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pharm1 S.Horvath > GI > Flashcards

GI Flashcards

1
Q

early PONV

A

2-6h

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2
Q

late PONV

A

6-24h

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3
Q

delated PONV

A

> 24h post op

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4
Q

post discharge n/v

A

> 24h post dc

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5
Q

one risk factor %

A

20%

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6
Q

two risk factors %

A

40

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7
Q

three risk factors %

A

60

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8
Q

four risk factors %

A

80

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9
Q

post discharge NV risk factors

A

female, <50yo, hx of PONV, opiates in PACU, nausea in PACU

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10
Q

risk factors for children - procedure length

A

> 30min

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11
Q

risk factors for children - age

A

> 3 years

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12
Q

strabismus surgery is a risk factor for

A

children

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13
Q

child risk factor - history

A

history of PONV or PONV in relatives

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14
Q

who to pretreat?

A

moderate to high risk pt’s (3 or more risks)

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15
Q

which drug should you give before induction

A

dexamethasone

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16
Q

which drug do you give the evening before surgery or 4h prior to awakening

A

scop patch

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17
Q

which drug do you give 1-3 hours prior to surgery

A

aprepitant

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18
Q

impact trial

A

zofran+droperiodl vs dex…. both equally effective

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19
Q

which drugs are 5HT3 Antagonists

A

ondansetron, granisetron, dolasetron, palonosetron

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20
Q

what percent of gen pop experiences vomiting

A

30%

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21
Q

what percent of gen pop experiences nausea

A

50

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22
Q

top 3 PONC factors

A

female, history of PONV, non-smoker

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23
Q

GA has a __x higher risk of PONV than regional

A

9

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24
Q

every 30 min you increase PONV risk by

A

60%

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25
Q

___ of patients experience PONV post discharge

A

1/3

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26
Q

which med has a long onset and long duration

A

dexmethasone

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27
Q

neurokinen receptor antagonist

A

aprepitant

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28
Q

5HT3 receptor is primarily located in

A

GI tract

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29
Q

5HT3 receptor ___ afferents

A

vagal, chemosenstive center

30
Q

how are 5ht3’s metablolized

A

liver. CYP3A4 450

31
Q

Which 5HT3 is a prodrug

A

dolasetron

32
Q

whats zofrans half life

A

4h

33
Q

whats zofrans onset

A

15min IV, 30min PO

34
Q

side effects of 5Ht3’s

A

constipation, diarrhea, nausea, dizziness

35
Q

whats a prolonged QTc

A

450 milliseconds and above

36
Q

what is 5HT3’s mechanism

A

antagonism

37
Q

dexamethasone MOA

A

unknown, thought to be prostaglandin antagoinist, endorphin release.

38
Q

side effects dex

A

impaired wound healing/infection, increased glucose, htn, edema, AMS

39
Q

onset of dexamethasone

A

4-6h

40
Q

half life of dexamethasone

A

35-54 h

41
Q

what kind of drug is droperidol

A

anti-dopaminergic (D2)

42
Q

droperiodl mildly works as

A

antihistamine, antiserotonergic

43
Q

droperiold’s main receptor is D2 but also works in the

A

chemoreceptor trigger zone

44
Q

black box warning for droperiol

A

QT prolongation at doses >5mg

45
Q

side effects of droperiol

A

dysphoria, hypotension, EPS

46
Q

droperidol metabolism

A

hepatic

47
Q

droperidol half life

A

2.3

48
Q

dopamine in the brain - balance between

A

movement disorders like parkinson’s and psychosis

49
Q

which drugs are phenothiazines

A

promethazine (phenergan) and prochlorpromazine.

50
Q

what is the MOA for phenothiazines

A

d2 receptor antagonist

51
Q

how is phenothiazines metabolized

A

hepatic

52
Q

what is the half life of phenothiazines

A

4-8h

53
Q

issue with phenothiazines

A

highly sedating , EPS

54
Q

what kind of drug is dimenhydrinate

A

h1 antagonist

55
Q

what cranial nerve is associated with inner ear feeling - both cholinergic tracts and histimanergic tracts.

A

c8

56
Q

which drug is also used to treat motion sickness

A

dimenhydrinate

57
Q

BP effects of h1 antagonists like dimenhyrinate

A

may see htn since its anti-histamine

58
Q

scopolamine is an ___ med

A

anticholinergic

59
Q

when should you place scop patch

A

either prior to surgery or 4 hours prior to awakening

60
Q

side effects of scop patch

A

blurred vision, dilated pupil on the same side patch is applied, constipation, urinary retention

61
Q

what kind of drug is aprepitant (Emend)

A

neurokinin 1 receptor antagonist

62
Q

where in the neuro system does aprepitatnt work

A

brain steam and dorsal vagal complex

63
Q

what is the injectable form of Aprepitant called

A

fosaprepitant

64
Q

substance P is blocked by

A

neurokinin 1 receptor antagonist (aprepitant )

65
Q

aprepitant is reserved for

A

end of life, HIV, cancer, very serious GI upset, super expensive

66
Q

what is substance p

A

hormonal type compound that is released in injury, trauma.

67
Q

aprepitant side effects

A

few. generally pretty safe

68
Q

aprepitant

A

cyp3A4 substrate and weak inhibitor

69
Q

aprepitant half life

A

9-13h

70
Q

aprepitant protein binding

A

highly

pharm1 S.Horvath (18 decks)

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