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Drugs drugs drugs Flashcards

1
Q

other name for lidocaine

A

xylocaine

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2
Q

other name for esmolol

A

brevibloc

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3
Q

esmolol class

A

cardio selective beta-1 receptor blocker of the sympathetic nervous system
blocks action of epinephrine and norepinephrine

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4
Q

esmolol use

A

decrease HR, beta one receptor blocker

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5
Q

***esmolol duration of action and onset

A

fast onset, short duration

5 minutes, 10-30 minutes

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6
Q

esmolol metabolism

A

plasma cholinesterase

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7
Q

metropolol other name

A

lopressor

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8
Q

metropolol class

A

beta-1 receptor blocker

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9
Q

metropolol use

A

lower heart rate as a B1 antagonist

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10
Q

duration of action for metropolol

A

on the scale of hours

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11
Q

labetalol other name

A

normodyne

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12
Q

labetalol class

A

mixed antagonist a1,b1,b2

b:a=7:1

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13
Q

labetalol use

A

decrease HR and BP

due to its Alpha receptor effects can dilate blood vessels

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14
Q

cautions for labetalol

A

do not give to asthmatics because B2 antagonist effects can cause bronchoconstriction

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15
Q

duration of action for labetalol

A

long

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16
Q

four peripheral vasodilators mentioned

A

sodium nitroprusside
nitroglycerin
nicardipine
hydralazine

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17
Q

**nitroglycerin bolus dose **

A

50-100 ug

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18
Q

nitroglycerin supply

A

50-100 ug/mL

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19
Q

nitroglycerin main area of impact in circulation

A

venous dilator

also dilates coronary arteries (can relieve angina)

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20
Q

what does nitroglycerin do to ventricular wall tension?

What does it do to preload and after load?

A

decreases all
decreases overall work heart must do
after load-pressure against which heart must pump
preload- volume in heart after filling

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21
Q

timing of nitroglycerin

A

works very fast

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22
Q

hydralazine use

A

treats hypertension

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23
Q

hydrazine and nitroglycerin class

A

hypotensive agents

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24
Q

onset and duration of hydralazine

A

20 minutes

6-8 hours.. long lasting

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25
Q

hydralazine principle area of impact in circulation?

A

arterial dilator

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26
Q

ondansetron other name

A

zofran

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27
Q

ondansetron class

A

serotonin receptor antagonist

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28
Q

use of ondansetron

A

antiemetic

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29
Q

what is droperidol

A

an antidopaminergic drug used as an antiemetic

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30
Q

what is dexamethasone and whats its other name

A

an antiemetic
decadron
great for long lasting nausea prevention

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31
Q

what is diphenhydramine

A

Benadryl used an antiemetic

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32
Q

what is famotidine

A

Pepcid-controls stomach acid

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33
Q

what is metaclopramide

A

a GI prokinetic …give slowly

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34
Q

what to not give metaclopramide to?

A

parkinsons patients

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35
Q

when do you give decadron/dexamethasone

A

after induction due to anal burning symptom

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36
Q

epinephrine class

A

catecholamine

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37
Q

three catecholamines

A

dopamine
norepinephrine
epinephrine

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38
Q

two synthetic non-catecholamines

A

ephedrine

phenylephrine

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39
Q

use of epinephrine(4)

A

increase hr and BP
treat anaphylaxis
treat bronchospasm
with use of lidocaine for vasoconstriction

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40
Q

ephedrine use

A

increase HR and BP

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41
Q

cautions with ephedrine

A

depletes norepinephrine (tachyphylaxis… need to more and more to see an effect)

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42
Q

use of phenylephrine

A

increase BP

nasal decongestion

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43
Q

how does phenylephrine work?

A

through binding to alpha one and vasoconstriction

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44
Q

two cautions of phenylephrine

A

reflex bradycardia

increase afterload .. systematic vascular resistance

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45
Q

other HR increasing drugs

A

anticholinergic
atropine and glycopyrrolate ..scopolamine (vagolytic)
vagus nerve is parasympathetic.. thus decreases HR

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46
Q

neostigmine caution

A

BLUDS
bronchoconstriction.. parasympathetic response
bradycardia

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47
Q

neostigmine class

A

anticholinesterase.. act increases an outcompetes the NMB

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48
Q

scopolamine isn’t used very much because…

A

causes sedation

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49
Q

sugammadex other name

A

bridion

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50
Q

do not use sugammadex with

A

succinylcholine or cistracurium

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51
Q

sugammadex deserves caution with..

