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Advanced Pharmacology > Exam 1 Drugs - BZDs and Pre-Op > Flashcards

Exam 1 Drugs - BZDs and Pre-Op Flashcards

1
Q

At which pH is Midazolam water-soluble? Lipid-soluble?

A

Water-soluble pH < 3.5 - Open ring
Lipid-soluble pH > 4.0 - Closed ring

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2
Q

Midazolam (Versed):
pK
Peak
Elimination 1/2 Time
Vd

A

pK = 6.2
Peak: 20-30 mins (Peds), 5 minutes in adults
E 1/2 Time = 2 hours
Vd = 1-1.5 L/kg

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3
Q

Active metabolite of midazolam?

A

1-hydroxymidazolam

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4
Q

Midazolam sedation dose?

A

Peds: 0.25-0.5 mg/kg (Peaks in 20-30 mins)
Adults: 1-5 mg (Peaks in 5 mins)

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5
Q

Midazolam induction dose?

A

0.1-0.2 mg/kg over 30-60 seconds

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6
Q

Post-op Versed dose?

A

1-7 mg/hr

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7
Q

Concerns for prolonged midazolam administration?

A

T-cell suppression

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8
Q

Diazepam (Valium)
Onset
Peak
Elimination 1/2 Time
Vd

A

Onset: 1-5 mins
Peak: 1 hour (Adults), 15-30 mins (Peds)
Elimination 1/2 Time: 20-40 hours

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9
Q

Valium active metabolites?

A

Desmethyldiazepam (lasts 48-96 hours) and oxazepam

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10
Q

Diazepam (Valium) doses for…
Induction?
Seizures?

A

Induction = 0.5-1 mg/kg
Seizure = 0.1 mg/kg

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11
Q

Why does valium burn upon injection?

A

It contains propylene glycol

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12
Q

Lorazepam (Ativan)
Peak
Elimination 1/2 Time
Duration
Post-Op Dose

A

Peak: 20-30 minutes
E 1/2 Time: 14 hours
Duration: 6-10 hours
Dose: 1-4 mg

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13
Q

List benzodiazepine duration of action from shortest to longest…

A

Versed < Diazepam < Lorazepam

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14
Q

Romazicon (Flumazenil) is derived from…

A

1,4 imidazobenzodiazepine

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15
Q

Romazicon (Flumazenil) dosage to reverse sedation? Complete reversal?

A

0.3-0.6 mg
Complete reversal = 0.5-1 mg

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16
Q

Romazicon (Flumazenil) onset? Duration?

A

Onset = 2 mins
Duration = 30-60 mins

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17
Q

Diphenhydramine (Benadryl):
Class
Receptor
E 1/2 Time
Onset
Dose

A

Class: H1 Antagonists
Receptor: Vestibular
E 1/2 Time: 7-12 hours
Dose: 25-50 mg

18
Q

Diphenhydramine inhibits what reflex?

A

Oculo-Emetic Reflex

19
Q

Promethazine (Phenergan)
Class
Receptor
E 1/2 Time
Onset
Dose

A

Class: H1 Antagonsist
Receptor: Vestibular
E 1/2 Time: 9-16 hrs
Onset: 5 minutes
Dose: 12.5-25 mg

20
Q

What is the most common bacterial infection associated with long-term H2 antagonist use?

A

Candida Albicans

21
Q

What is the dose for the H2 antagonist Cimetidine (Tagamet)?

A

150-300 mg (1/2 for renal impairment)

22
Q

What is the dose for the H2 antagonist Ranitidine (Zantac)?

A

50 mg diluted in 20 cc over 2 mins
1/2 dose for renal impairment

23
Q

What is the dose for the H2 antagonist Famotidine (Pepcid)? Half-time?

A

20 mg - 1/2 dose for renal impairment
1/2 Time = 2.5-4 hours

24
Q

What electrolyte should be monitored in a patient taking Pepcid?

A

Phosphorus

25
Q

PPIs _________ Warfarin metabolism

A

Inhibit

26
Q

PPIs block the enzyme that activate……

A

Plavix (Clopidogrel) - It doesn’t work as well

27
Q

Omeprazole (Prilosec)
Dose:
How long before surgery do you administer?

A

40 mg dilated in 100cc NS over 30 mins

> 3 hours prior to surgery

28
Q

Pantoprazole (Protonix)
Dose
Onset?

A

40 mg diluted in 100 cc NS over 2-15 mins
Onset - 1 hr

29
Q

PPIs decrease ____________ and increase ____________

A

Gastric volume
pH

30
Q

Particulate antacids are aluminum and magnesium based - Aspirating this is just as bad as aspirating…

A

Stomach acid

31
Q

Non-particulate antacids neutralize acids and consist of…

A

Sodium, Carbonate, CItrate
Bicarb based

32
Q

Sodium Citrate (Bicitra)
Onset
Duration
Dose

A

Onset - Immediate
Duration - 30-60 mins
Dose - 15-30 mL

33
Q

Metoclopramide (Reglan) is FDA approved for…

A

Diabetic gastroparesis

34
Q

Metoclopramide (Reglan) slows the metabolism of what?

A

Succinylcholine - Decreases plasma cholinesterase

35
Q

Metoclopramide (Reglan)
Dose
When do administer?

A

10-20 mg over 3-5 mins
Give 15-30 prior to induction

36
Q

What was the initial use for Droperidol?

A

Schizophrenia, psychosis

37
Q

Droperidol dose?

A

0.625-1.25 mg

38
Q

Ondansetron (Zofran)
Receptor
Dose
E 1/2 time

A

5-HT3
Dose - 4-8 mg
E 1/2 Time - 4 hours

39
Q

Dexamethasone (Decadron)
Onset
Dose
Duration
When do you administer this?

A

Onset: 2 hours
Dose: 4-8 mg; Give more (12-20 mg) for airway trauma
Duration: 24 hours

Administer at start of case or 2 hours before the end of a long case

40
Q

Scopolamine Patch
Class
E 1/2 Time
Onset
Peak
Dose

A

Class: Anticholinergic, Musarinic antagonist
E 1/2 Time: 24-72hours
Onset: 4 hours
Peak: 8-24 hours
Dose: The priming dose is 140 mcg, then over the next 72 hours 1.5 mg is absorbed through the skin

Advanced Pharmacology (4 decks)

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