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Pharm > Final Cram > Flashcards

Final Cram Flashcards

1
Q

The vomiting center lies in the ______ and consists of the nucleus of the ______ & parts of reticular formation

A

Medulla oblongata; tractus solitarius

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2
Q

Detects noxious chemicals in the bloodstream

A

CRTZ

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3
Q

Upon activation, the vomiting center sends _______ via the CN _____ through the ________ & _______ and to skeletal muscle through ________. Signals for t eh vomiting center via these nerves trigger the motor process resulting in emesis

A

Efferent signals; V, VII, IX, X, XII; vagal parasympathetic fibers; sympathetic chain; alpha motor neurons

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4
Q

Pt PONV risk factors

A

Women, non smokers, hx of motion sickness, previous PONV

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5
Q

Surgical risk factors for PONV

A

LOSx, laparotomies, gynecological procedures, ENT, breast, plastic, ortho

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6
Q

10-20mg IV over 3-5 min 15-30 min before induction results in increased LES tone & decreased gastric fluid volume

A

Reglan

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7
Q

Reglan should not be administered to which pts?

A

Parkinson’s, restless leg, or movement disorders r/t dopamine inhibition/depletion

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8
Q

Droperidol prophylactic dose for PONV

A

0.625 - 1.25 mg IV

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9
Q

Nutritional support for severe burns

A

Energy requirements may double & protein triple

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10
Q

___ comes from diet and ___ is synthesized by UV lights action on 7-dehydrocholesterol

A

D2, D3

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11
Q

Prototype of sulfonamides that bind to carbonic anhydrase, produce non competitive inhibition of enzyme activity

A

Acetazolamide

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12
Q

Where does acetazolamide inhibit carbonic anhydrase

A

Proximal renal tubules & collecting ducts

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13
Q

The increase in ____ results in alkaline urine and metabolic acidosis

A

HCO3

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14
Q

The increase in delivery of ___ to distal tubules leads to ___ loss

A

Na; K

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15
Q

Loop diuretics inhibit reabsorption of ?

A

Na, K, Cl

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16
Q

______ may be used to mobilize edema a/w renal, hepatic, or cardiac dysfuntion

A

Thiazide diuretics

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17
Q

______ diuretics are ineffective in pts with severe renal insufficiency & the use of _____ diuretics is recommended for diuresis

A

Thiazide; loop

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18
Q

Thiazide diuretics potentiate NMBD by producing _____

A

Hypokalemia

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19
Q

Principal site of action of osmotic diuretics

A

Proximal renal tubules & loop of Henle

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20
Q

Mannitol increases plasma osmolarity thus drawing fluid form ______ to ______ spaces

A

Intracellular, extracellular

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21
Q

Intact ____ is necessary for cerebral effects of Mannitol. Why?

A

BBB. Non-intact BBB may enter brain drawing fluid with it causing worsening cerebral edema

22
Q

Prevent Na reabsorption in the cortical collecting duct by blocking the epithelial Na channels

A

Pteridines (K sparing diuretic)

23
Q

Prevent the synthesis and activation of the aldosterone-dependent basal cell Na-K-ATPase pump

A

Aldosterone receptor blockers (K sparing diuretic)

24
Q

Although triamterene is a weak ______ antagonist, it rarely causes megalobastic anemia except in pts already at risk for ______ deficiency

A

Folic acid

25
Q

Large volumes of NS can result in ?

A

Hyperchloremic metabolic acidosis

26
Q

Contain macromolecules suspended in electrolyte solutions

A

Colloids

27
Q

Most commonly used semisynthetic colloid solution.
At 26 wks trace amounts still detectable.
Renal excretion is 2 phases: immediate glomerular filtration & delayed glomerular filtration

A

Hydroxyethyl Starch (HES)

28
Q

Immediate tx of life-threatening hypermagnesemia

A

Calcium gluconate 10-15 mg/kg IV, follow with diuretics or dialysis

29
Q

Tx for hypocalcemia following IV bisphosphonate:

A

Calcium & vitamin D

30
Q

Osteonecrosis of the jaw is a/w high-dose ____

A

Bisphosphonates (zoledronic acid & pamidronate)

31
Q

Which hormones influence renal K secretion:

A

Aldosterone, glucocorticoids, catecholamines, arginine vasopressin

32
Q

______ opposes and _____ favors K secretion

A

Acidosis; alkalosis

33
Q

Catecholamine shift K ______

A

Intracellularly (predominantly into liver & skeletal muscles)

34
Q

Drugs cause hyperkalemia by:

A

Redistribution;
suppression of aldosterone secretion;
inhibition of K secretion in distal collecting duct; direct cell destruction

35
Q

In hyperkalemia, 10-20 cc of ______ restores myocardial contractility in 1-2 min and lasts 15-20 min

A

10% calcium chloride solution

36
Q

Iatrogenic hyperglycemia can induce _____

A

Osmotic diuresis

37
Q

Primary water losses are replace with _____

A

Hypotonic solutions (maintenance type D5W, 1/2NS)

38
Q

Water & electrolyte losses are replaced with _____

A

Isotonic electrolyte solutions (replacement type NS, LR, D51/4NS)

39
Q

Crystalloids stay intravascularly for how long?

A

20-30 min

40
Q

most intraoperative fluid loss is?

A

Isotonic

41
Q

_____ solutions should be avoided in neurosurgery bc they promote cerebral edema

A

Dextrose containing

42
Q

Half-life of colloids

A

3-6 hrs

43
Q

Indications for colloids:

A 
Fluid resuscitation (hemorrhage) prior to transfusion (trauma); 
Fluid resuscitation (hypoalbuminemia or protein loss) (burns)
44
Q

UO goal during surgery

A

0.5 - 1 ml/kg/hr

45
Q

What must be taken into consideration for fluid replacement?

A

NPO loss;
Insensible loss (third space);
EBL replacement;
Maintenance

46
Q

Third space replacement

A

Minor trauma 2ml/kg/hr;
Moderate trauma 4ml/kg/hr;
Extensive trauma 8ml/kg/hr

47
Q

When does mobilization of third space fluids occur?

A

72 hrs post-op

48
Q

NPO deficit = ?

A

Hourly maintenance x hrs NPO

49
Q

Give ____+ hr maint in first hour, ____ + hr maint in second hour, & ____ + hr maint in third hour

A

1/2 NPO; 1/4 NPO; 1/4 NPO

50
Q

Acute blood loss in the range of _____ or ___% of EBV exceeds ability of crystalloids to replace w/o jeopardizing O2 carrying capacity of blood

A

1500 -2000 ml; 30%

51
Q

1 unit of PRBCs will raise Hgb ___ & Hct ___

A

1 g/dL, 3%

52
Q

10 ml/kg of PRBCs will increase Hgb ____ & Hct ___

A

3 g/dL; 10%

Pharm (15 decks)

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