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DSouza 2015 > Pharma > Flashcards

Pharma Flashcards

1
Q

2 methods used to measure the duration of exponential process

A

Time constant and half/life

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2
Q

After one half life … of the process is still remaining where 2 half life … and 3 half life’s … of process still remaining

A

50%
25%
12.5%

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3
Q

After one Time constant … of the process remaining, where 2 time constant … and 3 time constant … of the process still remains to complete

A

37%
12.5%
5%

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4
Q

Time constant for breathing circuit is

A

Volume of circuit/fresh gas flow rate

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5
Q

Time constant for lungs =

A

FRC / minute ventilation

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6
Q

Context sensitive half life is …

A

The time taken for drug concentration to fall by 50% after DC

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7
Q

ED95 means

A

The dose of drug that is required to produce a specific response in 95% of the population exposed to the drug

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8
Q

ED 95 for NMB

A

Is the amount of drug needed to decrease the twitch height by 95%

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9
Q

1st order kinetics

A

Rate of decrease of plasma concentration of the drug depends of plasma concentration of the drug

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10
Q

Zero order kinetics

A

The plasma concentration of drug decreases at a constant rate

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11
Q

Drug dosing in RF relation to volume of distribution

A

Volume of distribution is increased and clearance reduced leading to increased loading and dosing interval

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12
Q

Drugs acting on GABA receptors

GABA-A

GABA-B

A

GABA-A -> Cl channel opening (thiopental, propofol, BZDs, etomidate)

GABA-B -> K channel opening (Baclofen)

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13
Q

Ketamine acts on

A

noncompetitive antagonist of NMDA Ca channel pore

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14
Q

Baclofen acts on

A

Agonist of GABA- B receptors both pre and postsynaptic

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15
Q

Ion channels and drugs act on

Ca

Cl

Na

K

A

Gaba + ketamine -> Ca

Thiopental, propofol, Etomidate -> Cl

Local anesthetic, phenytoin, NMB -> Na

Baclofen -> K

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16
Q

Agents that work on cGMP and cAMP

A

Nitric oxide

Glucagon, insulin, Epi, NorEpi, milrinone, PGs -> all cAMP

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17
Q

Dose of oral Versed is higher then IV because …

A

High first pass metabolism in liver

0.5-0.7 mg/kg body weight

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18
Q

Location of brain opioid receptors

A

Periaqueductal gray matter
Amygdala
Corpus striatum
Hypothalamus

At spinal -> substantia gelatinosa

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19
Q

Clinical effect of mu opioid receptors

A

Spinal and supraspinal analgesia
RS depression
Physical dependence
Ms rigidity

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20
Q

Clinical effect of kappa opioid receptors

A

Sedation and spinal analgesia

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21
Q

Clinical effect of delta opioid receptors

A

Analgesia and behavioral

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22
Q

Clinical effect of sigma opioid receptors

A

Dysphoria and hallucination

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23
Q

The ceiling effect of Nalbupine is due to ..

A

It’s partial agonistic activity

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24
Q

What’s the reason of rapid action of Alfentanil? And it’s short duration?

A

Low pKa

Where it has low VoD and it’s rapid metabolism in liver makes it short duration of action

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25
Q

The rapid duration of action of ramifentanil is due to its …

A

Rapid metabolism by plasma esterases (its metabolism not dependent on liver like alfentanil)

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26
Q

Drugs metabolized by esterases:

A

Esmolol

Etomidate

Remifentanil

Atracurium

Succinylcholine

Ester local anesthetics

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27
Q

The onset of action of opioids depends on …

A

Lipid solubility (how rapid it diffuses into CNS and offset of action is due to rapid redistribution from CNS)

Morphine has the lowest lipid solubility and therefore it’s onset of action is slowest sand had longest duration of action

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28
Q

Onset of opioid depends on …

A

pKa and VoD, as well as lipid solubility

Meperidine has the highest (8.5) -> slowst onset of action

Alfentanil has the lowest (6.5) -> fastest onset of action.

