key terms final Flashcards
what do you use for antimicrobial prophylaxis in a clean orthopedic procedure?
none
How do volatile anesthetics affect coronary blood flow?
Iso is a potent coronary vasodilator, may cause coronary steal
Other volatiles are weak coronary vasodilators
What is the clinical use of phentoalamine?
nonselective Competitive alpha blocker used in acute hypertensive emergency, i.e. pheochromocytoma or autonimic nervous system hyperreflecxia
What are the side effects of protamine?
Allergy
hypotension
Pulmonary hypertension
What is the mechanism of action of ondansetron?
5Ht3 blocker
What is used for antimicrobial prophylaxis in head and neck surgery in a pt with a cephalosporin allergy?
clinda (600-900)+ genta (1.5mg/kg)
How is flumazenil metabolized?
100% hepatic
What is the mechanism of action of coumadin?
Vitamin K antagonist causes defective vitamin K factors (2,7,9,10)
Which opioid is associated with siezure?
merperidine
Which beta blocker is used to treat glaucoma?
Timolol
What is the potency of opioids from least potent to most?
(0.1)Merperidine<(500-1000)Sufentanyl
How is metformin metabolized?
Cleared by kidneys 100% unchanged
Which is the quickest acting opioid?
Remifentanyl–6-12 min duration
Which drugs are examples of class IV?
Verapamil and Diltiazem
Lidocaine is used to tx _______ arrhythmias
ventricular
At what receptor occupancy does midazolam cause
anxiolysis
sedation
unconsciousness
anxiolysis: 20%
sedation 30-50%
uncosciousness: 60%
What is the onset of edrophonium?
shortest of the anticholinesterase
What is the mechanism of class IV antidysrhythmics?
Ca+ channel blockers
decrease action potential duration
What is the effect of induction drugs on ICP?
decreased
Which opioids should you not use in a pt with renal failure?
merperidine and morphine
What is the order of volatile agents from lowest blood:gas coefficient to highest
Desflurane (.42)<Halothane
What are examples of oral anticoagulants?
coumadin and pradaxa
How much cardiac output goes to each of the tissue groups?
VRG-75%
Muscle-19%
Fat-6%
What is the duration of action for regular insulin?
6-10 hours
What is the mOA for Hirudin?
direct thrombin inhibitior: Supresses platelet function
What is the order of most metabolized to least metabolized volatile anesthetics?
Halothane-20%>Sevo 2-5%>Iso .2%>Des 0
HOw do NSAIDS work and what happens if you give a whole lot?
Inhibition of both cyclooxygenase without specificity
ceiling effect–exceeding recommended dose only adds to risk of toxicity
What determines the rate local anesthetics are absorbed?
dosage site of injection drug tissue binding local blood flow addition of a vasocontrictor
What is the mechanism of action of histamine antagonists?
Antagonize histamine receptor/ do not decrease amount of histamine (except H3)
What is the pH of thiopental?
10.5
What is the side effect of sulfonylureas?
hypoglycemia
Which local anesthetics cause methemoglobinemia?
prilocaine and benzocaine
What is the concentration for epi added to local anesthetics?
1:200000 aka 5mcg/ml
What does NPH stand for ?
neutral protamine hagedorn
What is the toxic dose of lidocaine without epi?
with?
without 5mg/kg
with 7mg/kg
What is the treatment for methemoglobinemia?
methylene blue 1-2 mg
What is Im dose for induction with ketamine?
4-8mg/kg
what are contraindications for droperidol?
prolonged QT and parkinsons
What is toxic doses of bupivicaine w/ and w/out epi?
without 2.5mg/kg
with 3mg/kg
What is the gold standard K+ sparing diuretic?
triamterene
amiloride was the other one listed as an example
What does VRE stand for?
Vancomycin resistant enterococcus
What does MRSA stand for
methicillin resistant staphylococcus aureus
What is the intubating dose for cisatracurium?
.1mg/kg (-.15mg/kg)
What do you give for Anticholinergic overdose?
physostygmine
What infusion rates of epi are associated with alpha1?
beta1?
beta2?
Alpha1 1-2 mcg/min
Beta1 4mcg/min
Beta2 10-20 mcg/min
In the 2006 medical letter guidelines which antibiotic is indicated for bowel procedures?
cefoxitin
What do you give to treat biliary colic from opioids?
glucagon 2mg iv
Which opioid receptor do enkalphalins bind to?
delta
Which opioid receptor do dynorphins bind to?
kappa
Which opioid receptor is associated with feeling of dysphoria?
kappa–where agonist/antagonist work
which opioid has atropine like effects?
merperidine
Which diurectic is prescribed for IOP?
acetazolamide–carbonic anhydrase inhibitior
how is esmolol metabolized?
plasma choliesterase
what is ped dosage of ondansetron?
0.1mg/kg
what is papaverin used for?
used by vascular surgeons not really us
anastamoses
(verapamil is derived from papavirine)
what drug is contraindicated in porphyria>?
thiopental
Which diuretic is prescribed for essential hyperetension?
hydrochlorothiazide (HCTZ)
Which antibiotic is given for prophylaxis in a C section?
ancef
clinda and genta also listed
How are opiods metabolized? whats the exception?
all hepatic except Remi-plasma and tissue esterases
which ca++ channel blocker provides the best vasodilation?
Nicardipine
which Ca++ channel blocker is used for cerebral vasospasm?
Nimodipine
At what dose of SNP do you start sseing CN accumulation?
> 2mcg/kg/min
(regular dose is 0.3-10 mcg/kg/min
what is ratio of beta:alpha in labetalol?
oral 3:1
IV 7:1
name 2 alpha 2 agonists
clonidine alpha2:1 200:1
dexametetomidine
which antacid does not cause acid rebound?
MgOH
which nsaid is used to close a PDA?
indomethecin
what are the effects of Beta 2 agonist?
vasodilation
Increased glucose secretion
gluconeogenesis ad glycogenolysis are inhibited
How do volatile anesthetics affect cerebral blood flow?
all increase
Which inhaled agent causes bone marrow supression?
NO
What is the formula for uptake?
solubility x CO x (Pa-Pv)
which induction agent causes adrenocorticoid supression?
etomidate
other sides: myoclonus, hiccups, increased PONV
which H2 blocker inhibits cytochrome p450 nand may delay lido metabolism
cimetidine (tagamet)
what are side effects of neuraxial opioid adminitstration?
respiratory depression, urinary retention, and itching/pruritis
