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ABSITE > pharmacology > Flashcards

pharmacology Flashcards

1
Q

CSF absorption requires lipid soluble vs insoluble? ionized vs nonionized?

A

lipid-soluble. nonionized.

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2
Q

how many half lives to reach steady state?

A

5.

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3
Q

meaning of tachyphylaxis?

A

tolerance after only a few doses.

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4
Q

drug metabolism via liver p450.

A

phase I. demthy/ox/redux/hydrol reactions… NADPH/oxygen required.
phase II. glucuronic acid and sulfates attach to make water soluble

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5
Q

p450 inhibitors

A

cimetidine, isoniazid, ketoconazle, erythromycin, cipro, flagyl, allopurinol, verapamil, amiodarone, MAOIs, disulfuram

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6
Q

p450 inducers

A

cruciform vegetables, ETOH, cigarettes, phenobarbital, phenytoin, theophylline, warfarin

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7
Q

urate crystals on microscopy

A

negative birefringent (yellow, needle shaped)

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8
Q

podagra?

A

1st MTP joint gout; MC area effected.

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9
Q

colchicine MOA

A

binds tubulin and inhibits migration CHEMOTAXIS of WBC in gout

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10
Q

allopuriol MOA

A

xanthine oxidase inhibitor; blocks urate from xanthine.

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11
Q

probenecid MOA gout

A

increase renal secretion of uric acid.

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12
Q

niacin MOA

A

inhibits cholesterol synthesis; can cause FLUSHING.

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13
Q

statin MOA

A

HMG COA REDUCTASE INHIBITOR

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14
Q

alvimopan MOA

A

binds and inhibits mu-opioid receptor for postop ileus.

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15
Q

zofran MOA

A

serotonin (central) receptor inhibitor.

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16
Q

promethazine and metoclopramide MOA

A

DA receptors; increase gastric and gut mobility

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17
Q

what agent improves survival in CHF?

A

ACEi

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18
Q

what agent improves survival after MI?

A

Bblocker.

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19
Q

highest MAC?

A

nitrous oxide NO2; low potency = high MAC = fastest!

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20
Q

malignant hyperthermia MOA?

A

ryanodine receptor defect… mucsle excitation from Ca release
after succinylcholine (IRREVERSIBLE).

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21
Q

malignant hyperthermia sx?

A

increased end tidal, fever, tachycardia, rigidity, acidosis, hyperkalemia, rhabdomyolysis

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22
Q

mgmt malignant hyperthermia?

A

dantrolene (10 mg/kg) inhibiting Ca release and decouples complex
cool, bicarb
glucose
supportive care.

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23
Q

succinylcholine and hyperkalemia

A

causes more; (depol = release K)
so avoid in: burn, neurologic injury, neuromusclar disorders, SCInjury, trauma, renal failure)

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24
Q

Hoffman effect?

A

degradation of drug in blood spontaneously.
nimbex.

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25
Q

metabolism of rocuronium, vec, pan

A

roc/vec: hepatic
pan: renal

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26
Q

nondepol MOA

A

compete with ACh

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27
Q

reverse nondepolarizing roc?

A

sugammadex: selective binding to paralytic…. to reverse roc and vec

neostigmine/edrophonium: block Achase to increase ACh.
with atropine/glycopyrrolate to reverse overwhelming ACh.

28
Q

MOA local

A

increase action potential threshold preventing Na influx into neuron

29
Q

dose of local anesthetic?

A

0.5 cc/kg of 1% lidocaine.

30
Q

max dosing lido and bup

A

lido 4 mg/kg
bup 2 mg/kg

31
Q

SE of meperidine demerol?

A

tremors, fasciculations, seizures (normeperidine) avoid in RENAL FAILURE.

but it also is used to treat postop shaking

32
Q

contraindication to epidural and spinal anesthesia?

A

hypertrophic cardiomyopathy, cyanotic heart disease (sympathetic denervation can cause decreased afterload which worsens conditions).

