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Amanda CRNA > Note Cards > Flashcards

Note Cards Flashcards

1
Q

Meds that cause reflex bradycardia

A

Phenylephrine

Dopamine

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2
Q

Drugs that are Racemix Mixtures

A 
Dobutamine
Verapamil
Sotalol
Mepivacaine
Bupivacaine
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3
Q

+/- isotomiers of Dobutamine

A

(-) potent alpha agonist; weak beta agonist

(+) competative agonist at alpha; potent Beta agonist

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4
Q

+/- isotomiers of Verapamil

A

(-) reason CCB classification

(+) Na-channels –> LA effect

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5
Q

+/- isotomiers of Sotalol

A 
(-) beta blocker
(+) class III
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6
Q

(+) S of bupivacaine

A

less toxic than that of mepivacaine?

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7
Q

Drugs to avoid with LHF

A

“CBL”

  • CCB (verapamil)
  • Beta blockers
  • left sided HF
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8
Q

Drugs to avoid in RHF

A

“DNR”

  • Dopamine
  • Norepi
  • right sided HF
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9
Q

Drugs that have Tachyphylaxis

A
  • Dobutamine (beta)
  • Ephedrine ( alpha inhibition p first dose)
  • NTG – more of a tolerance
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10
Q

Drugs it’s important to HYDRATE before administering :

A
  • Phenoxybenzamine
  • CCB’s
  • BB’s
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11
Q

Drugs known to cause ORTHOSTATIC hypotension

A
  • Phenoxybenzamine
  • Prazosin
  • Labetalol
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12
Q

Prodrugs:

A
  • SNP
  • Enalipril
  • Lovastatin
  • Simvastatin
  • ASA
  • Clopidegrel (Plavix)
  • Parsurgrel (effient)
  • T4 to T3
  • Fenofibrate?
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13
Q

Drugs to decrease w/Liver dx

A
  • cardizem

- Labetalol

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14
Q

Interactions with volitiles:

A

Yohimbine (alpha 2)

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15
Q

Interactions with NMBD:

A

CCB - decrease AcH at presynaptic cleft

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16
Q

Interactions with LA:

A

Verapamil

Diltaizem

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17
Q

Increase IOP:

A

Dopamine
Versed?
Fenoldopam
Succ

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18
Q

DUMBELLS

A

For Cholinergics – “Wet”

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19
Q

what increases ACh but is breaking on the heart?

A

cholinergics

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20
Q

Anti-Cholinergics (antimuscarinics) are:

A
  • atropine
  • Scopolamine
  • glycopyrrolate
  • Ipartropium
  • Oxybutinin
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21
Q

Protein binding Greatest to least - Beta Blockers:

A

“-PENAMA”

  • Propranolol
  • Esmolol
  • Nadolol
  • Acebutolol
  • Metoprolol
  • Atenolol
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22
Q

Vd of Opioids greatest to least:

A

“FMMSRA”

  • Fentanyl
  • Meperidine
  • Morphine
  • Sufentanil
  • Remifentanil
  • Alfentanil
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23
Q

Protein binding (greatest to least) - LA:

A

“LBRMTLPPC”

  • Levo
  • Bupivacaine
  • Ropivacaine
  • Mepivacaine
  • Tetracaine
  • Lidocaine
  • Prilocaine
  • Chloroprocaine (zero)
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24
Q

LA Metabolism fastest to slowest (esters)

A

“PLEB”

  • Prilocaine
  • Lidocaine/Mepivacaine
  • Etiocaine
  • Bupivacaine/Ropivacaine

RPM - “start slow and speed up”
Ropiviacaine, Prilocaine = Metabolism

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25
Q

Protein binding of antiarrhymics (greatest to least)

A
  • Amiodarone
  • Propranolol
  • Verapamil
  • Quinidine
  • Lidocaine
  • Procainanide
  • Sotalol (zero)
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26
Q

Gases - hepatic effects greatest to least:

A

“HEIDes”

H > E> I > Des

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27
Q

NMB’s in order of R/O anaphylaxis (greatest to least)

A

-Succ> Atracurium >Cis > Roc > Vec

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28
Q

Gases that potentiate NMB (most to least)

A

Des > Sevo > Halo > N2O

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29
Q

Order of NMD’s Sugammadex works on (best to least):

A

Roc > Vanc&raquo_space; Panc

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30
Q

CO equation =

A

CO = SV x HR

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31
Q

Ficks Principle Equation

A

CO = [ O2 consumption / (O2 pulm vein) - (O2 pulm artery) ]

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32
Q

SV =

A

EDV - ESV

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33
Q

SV alternative (CO and HR)

A

SV = CO/HR

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34
Q

EF =

A

SV/EDV

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35
Q

SVR =

A

[ (MAP - CVP) / CO] x 80

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36
Q

MAP = (with SVR)