VoD of morphine, meperidine, and fentanyl is same 3-5 but because fentanyl has the highest lipid solubility of all (~580 vs 1 for morphine and 25 for meperidine) makes it fastest onset of action

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29
Q

10 of IV morphine equaled to … po

And 1 mg IV dilaudid = … po

A

30 mg

1 mg dilaudid IV = 5 mg po

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30
Q

IV-Epidural-Intrathecal opioid dosing

Morphine

Dilaudid

Fentanyl

A

Morphine: 10 mg IV = 1 mg Epidural = 0.1 mg intrathecal (very hydrophilic)

Dilaudid: 1mg IV= 0.2 mg Epidural = 0.04 mg intrathecal

Fentanyl: 100 mcg IV = 33 mcg Epidural = 6-10 mcg intrathecal (very lipophilic)

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31
Q

Among the opioids, … prolongs QT interval

A

Methadone

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32
Q

…. is prodrug opioid and needs to be converted into active metabolites

A

Codeine

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33
Q

Metabolic product of … is … and it’s accumulation in RF causes seizures activity

A

Meperidine is nor-meperidine

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34
Q

An opioid that has local anesthetic activity is …

A

Meperidine

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35
Q

Opioid effects that can be reversed with Nalaxone are …

A

RS depression
Analgesia
Pruritus

Can’t reverse (constipation, NV, ms rigidity, Miosis).

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36
Q

Propofol distributes to vessel rich, lipid rich organ (brain) and ptn become anesthetized. Ptn wakes up from single dose of propofol due to …

A

Redistribution

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37
Q

The primary organ for redistribution of propofol is

A

Ms skeletal > liver and kidneys

Redistribution to moderate BF and lipid content organs

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38
Q

The dose of thiopental in elderly should be reduced because of …

A

Decreased inter-compartment clearance

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39
Q

In obese patients, all drugs should be doses based on lean body weight except … doses per TBW to obtain …

A

Succinylcholine

Ideal intubating conditions during RSI

Induction agents act at brain and size of brain is similar in obese and non-obese patients (NMB are water soluble agents and the total body water is similar in both obese and non-obese patients).

Lean body weight = ideal Weight + 20%

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40
Q

What makes Etomidate ideal for ECT?

A

Because it increases seizure duration and often these patients failed previous treatment due to short seizure duration

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41
Q

Propofol compared to Etomidate

A

Etomidate associated with more pain on injection, myoclonus, NV. And has the association of adrenocortical suppression.

The only advantage over propofol is that has less incidence of hypotension

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42
Q

Propofol infusion syndrome clinical features

A 
Met. Acidosis
Hypotension 
Bradycardia resistance to treatment 
HyperTGs
Rhabdomyolysis
Hepatomegaly
ARF
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43
Q

Ketamine CI in … and indicated in …

A

Idiopathic hypertrophic subaortic stenosis

Cardiac tamponade, TOF, hypothyroid, asthma

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44
Q

Ketamine indicated in cardiac tamponade because…

A

It increases HR and SVR which is beneficial

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45
Q

Drugs not safe in porphyria …

A 
Barbiturates 
Etomidate 
Chlordiazepoxide
Nitrazepam
Flunitazepam
Hydralazine
Alpha methyl dopa
OCP
Steroids

(Propofol is safe)

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46
Q

Nitrous should be DC prior to … during vitrectomy for retinal detachment

A

Injection of suphur hexafluride

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47
Q

Which would nitrous expand rapidly, pneumothorax or air bubbles in the blood

A

Air bubbles as there is no tissue barrier

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48
Q

% of nitrous and size of pneumothorax increased

A

50% -> x2

66% -> x3

75% -> x 4

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49
Q

Volatiles and their metabolism %

A

Halothane 20%
Sevo and Enflurane 2%
ISO 0.2%
Des 0.02%

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50
Q

Why Des needs a special heated vaporizer?

