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Pharm Oral Final Flashcards

1
Q

MAC of DES

A

6%

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2
Q

MAC of SEVO

A

2%

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3
Q

MAC of ISO

A

1.2%

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4
Q

MAC of N2O

A

104%

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5
Q

VP Des

A

669 mmHg

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6
Q

VP Sevo

A

157 mmHg

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7
Q

VP Iso

A

238 mmHg

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8
Q

VP N2O

A

38770 mmHg

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9
Q

BG Des

A

.42

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10
Q

BG Sevo

A

.65

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11
Q

BG Iso

A

1.46

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12
Q

BG N2O

A

.42

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13
Q

Induction dose of Propofol

A

1.5-2.5 mg/kg

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14
Q

Induction dose of Ketamine

A

1-2.5 mg/kg IV

4-8 mg/kg IM “dart”

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15
Q

Induction dose of Etomidate

A

.2-.4 mg/kg

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16
Q

MOA propofol

A

GABA agonist

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17
Q

MOA ketamine

A

NMDA antagonist

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18
Q

MOA etomidate

A

GABA agonist

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19
Q

Vd Propofol

A

3.5-4.5 L/kg

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20
Q

Vd Ketamine

A

2.5-3.5 L/kg

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21
Q

Vd Etomidate

A

2.2-4.5 L/kg

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22
Q

Half-life Propofol

A

30min-1.5 hrs

CST <40 min

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23
Q

Half-life Ketamine

A

2-3 hours

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24
Q

Half-life Etomidate

A

2-5 hours

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25
Q

MOA Midazolam

A

GABA agonist

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26
Q

Midazolam dosing

A
  1. 02-0.04 mg/kg IV

0. 4-0.8 PO peds

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27
Q

Midazolam Vd

A

1-1.7 L/kg

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28
Q

Midazolam half-life

A

1.9 hours

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29
Q

Diazepam MOA

A

GABA agonist

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30
Q

Diazepam dosing

A

0.1 mg/kg IV

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31
Q

Diazepam Vd

A

0.8-1.3 L/kg

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32
Q

Diazepam half-life

A

> 40 hours

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33
Q

MOA lorazepam

A

GABA agonist

most potent benzo, slowest onset of action

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34
Q

lorazepam dosing

A

50 mcg/kg IV

max 4 mg

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35
Q

lorazepam Vd

A

0.8-1.3 L/kg

36
Q

lorazepam half-life

37
Q

flumazenil

A

selective benzodiazepine antagonist
weak intrinsic agonist of gaba, no abrupt reversal
0.2mg IV followed by 0.1 mg every 1 min
0.5-1 mg completely abolishes benzo effect

38
Q

Thiopental MOA

A

GABA agonist

39
Q

Methohexital MOA

A

GABA agonist

40
Q

Thiopental Induction Dose

A

2.5-.5.0 mg/kg IV

41
Q

Thiopental Vd

42
Q

Thiopental Half-life

A

ten-fold propofol

43
Q

Methohexital Induction Dose

44
Q

Methohexital Vd

45
Q

Methohexital Half-life

A

long ten-fold propofol

46
Q

Morphine MOA

A

opioid receptor agonist
phenanthrene
half-life: 1.7-3.3 hrs

47
Q

Morphine dosing

48
Q

Morphine Vd

49
Q

Meperidine MOA

A 
Mu receptor agonist
Kappa receptor agonist for shivering 
1/10 as potent as morphine 
phenylpiperdine ring
half life 3-5 hours
50
Q

Fentanyl dosing

A

1-3 mcg/kg to blunt SNS surgical response

51
Q

Fentanyl MOA

A

opioid agonist, synthetic opioid

75-125 times more potent than morphine

52
Q

Fentanyl CST

A

half-life 2-4 hours

increases with infusions on longer than 2 hours

53
Q

Sufentanil dosing

A

0.1-0.4 mcg/kg

54
Q

Sufentanil MOA

A

opioid agonist/synthetic opioid
most potent of phenylpiperdines
5-10 more times potent than fent

