Perioperative Pharmacology Flashcards
EMLA cream
Lidocaine with prilocaine topical analgesic
Omeprazole
gastric acid inhibitor (PPI)
Cyclizine
Anti-emetic (piperazine antiemetic)
Actrapid
short acting insulin
AMETOP
tetracaine topical analgesic
Ondansetron
5HT3 receptor antagonist
anti-emetic
Bupivacaine
long acting analgesic
Lisinopril
ACE-i
Metformin
anti-hyperglycaemic
Propofol
General anaesthetic
Lidocaine
short acting topical analgesic
Ranitidine
gastric acid inhibitor
H2 receptor antagonist
Temazepam
anxiolytic (sedation)
Morphine
mu opioid receptor agonist
Midazolam
anxiolytic (short acting)
Prochlorperazine
anti-emetic (phenothiazine)
Isoflurane
general anaesthetic
Lisinopril:
can safely be given in large doses in a hypertensive crisis
T/F
F
may induce refractory hypotension
Lisinopril:
may improve outcomes after MI
T/F
T
Lisinopril:
may cause an increase in plasma potassium
T/F
T
Lisinopril:
renal function and electrolytes should be checked before and during treatment with lisinopril
T/F
T
Lisinopril:
increases the rate of breakdown of angiotensin II
T/F
F
Mechanism of action of lisinopril
inhibits the conversion of angiotensin I to angiotensin II by ACE
Uses of ACE-i
HTN
all grades of HF
prophylaxis after MI
Salbutamol:
can produce hypokalaemia
T/F
T
stimulation of Na/K ATPase results in potassium shift into cells which can lead to hypokalemia
Salbutamol:
acts on the lungs only when given by the inhalational route
T/F
F
Salbutamol:
Induces bronchodilatation
T/F
T
Salbutamol:
is a beta-1 adrenoceptor agonist
T/F
F
beta-2
Salbutamol:
may induce a tremor and anxiety at high dose
T/F
T
Warfarin’s anticoagulant effect:
is altered by antibiotics
T/F
T
Antibiotics potentiate activity
Warfarin’s anticoagulant effect:
is exerted directly on the blood
T/F
F
inhibits the synthesis of Vitamin K dependent clotting factors
Warfarin’s anticoagulant effect:
is potentiated by barbituates
T/F
F
barbituates, oral contraceptives, carbamazepine inhibit activity
Warfarin’s anticoagulant effect:
is slow in onset
T/F
T
Atenolol:
acts by reversible competitive blockade of cardiac beta-1 adrenoceptors
T/F
T
Atenolol:
has no effect on B2 adrenoceptors in the lung
T/F
F
Atenolol:
can be used to treat hypertension and tachydysrhythmias
T/F
T
Atenolol:
can mask the signs of hyperglycaemia
T/F
T
b2 adrenoceptors normally stimulate hepatic glycogen breakdown & pancreatic release of glucagon, so increased plasma glucose. therefor blocking b2 adrenoceptors lowers plasma glucose
Atenolol:
has positive chronotropic and ionotropic effects on the heart
T/F
F
have a -ve chronotropic and -ve ionotropic efect
i.e. decrease heart rate and contractility
Morphine:
is an antagonist at mu-opioid receptors
T/F
F
It’s an agonist!
Morphine:
in susceptible patients, opioids may induce N+V
T/F
T
Morphine:
Delayed (up to 12 hours) respiratory depression can occur in patients with spinal or epidural opioid administration
T/F
T
Morphine:
causes histamine release
T/F
T
Morphine:
has no effective metabolites
T/F
F
morphine-6-glucoronide
How are the opioid actions of morphine reversed
Naloxone or Naltrexone
Morphine has extensive first pass metabolism
T/F
T (half life 3-4h)
Insulin:
is presented in a variety of preparations containining 1 unit/ml
T/F
F
100 units/ml as standard
Insulin:
stimulates carbohydrate metabolism, protein synthesis and lipogenesis
T/F
F
BZDs:
IV administration of BZDs is safe in a general ward setting
T/F
T
BZDs:
The half life of flumazenil is longer than temazepam
T/F
F
BZDs:
Flumazenil reverses the central effect of BZDs and IV general anaesthetics
T/F
F
Only reverses BZDs
NOT GAs
Local anaesthetics:
Accidental IV administration of local anaesthetic may lead to CV collapse
T/F
T
Local anaesthetics:
prevent action potential propagation in neurones
T/F
T
block Na channels (neurone cant depolarise)
Local anaesthetics:
toxicity can be reversed using adrenaline
T/F
?
Local anaesthetics:
allergy is extremely rare
T/F
T
Local anaesthetics:
spinal anaesthesia may cause hypotension through sympathetic nervous system block
T/F
T
Gastric Pharmacology:
steroid and NSAID therapy does not affect the integrity of gastric and duodenal mucosa
T/F
F
Gastric Pharmacology:
Lansoprazole tablets are usually administered OD
T/F
T
Gastric Pharmacology:
Fasting guidelines help reduce acid aspiration in surgical patients
T/F
T
Gastric Pharmacology:
Ranitidine acts as an antagonist at H1 receptors
T/F
F
H2 receptors
Gastric Pharmacology:
Omeprazole redcues gastric acid secretion by proton pump inhibition
T/F
T
Antiemetics:
Post operative nausea and vomiting is rare after surgical procedures
T/F
F
Antiemetics:
Metoclopramide is a useful antiemetic in children and elderly
T/F
F
Antiemetics:
Often more than a single antiemetic drug is required for the Tx of PONV
T/F
T
Antiemetics:
Ondansetron is a 5HT3 receptor antagonist
T/F
T
Antiemetics:
Smokers have a higher risk of PONV
T/F
F
General Anaesthetics:
Most GA agents induce cardio-respiratory depression
T/F
T
General Anaesthetics:
all GAs provide effective analgesia
T/F
F
General Anaesthetics:
The IV agent propofol can be used safely and effectively for sedation on general wards
T/F
F
General Anaesthetics:
Isoflurane is a useful anaesthetic for total IV anaesthesia
T/F
F
General Anaesthetics:
GA can be reversed by flumazenil
T/F
F