A

Because it’s saturated vapor pressure (SVP) is close to atmospheric pressure ~ 680 mmHg and it’s boiling point is close to room temperature ~ 21 C

This property results in fluctuations of vaporizer output when the vaporizer is exposed to different ambient temperatures

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51
Q

Rapid FA/FI results when …

A

Increase inspired agent concentration

Increased minute ventilation

Decreased CO

Low blood gas solubility coefficient

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52
Q

Why N2O has higher FA/FI then Des even though Des has lower B/G solubility coefficient (0.42 compared to 0.45 for N2O)?

A

Due to higher concentration effect

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53
Q

MAC for each volatiles

A

104 N2O

6 Des

2 Sevo

  1. 8 Enflurane
  2. 2 Iso
  3. 8 Halothane
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54
Q

B:G coefficient for each volatiles

A
  1. 42 Des
  2. 46 N2O
  3. 6 Sevo
  4. 4 Iso
  5. 7 Enflurane
  6. 3 Halothane

The lower the faster FA/FI (except N2O faster then Des because of its higher concentration)

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55
Q

All volatiles increases HR and useful in ….

Except … therefore it is useful in IHSS

A

Cardiac tamponade, AR, MR

Halothane dose not increase HR and therefore useful in IHSS

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56
Q

N2O effect in myocardium

A

It’s depressant (causes symptomatic stimulation)

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57
Q

HD goals in IHSS

A

Increase preload, decrease myocardial contractility, avoid tachycardia, maintain afterload

Therefore ketamine is CI

Halothane is useful

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58
Q

HD goals in Cardiac tamponade

A

Maintain HR, increase preload and afterload (fast full and tight).

Ketamine is ideal

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59
Q

HD goal in MR?

A

Mild tachycardia and vasodilation

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60
Q

HD goals in AS and MS?

A

Avoid tachycardia and decrease in afterload

Avoid extreme bradycardia

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61
Q

Uptake of volatiles in neonate is faster than adults because

A

Increased ventilation and CO result in faster delivery of agent and rapid induction

On other hand, that low CO results in increase FA/FI

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62
Q

MAC requirement increases up to age of … and then decreases.

Only one volatile exception …

A

6 months

Sevo -> MAC is highest in neonates and then steadily decreases

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63
Q

MAC is unaffected by …

A

Duration of anesthesia

Gender

Alkalosis/Acidosis

Hypo/hyperthyroidism

Hypo/hypercarpia (paCO2 <90)

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64
Q

MAC decreases in …

A 
Hypothermia
Hypoxia
Acute alcohol 
Sever hypotension 
Lithium
Narcotic 
Ketamine 
Chronic amphetamines
Cholinesterase inhibitor 
Elderly
Pregnancy ***
Hyperbaric chamber
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65
Q

MAC requirement increases in …

A 
Chronic alcohol 
Acute amphetamines
MOA inhibitor 
Cocaine 
Hyperthermia 
Hypertension 
Neonates
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66
Q

Hyperbaric chamber anesthesia decreases the MAC of volatiles due to …

A

Nitrogen narcosis

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67
Q

N2O can be used as sole anesthetic agent in …

A

Hyperbaric conditions

68
Q

A volatile that if it’s concentration changed rapidly results in symptometic stimulation?

A

Desflurane

69
Q

Right to left shunt results in inhalation’s induction … and IV induction …

Where left to right shunt …

A

Slow inhalation all and rapid IV induction with Rt->Lt shunt

IV induction delayed with Lf->Rt shunt, no effect on inhalational

70
Q

High altitude effect on flow meter of gas compared to sea level?

A

Flow increases at higher flow rate (due to decreased density)

However, flow is unchanged at low flow rates because the viscosity is same

71
Q

High altitude effect on vaporizer output of gas compared to sea level?

A

Output increases as the potency decreases at high altitude but however the change in dial setting is not indicated at high altitude

Exception is Desflurane -> no change in output as the vaporizer is electrically heated.

