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Anesthesia Pharm > Meds > Flashcards

Meds Flashcards

1
Q

Isoflurane boiling point

A

48.5 *C

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2
Q

Isoflurane vapor pressure

A

238 mmHg

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3
Q

Isoflurane Blood:Gas coefficient

A

1.4

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4
Q

Isoflurane Oil:Gas coefficient

A

90.8

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5
Q

Isoflurane MAC

A

1.15

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6
Q

Isoflurane MAC-awake

A

0.49

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7
Q

Isoflurane MAC-BAR

A

1.3

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8
Q

Des fluorine molecular weight

A

168

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9
Q

Desflurane boiling point

A

23.5 *C

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10
Q

Desflurane vapor pressure

A

664 mmHg

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11
Q

Desflurane blood:gas coefficient

A

0.42

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12
Q

Desflurane oil:gas coefficient

A

18.7

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13
Q

Desflurane MAC

A

6%

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14
Q

Desflurane MAC-awake

A

2.5%

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15
Q

Desflurane MAC-BAR

A

1.3%

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16
Q

Sevoflurane molecular weight

A

200

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17
Q

Sevoflurane boiling point

A

58.5 *C

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18
Q

Sevoflurane vapor pressure

A

160 mmHg

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19
Q

Sevoflurane blood:gas coefficient

A

0.69

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20
Q

Sevoflurane oil:gas coefficient

A

47.2

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21
Q

Sevoflurane MAC

A

1.7%

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22
Q

Sevoflurane MAC-awake

A

0.62

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23
Q

Sevoflurane MAC-BAR

A

2.2

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24
Q

N2O Molecular Weight

A

44

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25
Q

N2O boiling point

A

-88 *C

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26
Q

N2O vapor pressure

A

39,000 mmHg

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27
Q

N2O blood:gas coefficient

A

0.47

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28
Q

N2O oil:gas coefficient

A

1.4

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29
Q

N2O MAC

A

104%

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30
Q

N2O MAC-Awake

A

0.68

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31
Q

Thiopental sodium (Pentothal) induction dose

A

3-5 mg/kg

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32
Q

Thiopental sodium (Pentothal) half life?

A

3-8 hours

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33
Q

Methohexital (brevital) induction dose

A

1-1.5 mg/kg

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34
Q

What receptor do barbiturates act on?

A

GABAa receptors

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35
Q

Etomidate induction dose?

A

0.2-0.3 mg/kg

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36
Q

What is a big draw back of etomidate?

A

Suppresses cortical adrenals leading to suppression of intrinsic steroid production.

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37
Q

What are some properties of Methohexital (Brevital)?

A

Ultra short acting, rapid redistribution, highly protein bound, very lipid soluble

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38
Q

If a drug is highly lipid soluble, will it have a faster or slower onset of action?

A

Faster

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39
Q

What is one downfall to Methohexital (brevital)?

A

Hangover effect

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40
Q

What type of drug is etomidate?

A

Non-barbiturate hypnotic

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41
Q

What are some properties of etomidate?

A

Highly lipid soluble, undergoes redistribution but rapid return to baseline

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42
Q

What side effect does etomidate have?

A

Can cause extra pyramidal movements due to the dis inhibitory effect on sub cortical structures - can cause myoclonus. Can also cause PONV

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43
Q

What type of drug is propofol?

A

2,6 diisoporopyl pheno

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44
Q

What are some properties of propofol?

A

Ultra short acting, rapidly cleared, highly lipid soluble

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45
Q

How is propofol metabolized?

A

Cytochrome P450 sx to 4-hydroxyl propofol (active) then glycerin ideation or sulfation. Clearance exceeds hepatic blood flow implying an extra hepatic mechanism that is not yet identified (pulmonary?)

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46
Q

What type of drug is ketamine?

A

Phencycidine (PCP) derivative

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47
Q

What are some properties of ketamine?

A

Slow onset, can be used for preemptive analgesia

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48
Q

Where does ketamine work?

A

Thalamus and limbic systems - no competitive antagonist at NMDA receptor.

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49
Q

What are some side effects of ketamine?