A 
young women (birth control)
and for possible allergic reaction
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52
Q

what does acetylcholine work on

A

parasympathetic response.. rest and digest

muscarinic effects are what we don’t want!!

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53
Q

use for glycopyrrolate

A

counteract effects of neostigmine increasing amount of acetylcholine at muscarinic sites
blocks muscarinic receptors

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54
Q

other name for glycopyrrolate

A

robinul

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55
Q

isoflurane MAC

A

1.1

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56
Q

desflurane mac

A

6.0

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57
Q

sevoflurane mac

A

2.0

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58
Q

caution with desflurane

A

carbon monoxide…occurs with a too dry desiccator

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59
Q

caution with sevoflurane

A

compound A

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60
Q

gases to be avoided with reactive airways

A

desflurane and isoflurane

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61
Q

blood gas solubility of inhalation anesthetics

A

iso>sevo>des
1.4>0.65>0.42
des comes off the fastest

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62
Q

des, sevo, and iso decrease ..

A

MAP, systematic vascular resistance, myocardial function, tidal volume, responses to hypercarbia and hypoxia, minute ventilation

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63
Q

inhaled anesthetics des, sevo, and iso increase

A

HR and respiratory rate

64
Q

MAC bar

A

concentrated required to block autonomic reflexes to nociceptive stimuli
2MAC

65
Q

1.3 MAC

A

prevents movement in 95%

66
Q

caution for nitrous

A

PONV

cannot be used for laparoscopic

67
Q

use for nitrous

A

can be used to decrease the amount of other agents needed to put someone asleep although it cannot completely keep someone asleep on its own

68
Q

MAC awake

A

0.3 MAC

69
Q

how does succinylcholine work

A

binds and activates receptor mimicking endogenous neurotransmitter acetylcholine
depolarizing NMBD

70
Q

use of succinylcholine

A

intubation, paralysis, laryngospasm, RSI, super short cases,

71
Q

onset of succinylcholine

A

30 seconds

72
Q

what happens with the muscles with succinylcholine

A

fasiculations- small muscle contractions and relaxations

73
Q

metabolism of succinylcholine

A

plasma cholinesterase

74
Q

cautions with succinylcholine

A 
malignant hyperthermia (also can happen with volatile anesthetics)
hyperkalmia
75
Q

another name for succinylcholine

A

anectine

76
Q

other name for rocuronium

A

zemuron

77
Q

class for rocuronium

A

aminosteroid non depolarizing

78
Q

use for rocuronium

A

paralysis, RSI

79
Q

onset and duration of rocuronium

A

1-2 minutes.. as short as 30 seconds with higher doses

25-30 minutes

80
Q

metabolism of rocuronium

A

liver and kidneys

81
Q

other name of vecuronium

A

norcuron

82
Q

class for vecuronium

A

aminosteroid, non depolarizing

83
Q

metabolism of vecuronium

A

liver and kidneys

84
Q

onset and duration of vecuronium

A

3-5 minutes

20-35 minutes

85
Q

cisatracurium class

A

benzyl isoquinolinium non depolarizing

86
Q

what is cisatracurium great for

A

renal and hepatic dysfunction patients

87
Q

cisatracurium onset and duration

A

onset 3-5 minutes

duration 20-35 minutes

88
Q

propofol class

A

diisopropylphenol

89
Q

propofol other name

A

diprivan

90
Q

cautions regarding propofol

A 
bacterial growth (throw away every 6 hours)
soy or egg allergy
hypotension- vasodilation
burns on injection
apnea-dose dependent
91
Q

something really great about propofol

A

decreases PONV

92
Q

why such rapid awakening with propofol?

A

it is redistributed to other tissues

93
Q

other name of propofol

A

diprivan

94
Q

etomidate other name

A

amidate

95
Q

whats great about etomidate

A

cardiovascular stability

doesn’t cause apnea/respiratory depression

96
Q

cation for etomidate

A

pain on injection (propylene glycol)
myoclonus
increased PONV
decreases ICP

97
Q

ketamine other name

A

ketalar

98
Q

ketamine class

A

phencyclidine

99
Q

use of ketamine

A

induction, analgesia, amnesia

100
Q

caution with ketamine

A

emergence delirium

101
Q

ester local anesthetics are metabolized…

A

by plasma enzymes

102
Q

identifying an amide local anesthetic

A

will have an I before the caine

103
Q

duration of action of propofol

A

3-5 minutes

104
Q

amide local anesthetics metabolized in..