72
Q

High altitude effect on induction of gas compared to sea level?

A

Slower at high altitude

73
Q

Factors producing increased Carbon Monoxide?

A 
Desflurane
Low gas flow
Dry absorbent
Barely me > sodalime
Increased temp of absorbent
74
Q

Decreased in single twitch height seen in both DNMB and NDNMB, but however the tetanus fade and post tetanus potentiation seen only in …

The potentiation of the block with anti cholinesterase seen only with …

A

NDNMB

DNMB

75
Q

The order of onset/recovery of NMB from first to last …

A

Diaphragm > laryngeal muscle > adductor pollicis

76
Q

Tetanus fade explained by ….

Post tetanus facilitation explained by …

A

The depletion of Acho stores in prejunctional area results in decreased Acho release in synaptic cleft -> tetanus fade

Following a pause, post tetanus stimulation is applied. During this pause period Acho reacumulates In presynaptic vesicles and subsequent stimulation results in increased release of Acetylcholine

77
Q

The termination of action of 2 NMB … by diffusion away from NM junction are …

A

Succinylcholine and pancuronium

78
Q

Acetylcholinesterase is not present in plasma, it’s present at …
Where pseudo cholinesterase only present in …

A

NM junction

Blood

79
Q

3 main Antibiotics dose not potentiate NM blockade are …

A

Penicillin, cephalosporins, erythromycin

80
Q

The best test for NMB recovery is …

A

TOF ratio > 0.9

81
Q

Best clinical test of adequate NMB recovery …

A

Sustained leg lift in neonates

Mastered muscle tone in adults

(Sustained head lift for 5 sec, can be obtained with TOF ratio of 0.5 and at this point respiratory muscle have not yet completely recovered).

82
Q

The exertion of neostigmine and pancuronium is prolonged in … patients

A

RF

83
Q

Debucaine is …. local anesthetic and number measured is % of

A

Amide

% of inhibited Palawan cholinesterase (normal should be > 80% inhibition as indicated presences of enzyme)

Heterozygous-> 40-60
Homozygous-> 20 (this develops periods of apnea after succinylcholine)

84
Q

Psudocholinesterase (butyrylcholinesterase) is responsible for metabolism of …

A

Succinylcholine
Ester local
Mivacurium

85
Q

Second dose of succinylcholine results in

A

Asystole 2/2 hypokalemia

Bradycardia 2/2 cavalry stimulation (pretreatment with atropine required).

86
Q

Succinylcholine dose or dose not produce hyperkalemia response in Cerebral Palsy patients?

A

Dose NOT

87
Q

Burns and paralyzed patients are sensitive to … and resistant to … NMB

A

Sensitive to DNMB

Resistant to NDNMB

due to presence of extrajunctional receptors

88
Q

Mg prolongs both DNMB and NDNMB because….

A

It decreases the release of acetylcholine at NM junction

89
Q

Electrolytes abnormalities that prolongs NM blockade

A

HYPo K and Ca

Hyper Na and Mg

90
Q

Because hypoCa prolongs NM blockade, the expected blockade in hyperparathyrodisim patient is …

A

Shortened

HyperCa antagonized the effect of NMB

91
Q

The effect of carbamazepine and phenytoin on NMB depends on duration of treatment

A

Chronic therapy -> shortens of NDNMB

Acute/one dose -> prolongs NDNMB

92
Q

CCB prolongs/shortens NMB?

A

Prolongs it (low Ca -> prolong blockade).

93
Q

Drugs inhibits psudocholensterse and therefore prolongs action of succinylcholine

A 
Nitrogen mustard
Trimetaphan
Ecothiopate
Pancuronium 
Anti cholinesterase
Metoclopramide

(Mivacurium is partly metabolized by psudocholensterse).

94
Q

Ester local anesthetic potentiate/shortens anticholinesterse (pyridostigmine or neostigmine)?