A
  • Increased airway secretions

- dissociative hypnotic, vivid dreams, hallucinations possible

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50
Q

What are some possible benefits of ketamine?

A

Increases CPP via increases in MAP, bronchodilator

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51
Q

What type of drug is dexmedetomidine (preceded)?

A

Selective A2 agonist

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52
Q

How does dexmedetomidine work?

A

Decreases presynaptic NE levels (central), hyper polarizes post synaptic neural membranes (peripheral)

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53
Q

What is the loading dose of precedex?

A

1 mcg/kg given over 30 minuets

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54
Q

What is the infusion dose for precedex?

A

0.2-0.7 mcg/kg/hr

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55
Q

Thiopental distribution half life

A

2-4 min

56
Q

What is the elimination half life of thiopental?

A

10-12 minutes

57
Q

What is the clearance for thiopental?

A

3.5 ml/kg/min

58
Q

What is the volume of distribution for thiopental?

A

2.5 L/kg

59
Q

What is the protein binding for thiopental?

A

80%

60
Q

What is the distribution half life for Methohexital?

A

5-6 min

61
Q

What is the elimination half life for Methohexital?

A

2-4 min

62
Q

What is the clearance rate of Methohexital?

A

10 ml/kg/min

63
Q

What is the volume of distribution for Methohexital?

A

2.3 L/kg

64
Q

What is the protein binding for Methohexital?

A

85%

65
Q

What is the distribution half life for diazepam?

A

10-15 min

66
Q

What is the elimination half life for diazepam?

A

20-50 min

67
Q

What is the clearance rate for diazepam?

A

0.3 ml/kg/min

68
Q

What is the volume of distribution for diazepam?

A

0.8-1.3 L/kg

69
Q

What is the protein binding for diazepam?

A

98%

70
Q

What is the distribution half life of midazolam?

A

7-15 min

71
Q

What is the elimination half life of midazolam?

A

2-4 min

72
Q

What is the clearance rate of midazolam?

A

7-11 ml/kg/min

73
Q

What is the volume of distribution of midazolam?

A

1-1.7 L/kg

74
Q

What is the protein binding of midazolam?

A

94%

75
Q

What is the distribution half life of etomidate?

A

2-4 min

76
Q

What is the elimination half life of etomidate?

A

2-5 min

77
Q

What is the clearance rate of etomidate?

A

22.5 ml/kg/min

78
Q

What is the volume of distribution for etomidate?

A

2.4-4.5 L/kg

79
Q

What is the protein binding of etomidate?

A

75%

80
Q

What is the distribution half life of propofol?

A

2-4 min

81
Q

What is the elimination half-life of propofol?

A

1-5 min

82
Q

What is the clearance rate of propofol?

A

25 ml/kg/min

83
Q

What is the volume of distribution of propofol?

A

2-6 L/kg

84
Q

What is the protein binding for propofol?

A

98%

85
Q

What is the distribution half-life if ketamine?

A

11-17 min

86
Q

What is the elimination half-life of ketamine?

A

2-3 min

87
Q

What is the clearance rate of ketamine?

A

14.5 ml/kg/min

88
Q

What is the volume of distribution for ketamine?

A

2.5-3.5 L/kg

89
Q

How much of ketamine is protein bound?

A

12%

90
Q

What is the induction dose of thiopental?

A

2-4 mg/kg

91
Q

What is the induction dose of Methohexital?

A

1-2 mg/kg

92
Q

What is the induction dose of etomidate?

A

0.2-0.3 mg/kg

93
Q

What is the induction dose for propofol?

A

1-2.5 mg/kg

94
Q

What is the induction dose of ketamine?

A

0.1-0.2 mg/kg

95
Q

What is the induction dose of midazolam?

A

0.1-0.2 mg/kg

96
Q

Of the 3 bentos, what is the shortest acting?

A

Midazolam

97
Q

Of the 3 benzos, which is the longest acting?

A

Diazepam

98
Q

Of the 3 benzos, which is the intermediate acting?

A

Lorazepam

99
Q

What are some key points of midazolam?

