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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
Q

MOA of Atracurium

A

benzylisoquinium non-depolarizing NMD (antagonist)

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26
Q

PK of Atracurium

A

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

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27
Q

PD of Atracurium

A

Histamine Release

May block peripheral nACHr causing bradycardia and hypotension

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28
Q

Dosing of Atracurium

A

0.5 mg/kg (intermediate acting onset)

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29
Q

MOA of Cisatracurium

A

Benzlisoquinium non-depolarizing NMBD (antagonist)

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30
Q

PK of Cisatracurium

A

cis isomer of atracurium

metabolized by Hoffmann elimination (good for liver and kidney patients)

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31
Q

Dose of Cisatracurium

A

0.1mg/kg (intermediate onset and action)

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32
Q

MOA of Pancuronium

A

Steroidal compoound nondepolarizing NMBD (antagonist)

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33
Q

PK of Pancuronium

A

deacetylated by liver
Accumulation of 3-OH metabolite prolongs block)
Cleared by Kidney
- don’t use in renal patient s

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34
Q

PD of Pancuronium

A

vagolytic (inhibits the vagus nerve/ blocks muscarinic receptors) and PChE-inhibiting properties
may block peripheral nAChR causing bradycardia and hypotension

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35
Q

Dose of Pancuronium

A

0.08mg/kg with onset time of 2.9 minutes (not for RSI)

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36
Q

MOA of Vecuronium

A

Steroid compound non-depolarizing NMBD (antagonist)

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37
Q

PK of Vecuronium

A

Pancuronium without quaternized methyl group (increased lipid solubility)
metabolized principally by the liver (3-deacteyl metbolite has 80% of neuromuscular potency)

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38
Q

PD of Vecuronium

A

May block peripheral nAcHr causing bradycardia and hypotension

39
Q

Dose of Vecuronium

A

0.1mg/kg wiht onset time of 2.4 minutes

40
Q

MOA of Rocuronium

A

Steroid compound non-depolarizing NMBD (antagonist)

41
Q

PK of Rocuronium

A

Primarily utilized by the liver (approximately 30% excreted in the urine)
NMBD with highest risk of allergic reactions

42
Q

PD of Rocuronium

A

see more histamine release d/t having to give larger doses

may block peripheral nAchr causing bradycardia and hypotension

43
Q

Dosing of Rocuronium

A

0.6-1.2mg/kg with onset time of 1.7 minutes (six times less potent then veco)

44
Q

MOA of Edrophonium

A

Cholinesterase Inhibitor

45
Q

Reversal Dose of Edrophonium

A

1-1.5mg/kg

46
Q

Side Effects of Edrophonium

A

bradycardia, hypotension, brochoconstriction, salivation, defectation

47
Q

Onset of Edrophonium

A

30 sec-1min

48
Q

MOA of Neostigmine

A

Cholinesterase inhibitor

49
Q

Reversal Dosing of Neostigmine

A

0.06-0.08mg/kg

50
Q

Side effects of Neostigmine

A

bradycardia, hypotension, brochoconstriction, salivation, defectation

51
Q

Onset of Neostigmine

A

5-15 minutes

52
Q

MOA of Ondanestron

A

5HT-3 antagonist

53
Q

Dosing of Ondanestron

A

4mg IV (0.1mg/kg if less then 40kg)

54
Q

When do you administer ondanestron?

A

30 minutes prior to wake up

55
Q

MOA of Promethazine

A

Anti-histamine (H1 antagonist) and anticholinergic effects responsible for antiemetic activity

56
Q

Dosing of Promethazine

A

12.5-25mg q4-6hr

57
Q

MOA of Reglan

A

Dopamine Receptor antagoinst

58
Q

Dosing of Reglan

A

20 mg for PONV

59
Q

MOA of Atropine

A

anticholinergic

60
Q

Indications of Atropine

A

bradycardia or to prevent side effects of AChE inhibitors

61
Q

Side effects of Atropine

A

mydriasis, cycloplegia, dry mouth, difficulty swallowing, photophobia, tachycardia, dry skin, flushed increase body temp
neuro-sedative effects

62
Q

Dosing of Atropine

A

0.015mg/kg

63
Q

MOA of Glycopyrrolate

A

Anticholinergic

64
Q

Indications of Glycopyrroalte

A

decrease secretions or to prevent side effects of AcHe inhibitor

65
Q

Side effects of Glycopyrroate

A

mydriasis, cycloplegia, dry mouth, difficulty swallowing, photophobia, tachycardia, dry skin, flushed increase body temp

66
Q

Dosing of Glycopyrroate

A

0.01-0.02mg/kg

67
Q

MOA of Scopolamine

A

Anticholinergic

68
Q

Indications of Scopolamine

A

PONV, pre-op sedation

69
Q

Side effects of Scopolamine

A

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
Q

Dosing of Scopolamine

A

1.5 mg topical patch behind ear

71
Q

Half life of Scopolamine

A

4.5 hrs

72
Q

MOA of Dexamethasone

A

Synthesis of proteins and target cells containing enzyme 11-beta hydroxysteroid dehydrogenase

73
Q

Stress Dosing of Dexamethasone

A

4-8 mg

74
Q

MOA of Acetaminophen

A

central analgesic effect thru activation of serontonergic pathways and antagonism of NMDA, substance P and nitric oxide pathways.

75
Q

1/2 Life of Acetaminophen

A

2-3 hours

76
Q

1/2 Life of Ibuprofen

A

2-2.5hr

77
Q

PK of Ibuprofen

A

oxidation

78
Q

Ketorolac is an

A

acid

79
Q

1/2 life of Ketorolac

A

2.5-8.5 hr

80
Q

PK of Ketorolac

A

Protein Bound

Metabolized through conjugation

81
Q

1/2 Life of Celecoxib

A

11-16 hours

82
Q

PK of Celecoxib

A

rapid GI absorption
increased protein binding
conjugation

83
Q

1/2 Life of Pancuronium

A

130 minutes

84
Q

1/2 Life of Roc

A

70 minutes

85
Q

1/2 Life of Vec

A

80 minutes

86
Q

1/2 Life of Cistracurium

A

less then 1 hour

87
Q

Elimination 1/2 Time of Atracurium

A

20 minutes

88
Q

1/2 Life of Succinylcholine

A

45 seconds

89
Q

1/2 Life of Glycopyrrolate

A

2-3hours

90
Q

1/2 Life of Atropine

A

2-3 hours

91
Q

1/2 Life of Edrophorium

A

30-120 mins

92
Q

Onset of Edrophorium

A

30seconds to 1 min

93
Q

1/2 life of neostigmine

A

1 hour

94
Q

onset of neostigimine

A

5-15 minutes

pharmacology (14 decks)

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