Med exam from flood

Question 1

The use of corticosteroids for pain relief, although popular, has yet to gain wider acceptance because of concerns over side effects, such as

Answer 1

1. adrenal suppression
2. osteonecrosis
3. impaired wound healing
4. concerns about efficacy

Question 2

clinical use of ketamine can be limited due to psychotomimetic adverse effects and other common adverse effects, including?

Answer 2

1. dizziness
2. blurred vision
3. nausea and vomiting.

Question 3

__________ and __________ patients are at increased risk for perioperative hyperglycemia when they receive a single dose of dexamethasone.

Answer 3

Obese and diabetic patients

Question 4

At susbanesthetic doses Ketamine is used as an adjuvanct to provide post anesthtic pain relief in opioid dependent patients. What is the subanesthetic dose

Answer 4

0.15 to 1 mg/kg

Question 5

Elimination half life of dexamethasone is

Answer 5

3 hrs

Question 6

This. drug prevents postoperative nausea and vomiting only when administered near the beginning of surgery, probably by reducing surgery-induced inflammation due to inhibition of prostaglandin synthesis

Answer 6

Dexamethasone

Question 7

Administration of higher doses __________mg of dexamethasone has a similar clinical effect to lower doses _________ mg.

Answer 7

8 to 10

4 to 5

Question 8

Antiemetic effects of dexamethasone often persist as long as

Answer 8

24hrs

Question 9

Dexamethasone at doses more than ___________ decreases acute postoperative pain and reduces opioid use, especially when administered preoperatively.

Answer 9

0.1 mg/kg

Question 10

Dexamethasone dose for postintubation laryngeal edema

Answer 10

0.1 to 0.2 mg/kg IV

Question 11

Dexamethasone dose for children with mild croup

Answer 11

0.6mg/kg

Question 12

The side effects of chronic corticosteroid therapy include

Answer 12

1. suppression of the HPA axis
2. electrolyte and metabolic changes
3. osteoporosis
4. peptic ulcer disease
5. skeletal muscle myopathy
6. central nervous system dysfunction
7. peripheral blood changes
8. inhibition of normal growth.

Question 13

These drugs attach to cytoplasmic receptors to enhance or suppress changes in the transcription of DNA and thus the synthesis of proteins. They also inhibit the secretion of cytokines via posttranslational effects.

Answer 13

Glucocorticoids e.g Dexamethasone

Question 14

A polypeptide containing approximately 70% arginine residues and the only available agent to reverse unfractionated heparin

Answer 14

Protamine

Question 15

Does protamine reverse lovenox

Answer 15

Protamine does not reverse low-molecular-weight heparin

Question 16

What is the MOA of protamine

Answer 16

It inhibits platelets and serine proteases involved in coagulation.

Question 17

Heparin rebound can occur after initial reversal and is generally observed ______________ hours after the first dose of protamine, when the patient is in the intensive care unit.

Answer 17

2 to 3

Question 18

The ACT is not a sensitive indicator of low heparin concentrations because

Answer 18

platelet counts and fibrinogen levels may also affect values.

Question 19

Protamine can cause adverse reactions including

Answer 19

1. anaphylaxis
2. acute pulmonary vasoconstriction
3. right ventricular failure
4. hypotension.

Question 20

Patients at an increased risk for adverse reactions include

Answer 20

1. exposure to neutral protamine Hagedorn (NPH)
2. patients with vasectomy
3. multiple drug allergies
4. prior protamine exposure.

Question 21

Esmolol can cause a minor prolongation of succs block due to?

Answer 21

Inhibition of butylcholinesterase

Question 22

What is the elimination half time of esmolol

Answer 22

about 10 minutes

Question 23

What is the typical initial dose of esmolol

Answer 23

0.5mg/kg IV over 60 seconds

Question 24

The full therapeutic effect of an intitial doses of esmolol is evident after

Answer 24

5 minutes

Question 25

Therapeutic duration of esmolol

Answer 25

10-30 minutes

Question 26

Esmolol dose given 15 seconds prior to induction that has been reported to prevent intraop HTN and Tachycardia

Answer 26

100-200 mg IV

Question 27

Widespread use of long-term hydralazine is limited due to?

Answer 27

Its ascociated with systemic lupus syndrome

Question 28

What is the onset of hydralazine?

Answer 28

5-20 minutes

Question 29

What is the half life and duration of hydralazine

Answer 29

Half life is 2-8

Duration 1-8 hrs

Question 30

What is the bolus dose of hydralazine?

Answer 30

5-20 mg

Question 31

What is the MOA of methergine

Answer 31

Ergot Derivative/Oxytocic - Acts directly on the smooth muscle of the uterus and increases the tone, rate, and amplitude of rhythmic contractions.