A

Potentiate it

95
Q

NMB in elderly to consider? Why NMB dose should be reduced in elderly?

A

Slow action in low CO

Decreased volume distribution in low muscle mass

Prolonged action in decreased renal and hepatic function

(So dose should be reduced)

96
Q

Why the following drugs dose not cross placenta?

Succinylcholine

Rocuronium

Chlorprocaine

Bupivacaine

A

Highly ionized

Large molecule

Rapid metabolism

High protein binding

97
Q

The most local anesthetic crosses placenta

A

Lidocaine then bupivcaine

98
Q

When neostigmine dose increased, there is a … and further dose induced the depolarizating block

A

Ceiling effect

99
Q

Muscurinic effect of neostigmine?

A

Increased secretion
Bronchi constriction
Increased GI motility
Miosis

100
Q

Insulin, heparin, LMWH, NDNMB dose or dose not cross placenta?

A

Dose NOT

101
Q

Following anticholinargics dose or dose not cross placenta?

A

Physostigmine, atropine, scopolamine-> crosses placenta

Neostigmine, pyridostigmine, glycopyrolate-> dose NOT

102
Q

Levorotatory isomers disperse the polarizing light to the …

Dextrorotatory isomers disperse the polarizing light to …

A

Left

Right

(Rovivacine is an enatiomer containing only levorotatory isomers)

(Bupivacaine has both levorotatory and dextrorotatory isomers).

103
Q

Local anesthetic potency depends on … , duration on …, and onset on …

A

Lipid solubility-> potency

Protein binding, lipid solubility-> duration

Onset -> pKa, concentration

104
Q

Why chlorprocaine has rapid onset despite its low pKa?

A

Because it’s administered in higher concentration

105
Q

Why chlorprocaine has the shortest duration of all locals when administering it epidurally?

A

Because it rapidly metabolized by plasma cholinesterase

106
Q

Methemoglobinemia associated with which local anesthetic?

A

Prilocaine > benzocaine

Treated with methylene blue and ascot if acid

107
Q

CI for methyl blue?

A

G6PD deficiency and patients on SSRI

108
Q

Patients who are more risk for methemoglobinemia?

A

G6PD deficiency patients

109
Q

Advantage of Ropivacaine and Levobupivacaine over bupivacaine are …

A

Less motor block and less cardiac toxicity

110
Q

Earliest sign of lintravascular injection of local anesthetics are …

A

Without Epi -> tinnitus and cirumoral numbness

With Epi -> Tachycardia

111
Q

RFs of Transient neurological symptoms (TNS) after spinal

A

Lidocaine > mepivacaine > procaine > bupivacaine

Highest incidence with 5% hyperbaric lidocaine

Higher concentration of local

Lithotomy position

112
Q

Highest to lowest of blood local anesthetics are …

A

Intercostal > caudal > epidural > brachial > femoral/sciatic

113
Q

Tumescent Lidocaine used for

A

Liposuction

Concentration 0.025% -0.1%
Peak concentration at 12-14 hours
Declining time: over 6-14 hours
Epinephrine dose in bag: 1:1,000,000

114
Q

Why metoclopramide is CI in parakinsons disease patients?

A

Extra pyramidal symptoms (rigidity)

115
Q

Onset time of H2 blockers?

A

30 min -> IV

60-90 -> po

116
Q

Effect of Ranitidine, Metoclopramide, Na-citrate on gastric volume and pH?

A

Metoclopramide only decreases gastric volume.

Na-Cirtate only increases gastric pH

Ranitidine decreases gastric volume and increases pH

117
Q

Metoclopramide effect on GI system?

A

Increases LE sphincter tone
Increase gastric emptying

Decreases gastric volume

No change in pH

118
Q

Drugs increases LE sphincter tone?

A

Metoclopramide
Neostigmine
Succinylcholine

119
Q

Drugs has no effect on LE sphincter tone?