A

MAP = [ (CO x SVR) / 80 ] + CVP

37
Q

MAP (with TPR)

A

MAP = CO x TPR

38
Q

MAP (pulse pressure)

A

MAP = Diastolic Pressure + 1/3 Pulse Pressure

39
Q

pulse pressure =

A

Systolic - Diastolic

*** aprox. = SV

40
Q

Factors that Increase VENOUS Return (Increase CO):

A
  • Venoconstriction by smpathetic stimulation
  • muscle pump
  • body posture (trend; raised legs)
  • Respiratory (Decreased intrathoracic pressure)
41
Q

Factors that Decrease VENOUS return (decrease CO):

A
  • Standing
  • PEEP (increases intrathoracic pressure)
  • Pneumothorax
  • Acure/severe asthma
42
Q

Preload is directly proportional to

A

SV

Increased Preload = Increased SV and vis versa

43
Q

SV is indirectly proportionate to:

A

Afterload

Decrease afterload = increase SV

44
Q

SV is directly proportionate to:

A

Contractility

45
Q

If your PCWP is high (normal is 8-14) what is harmful:

A

FLUIDS

46
Q

Normal CVP

A

5-8 mmHG

47
Q

L II, III, aVF indicate

A

inferior MI / RCA

48
Q

V1-V4 indicate

A

anterior
anterior septal MI
LAD

49
Q

V5 - V6, I and aVL indicate

A

Lateral Left circumflex

LAD?

50
Q

ST depression in V1, V2

A

Posterior

Left Circ or RCA

51
Q

RCA seen in

A

Leads II, III, aVF

sees RA and ventricle

52
Q

LCA supplies LAB and circumflex — then feeds?

A

septal anterior and lateral

53
Q

LAD in leads

A

V1-V4

54
Q

small box on ekg paper measures:

A

1mm x 1mm = .45

55
Q

Big box on ekg paper measures;

A

5mm x 5mm = .20 sec

56
Q

vertical small box on ekg measures:

A

0.1mV

57
Q

vertical large box on ekg paper measures:

A

0.5 mV

58
Q

R Prime indicates

A

RBBB

59
Q

T wave

A

asymmetrical and upright

60
Q

T wave in hypokalemia

A

low amplitude

61
Q

T wave in yperkalemia

A

tall and peaked

62
Q

leads on the upper body are

A

negative

63
Q

leads on the lower body are

A

positive

64
Q 
a = augmented
V= voltage
R= right arm
L= left arm
F =
A

left foot

65
Q

aVR does not view any

A

cardiac wall

66
Q

aVF views

A

Left Leg - inferior LV

67
Q

R axis normal in

abnormal in?

A

normal in young

abn change inspiration - COPD, WPW, RVH

68
Q

L axis normal in?

A

normal in old or obese

69
Q

P Wave is known as

A

P-Pulmonale

lung disease Right Atrial strain

70
Q

Poor R wave poor progression

A

anteroseptal infart

young women

71
Q

Q wave indicated

A

old MI

-not permanent

72
Q

u wave

A

hypokalemia

73
Q

ST elevation all leads but aVR may indicate

A

Pericarditis

74
Q

inferior MI

RCA is seen in

A

ST elevation in L II, III, aVF

75
Q

anterior septal MI

LAD is seen in leads?

A

LV1-V4

76
Q

ST Depression in leads V1 and V2 indicate

A

posterior MI

LCA or RCA

77
Q

systolic murmur heard b/w what heart sounds

A

S1 and S2

78
Q

what sound is heard with closure of tricuspid and mitral valves?

A

S1

79
Q

what sound is heard with the closure of the aortic and pulmonic valves?

A

S2

80
Q

S3 heart sound is normal in? abn?

A

normal in children <30 yrs old

heard with **Bell at Left sternal border

81
Q

S4 Heart sound indicates:

A

abn Stiff non-compliant ventricle

82
Q

PMI is heard at:

A

5th Intercostal Space

Left midclavicular line

83
Q

Diastolic Murmur

A

Mitral stenosis

-low open snamp after S2 before Murmur

84
Q

Aortic stenosis

A

loud harsh enection click; at 2nd intercostal space, diminished S2, CRACKLES

85
Q

Bell used to hear

A

LOW sounds
S3
Mitral stenosis

86
Q

Diaphragm used to hear

A

HIGH

S1, S2 & S4

87
Q

+ Thrill in grades

A

4-6

88
Q

Order of Nerve Blockade for Spinal or Epidural Anesthesia

The order in which nerves are blocked following epidural administration of a local anesthetic are:

A
  1. B fibers (preganglionic sympathetic efferents)

2. C and A-delta (A

Amanda CRNA (8 decks)

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