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Crozer Surgery > Medications > Flashcards

Medications Flashcards

1
Q

What is the treatment for malignant hyperthermia

A

Dantrolene (muscle relaxant)

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2
Q

If a Risk of malignant hyperthermia is suspected, what pre-operative test may be performed

A

CPK- elevated in 79% of patients with malignant hyperthermia

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3
Q

What is the mechanism of action for local anesthetics

A

Block Na+ channels and conduction of action potentials along sensory nerves

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4
Q

What is the toxic dose of lidocaine (Xylocaine)

A

Alone- 300

W/ epi- 500

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5
Q

What is the toxic dose of bupivicaine (marcaine)

A

alone-175

w/epi- 225

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6
Q

What are the side effects of lidocaine and bupivicaine associated with systemic exposure.

(CNS and CV)

A

CNS

  • initial excitation
  • –dizziness, blurred vision, tremor, seizures
  • followed by depression
  • –respiratory depression, LOC

CV
-hypotension, bradycardia, arrhythmias, cardiac arrest

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7
Q

What can be given to help reverse local anesthetic-induced cardiovascular collapse

A

Intravenous fat emulsion (intralipid)

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8
Q

Is there a risk with intra-articular injections of bupivicaine

A

studies have shown chondrocyte death following prolonged exposure to bupivicaine

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9
Q

In what age group should bupivicaine be avoided

A

Children <12 years of age

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10
Q

How are amides metabolized

A

Liver

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11
Q

How are esters metabolized

A

plasma pseudocholinesterase

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12
Q

What is the only local anesthetic with vasoconstriction

A

Cocaine

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13
Q

How is cocaine metabolized

A

plasma pseudocholinesterase

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14
Q

Can local anesthetics cross the placental barrier

A

yes

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15
Q

What does MAC stand for

A

monitored anesthesia care

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16
Q

For anesthesia, what cannot be given to a patient with an eggshell allergy

A

propofol

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17
Q

Pain management with a codeine allergy

A

STTUDDD-N

Stadol
Toradol
Talwin
Ultram
Darvon
Darvocet
Demerol
Nubain
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18
Q

First choice for oral

A

Darvocet

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19
Q

first choice for non-narcotic oral

A

tramadol (50 mg)

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20
Q

First choice for non-narcotic IV

A

Toradol 30-60 mg IV

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21
Q

Choice narcotic IV pain med

A

Demerol

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22
Q

Name two non-narcotic analgesics

A

ketoralac (toradol), tramadol

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23
Q

What schedule is percocet

A

II (high potential for abuse)

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24
Q

What schedule is vicodin

A

III (moderate potential for abuse)

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25
Q

What schedule is Tylenol #3

A

III (moderate potential for abuse)

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26
Q

What schedule is Darvocet

A

IV (low potential for abuse)

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27
Q

Percocet 5/325?

A

oxycodone/acetaminophen (5mg/325mg)

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28
Q

Roxicet?

A

oxycodone/acetaminophen (5/325)

-essentially a liquid form of Percocet that is good for pediatric patients

29
Q

What is the difference between percocet and percodan

A

percocet has acetaminophen

Percodan- percodan has ASA

30
Q

Vicoden 5/500

A

hydrocoden/ acetaminophen

31
Q

Tylenol #3

A

codeine/acetaminophen

32
Q

Darvocet- N100

A

propoxyphene/acetaminophen

100/650

33
Q

Ultram

A

tramadol 50mg

34
Q

Toradol

A

ketorolac 10 mg

30mg IV

35
Q

Darvon

A

propoxyphene

36
Q

OxyContin

A

oxycodone extended release

37
Q

Morphine sulphate

A

2-4mg IV q2-q6hr PRN

38
Q

MS contin

A

Morphine sulfate extended release

39
Q

Dilaudid

A

hydromorphone. (very strong drug)

40
Q

Demerol

A

meperidine

41
Q

What therapeutic effects are seen with acetaminophen

A

analgesic and anti-pyretic

42
Q

What is the maximum daily dose for acetaminophen

43
Q

What therapeutic effects are seen with most NSAIDs?

A

Analgesic, anti-pyretic and anti-inflammatory

44
Q

What pathway do NSAIDs work on

A

COX pathway. Non selectively

45
Q

What is the most common side effect of NSAIDs

A

GI disturbance

46
Q

What is the only FDA approved COX-2 inhibitor

47
Q

Which NSAIDs only have anti-inflammatory effects

A

indomethacin, tolmetin

48
Q

Do NSAIDs decrease joint destruction

A

no they only decrease inflammation

49
Q

Do NSAIDs affect bone healing?

A

NSAIDS and COX-2 inhibitors may inhibit bone healing via their anti-inflammatory effects

50
Q

What NSAID causes irreversible inhibition of platelet aggregation

51
Q

Which NSAID does not inhibit platelet aggregation at all

52
Q

What is the only IV NSAID

A

ketorolac/toradol

53
Q

Which NSAID is often given during surgery or immediately post-op to decrease pain and inflammation

54
Q

What are the NSAIDs with the least nephrotoxicity

A

Celebrex
Relafen
Lodine

55
Q

What is the effect of NSAIDs on asthma

A

can increase the symptoms

56
Q

what are the safest NSAIDs for a patient with asthma

A

diclofenac and ketoprofen

57
Q

Which NSAIDs treat collagen vascular disease

A

ibuprofen, sulindac, tolmetin

58
Q

Which NSAIDS are not renally cleared

A

indomethacin

sulindac

59
Q

What are the cardiovascular effects of NSAIDs

A

can cause vasoconstriction and increase BP

60
Q

Which NSAIDs have the least cardiovascular effects

A

diclofenac, ketoprofen

61
Q

Which NSAIDs are the msot hepatotoxic

A

ibuprofen, naproxen and diclofenac

62
Q

What should be given for an indomethacin overdose

63
Q

What is Arthrotec

A

diclofenac/misoprostol- an NSAID with protection for the stomach

64
Q

What NSAIDS work on both the lipooxygenase and cyclooxygenase pathways

A

ketoprofen and diclofenac

65
Q

What is the difference between Cataflam and Voltaren

A
  • Cataflam is diclofenac potassium and has an immediate release
  • Voltaren is diclofenac sodium and has a delayed release
66
Q

What are the only pro-drugs for NSAIDs

A

nabumetone and sulindac

67
Q

What is the only nonacidic NSAID

A

nabumetone

68
Q

Which NSAIDs have fewer pulmonary problems

A

ketoprofen and diclofenac

69
Q

What are NSAIDS effects to:

  • Coumadin
  • Sulfonylureas
  • Corticosteroids
  • Anti-epileptics
  • Antihypertensives
  • Digoxin
  • Methotrexate
  • Lithium
  • Probenecid
A
  • Coumadin: increases action
  • Sulfonylureas: increases action
  • Corticosteroids: increases GI risk
  • Anti-epileptics: increases anti-epileptic toxicity
  • Antihypertensives: antagonizes antihypertensive meds
  • Digoxin: increases digoxin effects
  • Methotrexate: decreases methotrexate clearance
  • Lithium: decreases Lithium’s clearance
  • Probenecid: increases concentrations of NSAIDs

Crozer Surgery (16 decks)

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