Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MBB > Pharm test 2 > Flashcards

Pharm test 2 Flashcards

1
Q

Efficacy

A

Maximal response a drug can produce

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Potency

A

Measure of dose required to produce a response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Name strong opioid agonist (high efficacy)

A

Morphine, methadone, Fentanyl, oxycodone, and heroin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name partial agonists for opioid

A

Codeine, hydrocodone, tramadol, tapentadol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Opioids that also have antidepressant

A

Tramadol and tapentadol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What would you use to treat a opioid addiction as an alternative to methadone

A

Buprenorphine (partial mu agonist, kappa opioid antagonist) -compete with heroin, so can’t get high because buprenorphine higher affinity -must give sublingual, because inactive if given orally -slow acting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A patient comes in with an opioid overdose what do you use to treat them?

A

Naloxone ( not orally active ) Antagonist with high affinity, no efficacy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

A patient is struggling with alcohol dependence and comes to you for help. What drug can you give them to help?

A

Naltrexone (Is orally active) Antagonist with high affinity, no efficacy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does morphine and other related opioids work? Side effects?

A

Activate the mu opioid receptor Side affects: constipation, respiratory depression, analgesia, sedation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Tolerance of opioids causes want?

A

Increase dose required to produce desired therapeutic effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Physical dependence of opioids withdrawl signs?

A

Muscle aches, insomnia, rhinorrhea, your name, piloerection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hyperalgesia opiods

A

Can happen when go off opioids Sensitization of pronociceptive pathways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Heroin pharmakinetics

A

Opioids: Rapid onset blood brain barrier, short duration ( more hydrophobic form)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Methadone, oral pharmakinetics

A

Opioids: Slowly absorbed, slowly penetrate. Slowly cleared, so drug accumulation can occur more easily and lead to toxicity. Hard to up titrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Naloxone, oral pharmakinetics

A

Prevent abuse of drugs when combine with other drug. Opioids: Rapid metabolized, give with buprenorphine or oxycodone to prevent diversion Can put inside drug so get withdrawl effects if inject (abuse deterrent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Loperamide, oral pharmakinetics

A

Opioids: Doesn’t penetrate brain, anti diarrheal ( reduce gut motility)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

18-year-old woman with severe hip pain and shoulder pain after hip and shoulder contusions 4 hours after a bicycle accident. No fractures or a head injury. Which opioid would you choose for treatment and why?

A

oral hydrocodone (opioid use for acute pain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

32-year-old woman with uncontrolled rheumatoid arthritis while on DMARD (disease modifying antirheumatic drug) and severe polyarthralgias, is still experiencing severe pain every 3 to 4 hours after taking moderately high does oxycodone on for more than two weeks. Which opioid would you choose to give this patient?

A

Oxycodone extended release oral (Chronic pain opioids) -last 3-4 hours but extended release mean release for 12 hours -taking more than 2 weeks mean tolerance build up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

35-year-old woman with the right femoral fracture that occurred after a fall injury. He is on buprenorphine/naloxone sublingual and clinic record support good control of her opioid use disorder. You recognize the obvious need for opioid to manage her severe pain prior to admission to orthopedics for urgent surgical internal fixation. Which opioid would you choose?

A

-Fentanyl IV -Need to treat with something with higher affinity, because she is on buprenorphine which has such a high affinity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

23-year-old male methadone user had a witnessed overdose and was transported to your ED following a bystander administration of Evzio (naloxone hydrochloride injection). He is awake and in acute withdrawal, but while in the ED he becomes increasingly more sedated. Why?

A

Naloxone is short acting and methadone is long acting, so methadone OD symptoms return after naloxone metabolized -give naloxone IV and wait til methadone clears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

46-year-old man with severe pain immediately after surgery for partial colon resection, following ruptured diverticulitis. Nausea and vomiting from post op. Has hypomotility of the gastrointestinal tract in the absence of mechanical bowel obstruction. Which opioid would you choose?

A
  • morphine IV -no addiction problems -oral route won’t work because vomitting -(can’t give fentanyl transdermal because takes to long to clear, get stuck in fat)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do volatile anesthetics work?

A

-Decrease effectiveness of excitatory transmission (glutamatergic) -increasing effectiveness inhibitory (GABArrgic) -effect throughout CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

2 year old need ear tubes what anesthetic use?

A

-Sevoflurane (can breathe in when awake and make smell good) -Can’t use desflurane because volatile, so child won’t breathe in when awake

24
Q

Minimal alveolar concentration (MAC)

A

ED 50, dose 50% effectiveness -Age best predictor (need lower dose) body -weight and gender doesn’t effect -measurement of anesthetic dose

25
Q

What measurement of MAC cause perception amnesia, but patients are MAC aware

A

.25-.30 MAC

26
Q

What MAC level make patients unconsc , MAC asleep?

A

.4-.5 MAC

27
Q

What level MAC cause immobility?

A

1.0 MAC

28
Q

Partial fraction for drugs effecting brain

A

1.4 times more in blood than lungs 2.2 amount of blood needed to effect brain

29
Q

If targeting brain for drug what would decrease the onset of drug effect?

