Pharm 1 Flashcards
As part of the ERAS program, how does giving a patient a carbohydrate-rich drink 2 hours before surgery help?
It increases insulin sensitivity which decreases post op insulin resistance?
How is surgery and general anesthesia associated with blood glucose?
Hyperglycemia
Also - higher catecholamine, cortisol, and glucagon levels
What is the recommended MAC for surgical incision?
1.3
1.0 is where 50% of the population will move to surgical stimulation.
1.3 is where 95% will not move
What type of pharmacokinetics is phase 2 reactions?
Conjugation
What type of metabolism does morphine undergo?
Phase 2 - Conjugation
Turns into M3G and M6G
Then excreted in the urine
M3G or M6G, which causes respiratory depression?
M6G
High dose oxytocin leads to what electrolyte abnormality?
Hyponatremia - due to retaining water
What is the reversal agent for Idarucizumab?
Dabigatran
What is the reversal agent for apixaban?
Andexanet alfa (factor 10a inhibitor)
How is chloroprocaine metabolized?
Plasma cholinesterase
How is remifentanil metabolized?
Nonspecific tissue and plasma esterases
What are the best treatments for opioid induced pruritus?
Opioid antagonists such as
Naloxone
Naltexone
Nalbuphine
How does metoclopramide effect the pyloric sphincter? GI motility? Esophageal sphincter ?
Relaxes pyloric
Increases GI motility
Constricts esophageal
How does lipid solubility effect the bioavailability of a drug?
The more lipid soluble, the more bioavailable
How does molecular weight effect the bioavailability of a drug?
The smaller the weight, the more bioavailable
How does blood circulation effect the bioavailability of a drug?
The more blood circulation, the more bioavailable
How does a prodrug effect the bioavailability of a drug?
It decreases it
How does a low first pass effect, effect the bioavailability of a drug?
It will have more bioavailability
Bioavailability route chart; most? least?
If the sevo vaporizer is filled with iso and is set at 2%, will there be a higher percentage delivered or lower?
Higher - at 2%, 3.4% iso would be delivered
Drug receptor affinity and efficacy are determined by its.
Stereochemistry
What is the antidote for anticholinergic syndrome or overdose?
Physostigmine
What is used to treat cyanide toxicity?
Vitamin B12
What is used to treat nerve gas?
Atropine
What is used to as prophalaxysis for nerve gas?
Pyridostigmine
How do nerve agents attack the body?
Inhibition of acetylcholinesterase
What may be the first sign of a pneumothorax ?
Increased airway peak pressures
Why is inhalational induction more rapid in infants than in adults?
They have a greater fraction of cardiac output to the vessel rich organ group
Where do Non dihydropyridines work? Which phase?
Target L-type calcium channel
Phase 0