A
  • highly lipid soluble
  • Rapid onset
  • short duration of action due to lipid solubility
  • Rapid redistribution
  • hepatic bio transformation
100
Q

What receptor does midazolam act on to produce sedation?

A

GABA

101
Q

Opioids act at which receptor?

A

Mu1 receptors

102
Q

Are opioids act as agonists or antagonists at receptor to provide analgesia?

A

Agonists

103
Q

What are the side effects at mu2 receptors?

A
  • respiratory depression
  • Brady cardia
  • Dependence
  • Illeus
104
Q

What do analgesics do?

A

Provide pain relief, blunt autonomic response to stress, produce CNS depression

105
Q

What are some properties of ketorolac?

A
  • inhibits prostaglandins
  • 30 Times more potent than morphine
  • Antiplatelet effects
106
Q

What type of drug is ketorolac?

A

NSAID

107
Q

What type of drugs are nalbuphine and butorphanol? What do they do?

A

Mixed agonist/antagonist.

  • Agonist at kappa
  • antagonist at mu
108
Q

What do opioids do to the CO2 curve?

A

Shifts it to the right - causes less response to increases in CO2

109
Q

Which is a more reliable form of amnesia and anesthesia between opioids and benzos?

A

Benzos

110
Q

What are some other opioid properties/side effects?

A
  • increase PONV

- decreased CBF and ICP

111
Q

Histamine release is caused with which opioid?

A

Morphine

112
Q

Which drug is 100 times as potent as morphine?

A

Fentanyl

113
Q

Compared to morphine, does fentanyl have a faster or slower onset of action?

A

Faster because it’s more lipid soluble

114
Q

Compared to morphine does fentanyl have a longer or shorter duration of action?

A

Shorter

115
Q

Between fentanyl and morphine, which has the narrower therapeutic index?

A

Morphine

116
Q

What are some side effects of fentanyl?

A

Truncal rigidity and bradycardia

117
Q

Which drug is 10 times as potent as fentanyl and why?

A

Sufentanil - higher affinity for receptor

118
Q

Is Sufentanil more or less lipid soluble than fentanyl? What does this mean?

A

More lipid soluble - faster onset and shorter duration

119
Q

Does sufentanil of fentanyl have a wider therapeutic index?

A

Sufentanil

120
Q

What are side effects of sufentanil?

A

Bradycardia and truncal rigidity

121
Q

Which drug is 1/5-1/10 the potency of fentanyl? Why?

A

Alfentanil - low affinity for receptor

122
Q

What is the onset of action of alfentanil?

A

Very rapid (1-2 min)

123
Q

How much of alfentanil is unionized? What does this mean?

A

90%, allows it to rapidly cross the BBB

124
Q

What allows alfentanil to have 1/3 as quick of a duration of action compared to fentanyl?

A

Because of the rapid redistribution and hepatic clearance

125
Q

What is the onset of action, peak and duration of ketorolac?

A

Onset - 45-60 min
Peak - 1-2 hours
Duration 4-6 hours

126
Q

How is ketorolac metabolized?

A

Glucagon if acid conjugation in the liver

127
Q

How much of ketorolac is protein bound?

A

99%

128
Q

Where is ketorolac eliminated?

A

Kidneys

129
Q

What does ketorolac do to platelets?

A

Inhibits platelet thromboxane production via inhibition of prostaglandin synthesis

130
Q

What can ketorolac cause in those sensitive to ASA?

A

Severe bronchospasm.

131
Q

Ketorolac can cause renal insufficiency, how?

A

Inhibits synthesis of renal prostaglandins

132
Q

What can be done to help prevent renal impairment when giving ketorolac?

A

Adequate fluid resuscitation.

133
Q

Ages 16-64, what is the dosing of ketorolac? Max dose?

A

30 mg IV, IM or PO q 6 hours, not to exceed 120 mg/24 hours and not to exceed 5 days

134
Q

Ages greater than 64 ketorolac dosing? Max dose?

A

15 mg IM, IV, or PO q 6 hours, not to exceed 60 mg/day for 5 days

135
Q

Isoflurane molecular weight

A

184.5

Anesthesia Pharm (5 decks)

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