A 
H2 blockers 
PPI inhibitors
Propofol 
Remifentanil
Precedex
120
Q

Drugs lower the tone of LE sphincter?

A

Morphine
Meperidine
High dose propofol (normal dose has no effect)

BDZs
TCA
Anticholinergics

121
Q

Clonidine and precedex are both alpha-2 …. and both results into hypotension and bradycardia but bradycardia seen more with … and hypotension seen more with …

A

Agonists

Hypotension-> precedex

Brady -> clonidine

122
Q

Toxic effect of:

Methotrexate 
Amiodarone
Bleomycin
Cyclophosphamide 
Doxorubicin/Donorubicin
Vincristine
Cyclosporine 
Cisplatin
A 
Megaloblastic anemia
Pulm fibrosis 
Pulmonary fibrosis
Hemorrhagic cystitis
Irreversible CMP
Peripheral neuropathy 
Renal toxicity 
Peripheral neuropathy
123
Q

SE of Amiodarone

A

QT prolongation
Pulm fibrosis
Hypo/Hyper thyrodisim

124
Q

Management of long QT?

A

Mg, k replacement

Long term; BB, pacing, left sympathectomy in refractory cases

Avoid Amiodrone

125
Q

Etiology of prolong QT?

A

Congenital

Acquired;

  • quinidine
  • procainamide
  • sotalol
  • amiodarone
  • macrolides
  • TCA
  • phenothiazines
  • droperidol
  • haloperidol
  • TMP-SMX
  • Zofran
126
Q

SE of hydrochlorothiazide?

A

Decreases -> K, Cl, Na, and platelets

Increases -> UA and Ca

127
Q

Diuretic works on proximal tubule?

A

Acetozolamide (carbonic anhydrase inhibitor-> inhibits reabsobtion of bicarbonate)

128
Q

Diuretics works on Medullary portion of ascending limb of loop of henle?

A

Furosemide
Bumetanide
Ethacrynic acid
Mannitol

Inhibits Na/K/Cl co-transport-> prevents NaCl reabsorption

129
Q

Diuretics work on Distal tubule?

A

Hydrochlorothizide

Inhibits Na + Cl reabsorption

130
Q

Diuretics works on collecting duct?

A

Amiloride
Triamterene

Inhibits Na channels

Spironolactone

Aldo antagonist-> inhibits Na reabsorption and K secretion

131
Q

Diuretics causes hyperkalemia

A

Spironolactone

Amiloride

132
Q

Metabolic effects of Diuretics? All causes metabolic acidosis except …

A

Furosemide and thiazides causes metabolic Alkalosis

133
Q

Diuretics causes venodilation and reduces preload

A

Furosemide

134
Q

SE of nalaxone?

A

Tachycardia

Hypertension

135
Q

SE flumazanil

A

NV and seizures

136
Q

SE of Dantrolene

A

Muscle weakness

137
Q

SE of Ritodrine/terbutaline/Albuterol? Which are B2 agonists

A 
Hypotension 
Tachycardia 
Hyperglycemia 
Pulm edema
Hypokalemia
138
Q

Medications reduces biliary spasms?

A

Atropine
Glucagon
Nitroglycerin

Used in

  • hypoglycemia
  • BB overdose
  • biliary spasm
139
Q

Amiodarone is class … anti arrhythmic which prolongs the …. of phase … by …

At the SA node it blocks different channels?

A 
Class 3
Prolongs depolarization (phase 3)
By K channel blockade

It blocks Ca channels at the AS mode and prolongs refractory period

140
Q

Acute SE of Amiodarone

A

Peripheral vasodilation-> Hypotension

And Bradycardia

141
Q

Indication for ACE inhibitor? And CIs?

A

CHF, Anterior MI with low EF, and DM-nephropathy

CI: pregnancy, BL RAS, prior angioedema

142
Q

Alpha 1 receptors location? Vs alpha2?

A

Postsynaptic In Vascular SM -> stimulation leads to vasoconstriction

Presynaptic and stimulation decreases release of NorEpi

143
Q

Beta 1 receptors location vs Beta 2?

