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first aid 2015 Teresa > Neuro: first aid 2015 pg 495-502 > Flashcards

Neuro: first aid 2015 pg 495-502 Flashcards

1
Q

A 42-year-old man involved in an automobile accident sustains multiple fractures of the right leg and arm and is suffering from severe pain. In the emergency department, his wife reports that her husband is a recovering heroin addict who has been enrolled in a methadone program for 3 months and is also taking phenelzine for depression. The most appropriate drug to alleviate the patient’s severe pain is

A. butorphanol.
B. meperidine.
C. morphine.
D. nalbuphine.
E. pentazocine.
A

A

methadone program —> withdrawal program so don’t give opioid agonist

so Butorphanol is Kagonist and u partial agonist!

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2
Q

butorphanol overdose–> easily reversible with naloxone?

A

nope

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3
Q

Tramadol
what is it?
and fatal side effect

A

tram it all work on everything
Serotonin syndrome!!
also decreases seizures threshold

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4
Q

Absence seizure treatment

A

Ethosuxmide

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5
Q

List Ca2+ blockers for antiseizures

A

EcG
Ethosuxmide
Calcium
Gabapentin

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6
Q

Increase in GABA

A

Topiramate and phenobarbital

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7
Q

where do you use Gabapentin other than seizures

A

peripheral neuropathy and postherpatic neuralgia

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8
Q

Migraine prophylaxis?

A

BACT

Topiramate!

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9
Q

drug that cause stevens-johnson syndrome

A

lamotrigine

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10
Q

antiepileptic causing SIADH

A

carbamazepine

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11
Q

bipolar

  1. manic phase
  2. depressed phase
A
  1. manic: carbamezepine

2. lamotrigine

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12
Q

status epilepticus DOC

A

phenytoin

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13
Q

tonic-clonic DOC

A

valporic

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14
Q

p450 inducer

A

carbamazepine

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15
Q

patient with tonic clonic and absence seizures

A

valporic

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16
Q

gingival hyperplasia

A

phenytoin

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17
Q

baby with cleft palate, cardiac

defects, phalanx/fingernail hypoplasia

A

fetal phenytoin syndrome

18
Q

eclampsia 1st line and what’s the other drug

A

MgSO4

BDZ

19
Q

hepatotoxic, neural tube defects

A

phenytoin

20
Q

kidney stones

A

topiramate

21
Q

list 2 GABA channels that works by Cl- influx

A

A and B
A is in brain
B is in retina

22
Q

what’s GABAb? MOA?

A

in brain too. it’s ta Gprotein so Gi
K+ efflux
decreased in Ca2+ influx
Net effect: hyperpolarize

23
Q

whats contraindicated in porphyria?

A

barbs

24
Q

low potency think what?

A

high MAC = low solubility in lipid

25
Q

high potency –> lipid or blood solubility

A

potency–> think lipid! want high solubility in lipid for high potency

26
Q

rapid induction think lipid or blood? (low or high)

A

blood, low blood

27
Q

rapid induction means what recovery times?

A

fast

28
Q

rapid induction, want B/G ratio to be?

A

low–> increased free fraction

29
Q

list properties of N2O in term of

  1. induction
  2. potency
A
  1. induction: rapid –> low blood solu

2. potency: low lipid solu –> low potency

30
Q

halothane SE

A

hepatotoxic

31
Q

Methyoxyflurane SE

A

nephrotoxic

32
Q

proconvulsant

A

enflurane

33
Q

treatment for

  1. malignant hyperthermia
  2. Neuroepileptic syndrome
  3. serotonin syndrome
  4. extrapyramidal systems SE of antipyschotics
A
  1. dantrolene (fever+severe muscle contractions) (SSRI+inhaled anesthetics except N2O)
  2. dantrolene and D2 agonists (bromocriptine) (myoglobinuria + ridigity)
  3. cyproheptadine (myoclonus + diarrhea)
  4. beztropine or diphenhydramine
34
Q

inhaled anethestics cause increased cerebral blood flow but this one cause decreased cerebral blood flow. its IV anesthetics. what is it?

A

barbituates (thiopental)

35
Q

for endoscopy, what anesthetics?

A

midazolam

36
Q

Chronic alcoholic came in for endoscopy. He seemed to make up stories. He is given midazolam. He is B1 deficient too. after surgery, what will happen to his memory?

A

Korsakoff syndrome: Ante> retro
midazolam: Retro

so he’s gone gone gone

37
Q

This IV anesthetics is used in older patients with bradycardia (or heart problem), and it is used when you the patient to be conscious but you just want to induce muscle catatonia?

A

ketamine

38
Q

what is ketamine?

A

arylcyclohexylamines ACHA

39
Q

this IV anesthetic is often used for outpatient quick and easy procedures like botox. K-pop stars favorites

A

propofol

40
Q

bad thing about propofol is there is pain at injection site, what would you use instead?

A

fospropofol

41
Q

local anesthetics most effective in what type of neurons?

A

activated Na+ –> rapidly firing neurons

first aid 2015 Teresa (9 decks)

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