A

liver

105
Q

symptoms of lidocaine toxicity

A 
mouth numbness
tinnitus
lightheaded
visual disturbance
unconsciousness
respiratory arrest
106
Q

use of lidocaine

A

local anesthesia, cough, cardiac arrhythmia

107
Q

agonist

A

mimics

108
Q

antagonist

A

blocks

109
Q

cation with midazolam

A

hepatic disease

elderly

110
Q

midazolam class

A

benzodiazepine

111
Q

opioids basic side effects

A

depression of ventilation
depression of gastric motility
addiction and tolerance

112
Q

onset and duration of morphine

A

15-30 minutes
3-6 hours
takes a while to get going and lasts a long time

113
Q

caution with morphine

A

PONV, pruritis (release of histamine), depression of ventilation

114
Q

class of morphine

A

opioid

115
Q

fentanyl class

A

synthetic opioid

116
Q

peak effect and duration of fentanyl

A

3-5 minutes

30-60 minutes

117
Q

caution with fentanyl

A

synergism with midazolam
patients with breathing issues
morbidly obese

118
Q

meperidine other name

A

demerol

119
Q

meperidine class

A

synthetic opioid

120
Q

meperidine use

A

analgesia and post-op shivering

121
Q

caution with meperidine

A

neurotoxic, renal disease

122
Q

hydromorphone other name

A

dilaudid

123
Q

class of hydromorphone

A

semi-synthetic

124
Q

use of hydomorphone

A

analgesia

125
Q

duration of hydomorphone

A

greater than 5 hours.. long lasting

126
Q

caution with naloxone

A

pain, tachycardia, increases SNS

127
Q

naloxone class

A

opioid antagonist

128
Q

naloxone use

A

overdose, respiratory depression

129
Q

why do opioids decrease breathing

A

numb bodies response to hypercarbia

130
Q

toradol or ketorolac class

A

non steroidal pain releiver

131
Q

toradol caution

A

bad kidneys or bleeding

132
Q

surgical site infection most likely caused by

A

staph aureus which is on the skin

133
Q

what is cephalosporin a derivative of

A

penicillin

134
Q

what type of bacteria is staph aureus

A

gram positive

135
Q

what does cefazolin target?

A

gram positive bacteria

136
Q

other name of cefazolin

A

ancef

137
Q

class of cefazolin

A

in the cephalosporin group

138
Q

what class is cefoxitin

A

another cephalosporin

139
Q

what is cefoxitin used for

A

more gram negative coverage specific to GI bacteria

140
Q

when to redone antibiotics

A

every 2-6 hours

141
Q

caution for cefoxitin and cefazolin

A

penicillin allergy

142
Q

what do you treat subacute bacterial endocarditis with?

A

ampicillin. and perhaps gentamicin. also would give to those with congenital heart disease or mechanical heart valves before seeing the dentist

143
Q

common use of gentamicin

A

urology cases

144
Q

levaquin use

A

broader gram negative coverage.. abdominal cases

ENT involving mouth

145
Q

nafcillin use

A

neuro cases

146
Q

redose clindamycin every..

A

6 hours

147
Q

first use if have penicillin allergy

A

clindamycin and then vancomycin

148
Q

what to use in general for hospital acquired infections

A

vancomycin

149
Q

caution for gentamycin

A

give slowly to avoid ototoxicity

150
Q

caution for vancomycin

A

give slowly over one hour or will get redman syndrome (hypotension, flushing)

151
Q

when to start vancomycin before surgery

A

must be started within two hours of incision

152
Q

controlled substances

A

propofol, ketamine, opioids, benzodiazepines

153
Q

dexamethasone used for

A

antiemetic

154
Q

what is diphenhydramine

A

benadryl

155
Q

what is flumazenil

A

reversal of benzodiazepine sedation. competitive antagonist of benzodiazepines.

156
Q

what is vasopressin

A

Its two primary functions are to retain water in the body and to constrict blood vessels

157
Q

atropine and glycopyrrolate anticholinergic affects

A

tachycardia, blurred vision, dry mouth , constipation

Drugs (3 decks)

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