A

Myocardium and stimulation causes positive intropic + chronotropic

Beta 2 causes vasodilation and positive chronotropic

144
Q

Adrenergic agents and their receptor action:

Dopamine

Dobutamine

NorEpi

Epi

A

All beta + alpha

Mainly B1 (mild Beta2 and alpha1)

The ones alpha1 + beta1

The ones (alpha1+beta1) and beta2

145
Q

Nitroglycerin effect

A

Reduces preload, myocardial wall tension, and O2 consumption.

146
Q

Why Ephedrine won’t be effective in chronic cocaine users?

A

Due to catacholamine depletion at the adrenergic nerve ending.

147
Q

Milrinone is a …. inhibitor.

1) It decreases intracellular breakdown of … which leads to increased their levels in …
2) increases intracellular….

A

Phosphdiesterase inhibitors

Decreases breakdown of cAMP and therefore increases their levels in myocardium and vascular SM

Increases intracellular Ca

148
Q

Milrinone effect?

A

Decreases afterload via decreased SVR, increases myocardium contractility, and CO

It has no effect on Alpha or Beta

149
Q

Toxic effect of N2O are due to?

A

Methemoglobinemia

Nitrogen dioxide

150
Q

Epinephrine benefits in anaphylaxis by … and in cardiac arrest by …

A

Stabilizing mast cell membrane

Increase afterload and improve cerebral and cardiac perfusion

151
Q

LMWH compared to SQH

A

Greater bioavailability
Longer duration of action
Has greater anti Xa than Anti IIa activity
Lower risk for HIT

152
Q

LMWH excreted through renal, where SQH …

A

Reticuloendothelial system. At higher dosage it’s excreted through kidneys

153
Q

Antiplateltes classifications;

Cyclooxygenase inhibitor->
ADP receptors inhibitors ->
G IIb/IIIa inhibitors->
Adenosine reuptake inhibitors ->

A

ASA

Clopidogril, ticlopidine, prasugrel

Abciximab, eptifbatide, tirofiban, deofibrotide

Dipyridamole

154
Q

Direct thrombin inhibitors

A

Hirudin
Bivalirudin
Lepirudin

155
Q

Plasminogen activators

A

tPA
Urokinase
Streptokinase

156
Q

Plasminogen inhibitors

A

Epsilon amniocaprionic acid

TXA

157
Q

Tertiary amine anticholenrgic that crosses BBB and causes CNS excitation ….

Tertiary amine anticholenrgic that crosses BBB but causes sedation ….

A

Atropine

Scopolamine = sedation

158
Q

Anticholinergic causes Mydriasis in order of more occurrences

A

Scopolamine > atropine > glycopyrolate

Where Antisialagouge;
Scopolamine > glycopyrolate > atropine

159
Q

2 CNS disease that anticholenirgics are CI?

A

Alzheimer’s and Parkinson’s

160
Q

DOC of acute asthma in a patient who is tachycardic?

A

Ipratripium (less absorption from bronchial tree)

161
Q

D/C of metformin is not recommended not …

A

Normal Kidney fiction presenting for elective surgery or prior contrast CT.

162
Q

Herbals that inhibits platelet aggregation

A

Garlic
Ginkgo
Ginseng (it also lowers blood glucose).

163
Q

Features of salicylic poisoning

A

Hyperpyrexia
Res. Alkalosis
Metabolic acidosis

164
Q

Treatment of organophosphate

A

Atropine

Pralidoxime

165
Q

SE lithium

A 
Leukcytosis
Hypothyroid 
DI
AV block
Sedation 
Hypothermia
Seizures 
Potentiate both DNMB and NDNMB
166
Q

First vs Zero order kinetics?

A

Zero -> a fixed amount of drug eliminated

First -> fixed % of drug elimination (every given time, t1/2 of drug eliminated).

DSouza 2015 (21 decks)

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