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Pharmacology > N926 Pharmacology Final Exam Second Half > Flashcards

N926 Pharmacology Final Exam Second Half Flashcards

1
Q

MOA of Butorphanol

A

antagonism at mu receptor and antagonist at kappa receptor

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2
Q

MOA of nalbuphine

A

Antagonism at mu receptor

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3
Q

Nalbuphine is 1/4 antagonist of

A

morphine

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4
Q

Acetaminophen has both

A

analgesic and antipyretic properties

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5
Q

PK of Acetaminophen

A

metabolized in the liver
damage to liver results from N-acetyl-p-benzoquinonemine
liver failure by depleting gluthathione

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6
Q

Dose of Acetaminophen

A

325-600mg PO q6h
Total not to exceed 4000mg/24 hr
2000mg for chronic alcoholics
IV-1000mg q6h

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7
Q

Acetaminophen Anesthetic considerations

A

use in multimodal approach but not in liver patients

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8
Q

MOA of Ibuprofen

A

nonselective COX inhibitor

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9
Q

Dosing of Ibuprofen

A

200-800mg PO q4-6h

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10
Q

Anesthetic Considerations of Ibuprofen

A

use in multi-modal approach

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11
Q

Ketorolac is common

A

used for perioperatively

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12
Q

Dosing of Ketorolac

A

15mg IV q6h

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13
Q

Ketorolac must be avoided

A

in renally compromised patients

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14
Q

MOA of Celecoxib

A

Selective COX 2 inhibitor

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15
Q

Dosing of Celecoxib

A

400mg PO preoperatively

200mg BID x 5 days post op

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16
Q

Risks of Celecoxib

A

increased cardiovascular risk

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17
Q

When is Celecoxib used?

A

ERAS protocol

Part of multi-modal pain management; give in pre-op

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18
Q

MOA of Succinylcholine

A

Depolarizing neuromuscular blocked on nACHr

partial agonist

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19
Q

PK of Succinylcholine

A

low Vd d/t quaternary ammonium (polar molecule)
metabolized by PChE (succinylmonocholine and choline)
first order kinetics

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20
Q

PD of Succinylcholine

A

Neuro: increases ICP/ IOP
Cardiac: may cause bradycardia, tachycardia, ventricular dysrhythmias, and increased BP, junctional rhythm sinus arrest (action on muscarinic receptors)

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21
Q

Side Effects of Succinylcholine

A

increase K level by 0.5mg/dl
Risk for MH and don’t administer to children
increasing intragastic pressure (GERD pts)
Myalgias
masseter spasm