55
Q

Sufentanil CST

56
Q

Remifentanil MOA

A

synthetic opioid
selective Mu agonist
same potency as fentanyl
ester linkage

57
Q

Remifentanil dosing

A

1 mcg/kg induction

  1. 1-0.3 mcg/kg/min
  2. 25-1 mcg/kg analgesia
58
Q

Alfentanil MOA

A 
opioid agonist (synthetic opioid)
less potent than fentanyl; shorter duration of action
59
Q

Alfentanil Vd

A

0.6L/kg

high fraction of unionized drug (gives rise to rapid onset)

60
Q

Alfentanil dosing

A

15 mcg/kg blunts stimulation of DL
150-300 mcg/kg IV – produces unconsciousness (induction)
combo with inhaled anesthetic 15-150 mcg/kg/hr

61
Q

Alfentanil CST

62
Q

Butorphanol MOA

A

opioid agonist/antagonist
low affinity for mu receptor (antagonist)
moderate affinity for kappa receptor (partial agonist)

63
Q

Nalbuphine MOA

A

opioid agonist/antagonist
antagonism at mu receptor
agonism at kappa receptor

64
Q

Opioid receptor agonist

A

Receptors located in spine, brain and periphery
• Pre synaptic – inhibit release of acetylcholine,
dopamine, norepinephrine and Substance P
• Post synaptic – increased K+ conductance = decreased function
Opioid receptors are G protein-coupled receptors
• Principle effect is to decrease neurotransmission
• Mimic the actions of endogenous ligands
• Enkephalins, endorphins and dynorphins

65
Q

Mu1

A
  • Analgesia (supraspinal and spinal)
  • Euphoria
  • Miosis
  • Bradycardia
  • Urinary retention
66
Q

Mu2

A 
Analgesia (spinal)
Depression of ventilation
Physical dependence
Constipation
"CAVA"
67
Q

Kappa

A

Activation results in the inhibition of neurotransmitter release
• Analgesia (supraspinal and spinal)
• Dysphoria, sedation
• Miosis
• Diuresis
• Lesser extent - hypoventilation and high-intensity pain
• Agonist-antagonist often act principally on K receptors’
• Low abuse potential

68
Q

Acetaminophen MOA

A

Activation of serotonergic pathways
Antagonism of NMDA, substance P and nitric oxide pathways
nonselective cox inhibitor

69
Q

Ibuprofen MOA

A

non selective cox inhibitor

70
Q

Ketorolac MOA

A

non selective cox inhibitor

71
Q

Celecoxib MOA

A

selective cox 2 inhibitor

increased CV risk

72
Q

Acetaminophen DOSING

A

325-650 mg PO 4-6h
Do not exceed >4,000mg/24h
IV: 1,000mg Q6h

73
Q

Dexmedetomidine dosing

A 
0.5-2 mcg/kg (max dose 20 mcg) 
gtt 0.2-0.7 mcg/kg/hr
severe bradycardia
half life: 2hrs
Vd: 1.54 l/kg
74
Q

Dexmedetomidine moa

A

highly selective alpha 2 agonist (presynaptic receptor)

blunts central sympathetic response

75
Q

Ketorolac dosing

A

15 mg IV Q6hrs preop

76
Q

Celecoxib dosing

A

400 mg PO preop

200 mg BID x5 days post op

77
Q

Ibuprofen dosing

A

200-800 mg PO

78
Q

Ibuprofen dosing

A

200-800 mg PO

79
Q

NMDA antagonist

A

NMDA: N-methyl-D-aspartate, GPCR ionotropic glutamate receptor
NMDA antagonists bind to receptor and inhibit function of glutamate (endogenous excitatory neurotransmitter)

80
Q

GABA agonist

A

Gamma-aminobutyric acid, major inhibitory neurotransmitter in CNS
Endogenous GABA binds to receptor and exerts its effects on chloride ion channels to cause hyperpolarization of the cell
Propofol & Etomidate bind to alpha subunit on GABA receptor and allosterically promote the effect of endogenous GABA

81
Q

meperidine dosing

A

12.5 mg postop shivering

82
Q

meperidine Vd

83
Q

remifentanil Vd

84
Q

remifentanil cst

85
Q

sufentanil Vd

86
Q

fentanyl Vd

SRNA Drugs (3 decks)

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