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Appendix > Drugs > Flashcards

Drugs Flashcards

1
Q

Reversal for dabigatran?

A

idaricizumab

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2
Q

MOA of dabigatran?

A

direct thrombin inhibitor

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3
Q

Can we get rid of dabigatran via dialysis?

A

YES

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4
Q

MOA of rivaraxaban?

A

Factor Xa inhibitor

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5
Q

Reversal for rivaraxaban?

A

andexanet alfa

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6
Q

For immediate reversa of rivaraxoba, where we dont have andexanet alfa, what do we use for reversal?

A

4-factor PCC

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7
Q

MOA of fondaparinux?

A

binds to anti-thrombin III, resulting in inhibition of factor Xa

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8
Q

MOA of clopidrogel?

A

irreversably blocks ADP receptor P2Y12 on platelet membrane

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9
Q

Reversal agents for warfarin?

A

PO vit K

FFP

PCC

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10
Q

What abx can precipitate serotonin syndrome?

A

linezolid

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11
Q

Sxs of serotonin syndrome?

A

high body temp
agitation
sweating, diarrhea, dilated pupils

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12
Q

Mu-opioid antagonist can mitigate the GI effects of narcotics without interfering with their analgesic affects and has been shown to be beneficial in ERAS protocols:

A

alvimopam

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13
Q

Idaricizumab is reversal for what?

A

dabigatran

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14
Q

Onset of idaricizumab for dabigatran reversal?

A

immediate onset

good for 24 hrs

**idaricizumab is a direct antibody that neutralizes dabigatran directly

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15
Q

If idaricizumab is not available, how do we reverse dabigatran?

A

4 factor PCC

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16
Q

Optimal reversal agent of all factor Xa inhibitors and warfarin?

A

4-factor PCC

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17
Q

Onset of 4-factor PCC in reversing factor Xa inhibitors and warfarin?

A

5-15 mins

lasts for 12-24 hrs

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18
Q

Half life of dabigatran?

A

12-17 hrs

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19
Q

Half life of rivaraxaban or apixaban?

A

riv—-> 5-9 hrs

apixaban–> 12 hrs

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20
Q

Pt has epidural catheter in place, post-op develops LE weakness and numbness; what are you thinking?

A

epidural hematoma

get an MRI

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21
Q

Pts with coronary stents on dual anti platelet therapy; ASA and plavix, when should their elective surgeries be performed?

A

defer for at least 6 weeks after bare-metal stent

defer for at least 6 months after drug-eluting stent

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22
Q

MOA of methadone?

A

full opioid agonist

dosed daily

23
Q

4 factor PCC is used or warfarin reversal, what does it contain?

A

factors II, VII, IX, X

proteins C, S, antithrombin III

24
Q

This direct thrombin inhibitor is given orally;

A

dabigatran

25
Q

What thrombin inhibitors given IV?

A

argatroban

bivalurdin

26
Q

Dabigatran is an oral direct thrombin inhibitor that should be used with caution in pts with?

A

renal problems

metabolized by the kidneys

27
Q

Dabigatran is metabolized by?

A

kidneys

28
Q

This Xa inhibitor is metabolized by kidneys and should not be given to pts with low Cr clearance;

A

rivaraxoban

29
Q

What Xa inhibitor can be given to pts with renal problems?

A

apixaban

hepatically cleared

30
Q

Apixaban is cleared by?

A

liver

OK in renal insufficiency

31
Q

vWF is a carrier protein for which factor?

A

VIII

32
Q

HIT has two types, what is type I?

A

hep associated thrombocytopenia

heparin clumps platelets directly

usually within first 48-72 hrs

mild/transient thrombocytopenia, with return to normal

no lab tests needed, can continue heparin

33
Q

IgG antibody against platelet factor 4?

A

HIT type 2

can cause thromboses

seen 4-5 days after starting UH/LMWH

34
Q

Half life of rivaraxoban?

A

5- 9 hrs in healthy pts

11-13 in elderly pts

35
Q

TXA shown the greatest benefits when used within what time frame?

A

within 3 hrs

36
Q

Only vasopressor that acts on all 5 adrenergic receptors;

A

epinephrine

37
Q

Pure a-adrenergic vasoconstrictor;

A

phenylephrine

38
Q

Can produce reflex bradycardia when sympathetic tone is lacking;

A

phenylephrine

39
Q

Toxic metabolite of meperidine?

A

normeperidine

40
Q

MOA of meperidine?

A

u-opioid agonist

41
Q

What do we have to be careful with with meperidine?

A

toxic metabolite normeperidine accumulates in renal failure pts

can cause CNS irritability, seizures

42
Q

MOA of dantrolene?

A

ryanodine receptor antagonist

43
Q

What causes malignant hyperthermia?

A

mutation in raynodine receptor type 1

44
Q

SE of reglan/metoclopramide?

A

acute dystonic reaction (involuntary muscle contractions)

45
Q

Flumazenil>

A

antidote for benzo overdose

GABA-A antagonist

46
Q

How do you correct Ca levels for hypoalbuminemia?

A

0.8 x [4 - measured albumin]

47
Q

Free Water Deficit Formula;

A

total body water x weight (kg) x (current Na/desired Na -1)

48
Q

MOst common side effect of pancuronium?

A

tachycardia

49
Q

How long does pancuronium last>

A

up to 90 mins

50
Q

SE of atracurium?

A

histamine release

51
Q

PTLD caused by what virus?

A

EB virus

transplant pts develop lymphomas

tx-> reduce immunosuppression first, rituximab if needed, surgery doesnt have a role

52
Q

What makes up CHOP therapy?

A

cyclophosphamide

doxarubicin

vincristine

prednisolone

53
Q

MOA of IV magnesium when used as a tocolytic in pre-term labor?

A

blocks influx of Ca at motor end plate

tocolysis delays delivery up to 48 hrs so steroids can be given for lung maturity

54
Q

MC side effect of mciphenolate mofetil?

A

leukopenia

Appendix (39 decks)

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