52

Contraindications for Olanzapine?

Answer 52

Parkinsons Neuroleptic Malignant Syndrome

Question 53

Onset of action and duration for Olanzapine

Answer 53

Onset 15 mins Duration 24 with peak at 6 hours

Question 54

MoA ondansetron?

Answer 54

Selective antagonist of Serotonin 5-HT3

Question 55

Paracetamol onset of action?

Answer 55

IV: 5-10 mins Oral: 15-30 mins

Question 56

Salbutamol contraindications?

Answer 56

<1 year old

Question 57

MoA of Salbutamol?

Answer 57

Beta-2 agonist --> Increase intracellular cAMP --> Inhibits phosphorylation of myosin and lowers intracellular calcium --> relaxation

Question 58

Indications for TXA use?

Answer 58

HR>120 or SBP <90 Less than 3 hours

Question 59

MoA TXA?

Answer 59

Inhibits the activation of plasminogen (binding of plasminogen to fibrin causes fibrinolysis)