A

Increase fat solubility= decrease how quick reach brain

30
Q

22 year old need dental work, what medication use?

A

NO, -Rapid onset, odorless, tasteless, low potency - don’t use if patient has pernicious anemia (inhibit enzymatic action of B12) SAE: nausea and vomiting

31
Q

Ethers do what?

A
  • Increased respiratory rate, decreased title volume. - all halogenated ethers cause vasodilation, decreased myocardial contractility, and generally decrease blood pressure
32
Q

All halogenated ethers can trigger what bad side effect that is very important to know? Can happen hours after exposure?

A

Malignant hyperthermia: ca2+ channel problem 1. Elevated core body temperature with rigidity 2. Severe metabolic acidosis 3. Multi organ system failure

33
Q

Treatment for malignant hyperthermia

A

Dantrolene

34
Q

Drug that kills people through respiratory depression via induce cytochrome p450 system

A

Sodium thiopental

35
Q

An infant is having trouble with seizures. What kind of drug can be used?

A

Phenobarbital (can also be used for alcohol withdrawal occasionally)

36
Q

Name the barbiturates that are used in the US today.

A

Phenobarbital and butalbital (HA), if combine with alcohol or other sedative = respiratory depression and death -high risk of OD and respiratory distress

37
Q

And eight-year-old child with severe epilepsy has developed a prolonged seizure that has been lasting for over 20 minutes. You see no good targets for an IV, how will you stop her seizure?

A

Ativan/lorazepam (benzodiazepines), nasal or rectal

38
Q

What are the effects of benzodiazepines?

A

Sedation, hypnosis, anxiolytics, muscle relax station, amnesia. - this drug acts through the GABA receptor - can be given orally, IM, IV, or rectally

39
Q

Long acting benzodiazepines

A

Diazepam (Valium): - highly lipid soluble, long half life (1-2 days) -tx: anxiety, muscle spasms, or in a reptile gel for status epilepticus

40
Q

Ativan treatment for…

A

Anxiety, agitation, status epilepticus ( can interfere with memory formation)

41
Q

22-year-old female, healthy, with CT demonstrated acute appendicitis. She is terrified of surgery. How are you going to premedicate for anesthesia?

A

-midazolam (versed) Short half life (1.5-2hrs)

42
Q

What do you NOT want to give to a patient that is on a benzodiazepines?

A

Opioids, would cause severe respiratory depression which can be life threatening

43
Q

Propofol

A

Brief sedation, wake up in 9 minutes -GABA receptor -drops bp fast, don’t use on hypotensive patients

44
Q

82-year-old female, Tachycardic, hypotensive, in need of urgent debridement of infected left foot wound. What drug give for sedation?

A

Etomidate - won’t drop bp, minimal impact on heart -suppression of adrenal function -act via GABA

45
Q

52 your old male, with the leg that needs irrigation, he Bridgman, and complex laceration repair. You don’t have any local anesthetic or anesthesia machine. You are in South Sudan. How will you induce anesthesia?

A

Ketamine: -Rapid onset and offset -acts NMDA receptor -“dissociative state” -no effect respiration, but increases salvation, HR, and bp -cause bad hallucinations

46
Q

31-year-old female on third trimester of pregnancy is scheduled for an urgent right heart catheterzation. Patient has a history of pulmonary hypertension, and chronic hypoxemia. Sedation and general anesthesia pose risk for aspiration, placental transfer of drugs, hemodynamic and possible need of emergency C-section.

A

Can use a local anesthetic

47
Q

Local anesthetic MOA

A

-target Voltage gated Na+ channels (block channels INSIDE cell) - prevents conduction an electrically tissue (nerves, myocardium, vascular smooth muscle) -block small myelinated nerves (pain and temperature) easily

48
Q

Lidocain

A

Local anesthetic -rapid onset, medium duration -safe Water soluble

49
Q

Bupivacaine

A

Local anesthetic -slower onset, long duration - potential serious cardiac toxicity Lipid soluble

50
Q

Local anesthetic toxicity

A

*CNS-seizures, respiratory depression *Myocardium- arrhythmia, myocardial Vasodepression *Water soluble (CNS>>>cardiac toxicity) *lipid soluble (CNS toxicity = cardiac toxicity) ventricle arrhythmias

51
Q

You need to perform surgery but the patient keeps moving. what can you give him to help immobilize the patient or to make him still for ventilation?

A

Neuromuscular blocker

52
Q

Neuromuscular blockers

A

Only block nicotinic acetylcholine receptor at endplate of muscle (target only skeletal muscle)

53
Q

You are planning on anesthetizing a 21 year old male for a short bronchoscopy procedure (20 minute). He will need an endotracheal tube. Do you choose a depolarizing or nondepolarizing neuromuscular blockers? What if the surgery was scheduled for two hours?

A

Depolarizing for short (b/c short onset) and non depolarizing for long surgery.

54
Q

Succinylcholine

A

-Depolarizing neuromuscular blocker - Rapid onset, Ultra short acting -can cause malignant hyperthermia

55
Q

Cerebellum damage

A
  • Loss coordination, posture, and balance on same side of damage
  • uses sensory input
  • damage doesn’t cause sensory loss or muscle weakness

MBB (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions