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Pharm 2 > Final, Lecture 2 > Flashcards

Final, Lecture 2 Flashcards

1
Q

Where the vomiting center lies

A

Medulla

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2
Q

4 Inputs to the vomiting center

A

GI tract,
cerebral cortex/thalamus,
vestibular region,
chemoreceptor trigger zone

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3
Q

Nausea/Vomiting Triggers

A 
General Anesthetics
Histamine
Serotonin
Dopamine
Opioids
Acetylcholine
Inflammatory mediators involved n nociceptive pathways
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4
Q

Risk factors for N/V

A

Female
Nonsmoker
History of motion sickness

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5
Q

Anesthetic agents that INCREASE the threshold for PONV

A

Propofol

Midazolam

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6
Q

General mechanism for antiemetics

A

Receptor antagonists at the vomiting center

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7
Q

Most commonly used antiemetic classes

A 
Serotonin antagonists
Dopamine antagonists
Anticholinergics
Glucocorticoids
Histamine antagonists
Neurokinin 1 antagonists
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8
Q

Antiemetics we give at OSU

A

Ondansetron (Zofran) - Serotonin antagonist

Dexamethasone (Decadron) - Glucocorticoids

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9
Q

Dosing for OSU antiemetics

A

Dexamethasone and Ondansetron - 4 mg IV

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10
Q

Antiemetic patch used

A

Scopolamine

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11
Q

Antiemetic that can cause gangrene

A

Promethazine (phenergan)

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12
Q

Management of Vomiting pt

A

Tredellenberg position
Turn on their RIGHT
Supplemental O2
Auscultate

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13
Q

Must be measured Continually during GA

A

Oxygenation
Ventilation
Circulation
Temperature

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14
Q

DEF: Oxygenation

A

Transport of oxygen from atmosphere to the alveoli and eventually the tissues

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15
Q

How to measure oxygenation

A

Pulse oximetry

Color of mucosa, skin, blood

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16
Q

Primary determinants of oxygen content

A

Hemoglobin concentration and oxygen saturation of Hb

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17
Q

Pulse oximetry shows

A

% of total hemoglobin saturated w/ O2

18
Q

Normal oxygenation reading

A

95-100%

19
Q

How pulse oximeter works

A

Shoots red and infrared lights through finger to see ratio of deoxy to oxy hemoglobin

20
Q

More infrared light absorbed means

A

More oxyhemoglobin

21
Q

Ventilation

A

Observe chest excursions

Auscultate breath sounds or monitor end-tidal volume

22
Q

DEF: Ventilation

A

Process of moving air into and out of lungs

23
Q

DEF: Capnography

A

Measures carbon dioxide concentration in exhaled air

24
Q

Typical partial pressure of CO2

A

40 mmHg

25
Q

Capnogram waveform phases

A

Phase 1 - exp begins but at first just CO2 less dead space air
Phase 2 - mix of CO2 and dead space air exp
Phase 3 - exhaled gas almost entirely alveolar
Phase 0 - inspiration

26
Q

Shark fin appearance Capnogram

A

Bronchospasms- asthma, COPD

27
Q

Circulation monitoring

A

Continually, document BP and HR every 5 min

Continuously w/ EKG if have heart hx

28
Q

Normal hemoglobin levels

A

12-14 for females, 14-15 for males

29
Q

Anemia affect on hemoglobin

A

Lowers Hb levels

30
Q

Normal amount of O2 a Hb can carry

A

1.34

31
Q

PP of 02 in blood at 90% pulse oximetry reading

A

60 mmHg - this is the low threshold for hypoxia- will get beeping

32
Q

pO2 if pulse oximetry reads 97%

A

97 mmHg - normal

33
Q

Cause Hb dissociation curve to shift to right

A

Acidic environment (Dec pH)
Inc in metabolism
Inc CO2
Inc 2,3 GTP

34
Q

End tidal volume you want to maintain during CPR

A

10 mmHg CO2

35
Q

Type of hypertension more common in younger people

A

Diastolic Hypertension- due to exaggerate cathecholamines

36
Q

Isolated Systolic HT

A

Seen in elderly people with stiffening of arteries

37
Q

Most common symptom of high BP

A

Headache

38
Q

EKG Lead 1

A

Right shoulder (-) to left shoulder

39
Q

EKG Leade 2

A

Right shoulder to left leg

40
Q

EKG Lead 3

A

Left shoulder to left leg

41
Q

Colors of EKG things

A

White on right, smoke over fire on left

42
Q

PONV

A

Prior motion sickness
Opioids
Non-smoker
Female

Pharm 2 (11 decks)

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