Miscellaneous Drugs & Drug Interactions Flashcards
Name three commonly used dyes and contrast media
Methylene blue
Indigo carmine
Fluoroscein
Methylene Blue is used for
evaluation of urine clearance time
to identify where ureters enter the bladder
treat methemoglobinemia
Large doses of M. blue may cause
Nausea, abdominal pain, h/a, METHEMOGLOBINEMIA
*IV bolus of M.Blue is associated with
TRANSIENT HYPOTENSION and False Sp02 reduction (dye changes blood color)
Never give M.Blue
SQ, Intrathecally
Indigo Carmine is used to
evaluate urine clearance time
to identify where ureters enter bladder
I. Carmine is associated with
slight hypertension
I. Carmine is prepared in a
0.8% solution in 5 mL ampules
M. Blue is prepared in a
1% solution in 10 mL ampules
Fluoroscein is used for
diagnostic angiography, or angioscopy of the fundus and iris vasculature
Fluoroscein should not be
injected intrathecally
Fluoroscein transiently causes skin and urine to turne
yellowish
True or False, Fluroscein can cause allergic rxn
True
*caution in asthmatics
The incidence of adverse drug interaction increases as the —— of concurrently administered drugs increases
Number
Thiopental (pH 10.5) precipitates when mixed with
Opioids (pH 3-4)
Heparin (acidic) is neutralized by
Protamine (basic)
Local anesthetics mixed with —— prolongs the DOA of the LA
epinephrine
Barbiturates are displaced from their protein binding site by ——- leading to an increase in the barbiturate effect
Contrast media
Hepatic Cytochrome P-450 system is INDUCED by
Barbiturates/ Phenytoin
** Pseudocholinesterase is inhibited by ——-, and thereby prolongs the DOA of ——-
Echothiphate (eye drop), Succinylcholine
Phenobarital’s excretion is enhanced if the urine is alkalinized by
Sodium bicarbonate
Alveolar elimination of volatile anesthetic agents are prolonged with what ventilatory depressant drug
Opioids
Naloxone inhibits the acitivity of
Opioids
*Magnesium increases the DOA of
Non-depolorizing muscle relaxants
Chlorpromazine (thorazine) combined with —–, produces profound hypotension
halogenated agents
Albuterol combined with ——– increase risk of dysrthythmias and hypertension
halogenated agents
ANTIcholenesterases have what effect on the heart rate
SEVERE BRADYCARDIA
Lidocaine can induce —– and decrease —–, and——.
induce and maintain anesthesia
decrease stress response during intubation
decrease MAC, if plasma levels maintained via infusion
Isoflurane sensitize myocardium to
catecholamines
*epinephrine must be limited to 3.5 mcg/kg/10-minute period when given with Isoflurane
MAO Inhibitors block metabolism of
Catecholamines
Nardil, Parnate, Marplan
MOAIs should be stopped how long before surgery
2 weeks
MAOIs have a synergestic effects with
halogenated agents, opioids, barbiturates
What opioid is STRICTLY CONTRAINDICATED with MAOIs
Meperidine»>CNS excitation, hyperpyrexia, DEATH
Tricylclc Antidepressants block reuptake of
Norephinephrine»»Profound Tachy, Hypertension
Elavil
Pamelor
Tofanil
Sinequan
TCA should be continued until
the day of surgery
** Pancuronium and cause ——when given with TCA
DYSRHYTHMIAS
Cimetidine inhibits
P-450 system
Cimetidine —-hepatic blood flow
decreases and thereby decreases the rate of biotransformation
Acute alcohol intoxication ——-MAC
decreases
Chronic alcohol abuse——MAC
increases
Cocaine ——-reuptake of ——
Inhibits, reuptake of norepinephrine
Key treatment goal of patient on cocaine
Avoid SNS stimulation due to exaggerated responses that can be life threatening.
What NMBA should be avoid in cocaine users
Pancuronium
All halogenated agents produce what effect of the heart
Myocardial depression