33
Q

epidural location for different thoracotomy vs laparotomy?

A

thoracotomy: T6-T9
laparotomy: T8-T10.

T5 = affects cardiac accelerator nerves

34
Q

spinal anesthesia location?

A

L2 to avoid spinal cord (subarachnoid)

35
Q

LR composition

A

Na 130
K 4
Ca 2.7
Cl 109
lactate 28 (converts to HCO3- in body though)

36
Q

NS vs HTS?

A

Na 154 … 513
Cl 154 … 513

37
Q

calculate plasma osmolarity?

A

2Na + glucose/18 + BUN/2.8.
normal 280-295.

38
Q

fluid loss in major abdominal operations?

A

0.5-1L/hr.

39
Q

gastrointestinal losses by organ per day?

A

stomach 1-2L
biliary system 0.5-1L
pancreas 0.5-1L
duo 0.5-1L

40
Q

hyponatremia

A

FW restriction and NS
no more than 1 mEq/hr (8 per day) otherwise central pontine myelinosis

41
Q

DI

A

decreased ADH… lots of diluted urine, hypernatremic, high serum osm
etiology: head injury
treat: DDAVP (or free water if chronic)

42
Q

SIADH

A

increased ADFH… minimal concentrated urine, hyponatremic, low serum osm
etiology: head injury, carbamazepine, SSRI, cyclophosphamid, cipro, haldol, amiodarone, vincristine, vinblastine, cisplatin, bromocriptine
treat: conviaptan, tolvaptan
chronic: slow diuresis and fluid restriction

43
Q

protein adjustment for calcium

A

for every 1 g decrease in protein, add 0.8 to Ca

44
Q

vit D metabolism

A

made in skin 7DHC to cholecalciferol goes to liver for 25 OH and then kidney for 1 OH (active)

45
Q

flumazenil dosing

A

0.2 mg over 30 seconds
repeat up to 3 mg

46
Q

hofman elimination

A

not cleared by liver

47
Q

renal excretion narcotics

A

yes: morphine, oxy, tramadol, hydrocodone
no: dilaudid = hydromorphone, fentanyl, sufentanil,

48
Q

spinal anesthesai

A

into intrathecal space

49
Q

vasopressin receptor

A

V1
vasoconstrict and inhibit NO release via IL-1 and NO synthease

50
Q

where is tetracycline and heavy metals stored

A

BONE

51
Q

0 order kinetics

A

CONSTANT amount eliminated regardless of dose

52
Q

1st order kindetics

A

drug eliminated proportional to DOSE

53
Q

how many half lives tilsteady state

A

5

54
Q

metyrapone and aminoglutethimide

A

inhibit adrenal steroid synthesis in adrenocortical carcinoma

55
Q

leuprolide

A

GnRH and LHRH analogues
inhibit LH and FSH release from pituitary…. for metastatic prostate ca

56
Q

tamsulosin

A

alpha-receptor ANTAGONIST for BPH

57
Q

misoprostol

A

PGE1 deriviative; PGE1 is GOOD! so protective prostaglandin…..
decrease PUD, consider in chronic NSAID use that is causing ulcers

58
Q

halothane

A

SLOW on/off… HIGH cardiac depression. smells good though.

SE: halothane hepatitis… fever, eosinophilia, jaundice

59
Q

isoflurane

A

for NSY… pungent decrease brain O2 consumption

60
Q

sevo

A

good for mask; fast. less laryngospasm

61
Q

enflurane

A

causes seizures

62
Q

MAC and potency

A

small MAC = more lipid soluble = MORE potent

63
Q

speed of induction goes up with solubility

A

so high MAC = less soluble = fast induction

64
Q

propofol metabolism

A

liver & pseudocholinesterases

65
Q

esters vs amides allergy

A

esters (I at the end only) ….cause allergy from PABA analogue

66
Q

versed in pregnancy

A

aVOID; crosses placenta

67
Q
A

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