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22
Q

Dosing of Succinylcholine

A

1mg/kg of IBW

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23
Q

When can you intubate after administering Succinylcholine

A

60 seconds

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24
Q

Recover to 90% muscle strength of Succinylcholine

A

9-13 minutes

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25
MOA of Atracurium
benzylisoquinium non-depolarizing NMD (antagonist)
26
PK of Atracurium
racemic mixture of 10 isomers metabolized by ester hydrolysis and Hoffman elimination (Laudanosine active metabolite implicated in convulsions) non-liver dependent for metabolism, okay to use in liver pts Small volume of distribution
27
PD of Atracurium
Histamine Release | May block peripheral nACHr causing bradycardia and hypotension
28
Dosing of Atracurium
0.5 mg/kg (intermediate acting onset)
29
MOA of Cisatracurium
Benzlisoquinium non-depolarizing NMBD (antagonist)
30
PK of Cisatracurium
cis isomer of atracurium | metabolized by Hoffmann elimination (good for liver and kidney patients)
31
Dose of Cisatracurium
0.1mg/kg (intermediate onset and action)
32
MOA of Pancuronium
Steroidal compoound nondepolarizing NMBD (antagonist)
33
PK of Pancuronium
deacetylated by liver Accumulation of 3-OH metabolite prolongs block) Cleared by Kidney - don't use in renal patient s
34
PD of Pancuronium
vagolytic (inhibits the vagus nerve/ blocks muscarinic receptors) and PChE-inhibiting properties may block peripheral nAChR causing bradycardia and hypotension
35
Dose of Pancuronium
0.08mg/kg with onset time of 2.9 minutes (not for RSI)
36
MOA of Vecuronium
Steroid compound non-depolarizing NMBD (antagonist)
37
PK of Vecuronium
Pancuronium without quaternized methyl group (increased lipid solubility) metabolized principally by the liver (3-deacteyl metbolite has 80% of neuromuscular potency)
38
PD of Vecuronium
May block peripheral nAcHr causing bradycardia and hypotension
39
Dose of Vecuronium
0.1mg/kg wiht onset time of 2.4 minutes
40
MOA of Rocuronium
Steroid compound non-depolarizing NMBD (antagonist)
41
PK of Rocuronium
Primarily utilized by the liver (approximately 30% excreted in the urine) NMBD with highest risk of allergic reactions
42
PD of Rocuronium
see more histamine release d/t having to give larger doses | may block peripheral nAchr causing bradycardia and hypotension
43
Dosing of Rocuronium
0.6-1.2mg/kg with onset time of 1.7 minutes (six times less potent then veco)
44
MOA of Edrophonium
Cholinesterase Inhibitor
45
Reversal Dose of Edrophonium
1-1.5mg/kg
46
Side Effects of Edrophonium
bradycardia, hypotension, brochoconstriction, salivation, defectation
47
Onset of Edrophonium
30 sec-1min
48
MOA of Neostigmine
Cholinesterase inhibitor
49
Reversal Dosing of Neostigmine
0.06-0.08mg/kg
50
Side effects of Neostigmine
bradycardia, hypotension, brochoconstriction, salivation, defectation
51
Onset of Neostigmine
5-15 minutes
52
MOA of Ondanestron
5HT-3 antagonist
53
Dosing of Ondanestron
4mg IV (0.1mg/kg if less then 40kg)
54
When do you administer ondanestron?
30 minutes prior to wake up
55
MOA of Promethazine
Anti-histamine (H1 antagonist) and anticholinergic effects responsible for antiemetic activity
56
Dosing of Promethazine
12.5-25mg q4-6hr
57
MOA of Reglan
Dopamine Receptor antagoinst
58
Dosing of Reglan
20 mg for PONV
59
MOA of Atropine
anticholinergic
60
Indications of Atropine
bradycardia or to prevent side effects of AChE inhibitors
61
Side effects of Atropine
mydriasis, cycloplegia, dry mouth, difficulty swallowing, photophobia, tachycardia, dry skin, flushed increase body temp neuro-sedative effects
62
Dosing of Atropine
0.015mg/kg
63
MOA of Glycopyrrolate
Anticholinergic
64
Indications of Glycopyrroalte
decrease secretions or to prevent side effects of AcHe inhibitor
65
Side effects of Glycopyrroate
mydriasis, cycloplegia, dry mouth, difficulty swallowing, photophobia, tachycardia, dry skin, flushed increase body temp
66
Dosing of Glycopyrroate
0.01-0.02mg/kg
67
MOA of Scopolamine
Anticholinergic
68
Indications of Scopolamine
PONV, pre-op sedation
69
Side effects of Scopolamine
cerebral depression, sedation amnesia watch for anticholinergic poisioning decreased secretions/ drying, bronchodilation tachycardia decreased motility, constipation, prolonged gatric emptying time decreased ureter and bladder tone (urine retention) dry mouth, increased thirst, dry skin, dizziness, blurred vision, dilated pupils, light sensitivity, mydrasis, cyclopegia
70
Dosing of Scopolamine
1.5 mg topical patch behind ear
71
Half life of Scopolamine
4.5 hrs
72
MOA of Dexamethasone
Synthesis of proteins and target cells containing enzyme 11-beta hydroxysteroid dehydrogenase
73
Stress Dosing of Dexamethasone
4-8 mg
74
MOA of Acetaminophen
central analgesic effect thru activation of serontonergic pathways and antagonism of NMDA, substance P and nitric oxide pathways.
75
1/2 Life of Acetaminophen
2-3 hours
76
1/2 Life of Ibuprofen
2-2.5hr
77
PK of Ibuprofen
oxidation
78
Ketorolac is an
acid
79
1/2 life of Ketorolac
2.5-8.5 hr
80
PK of Ketorolac
Protein Bound | Metabolized through conjugation
81
1/2 Life of Celecoxib
11-16 hours
82
PK of Celecoxib
rapid GI absorption increased protein binding conjugation
83
1/2 Life of Pancuronium
130 minutes
84
1/2 Life of Roc
70 minutes
85
1/2 Life of Vec
80 minutes
86
1/2 Life of Cistracurium
less then 1 hour
87
Elimination 1/2 Time of Atracurium
20 minutes
88
1/2 Life of Succinylcholine
45 seconds
89
1/2 Life of Glycopyrrolate
2-3hours
90
1/2 Life of Atropine
2-3 hours
91
1/2 Life of Edrophorium
30-120 mins
92
Onset of Edrophorium
30seconds to 1 min
93
1/2 life of neostigmine
1 hour
94
onset of neostigimine
5-15 minutes

Pharmacology (14 decks)

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