Pharmacology Flashcards
What is the receptor target of Ketamine?
What is the effect on the receptor (agonist or antagonist) AND what neurotransmitter does it block?
It affects the NMDA Receptor.
It is an ANTAGONIST of the NMDA receptor—it blocks the attachment of the neurotransmitter, Glutamate.
How is Ketamine metabolized?
Hepatic, through the Cytochrome P450 enzymes.
If a patient has ICH after thrombolysis, what is the most logical next move to overwhelm the fibrinolytic effect of tPA? (How much ?)
What else can be given, to ‘reverse or antagonize tPA?
Give more Fibrinogen—Cryoprecipcitate. If fibrin is being consumed and cleaved, give more fibrinogen.
( 10 Units, make sure fibrinogen > 150 )
Aminocaproic Acid or Tranexamic Acid (1gm IVPB)
What is the dose of ketamine for NON-DISSOCIATIVE ANALGESIA ? (Bolus, drip, or both)
0.1 to 0.3 mg/kg (0.2mg/kg) IVPB over 15 minutes, with continuous infusion of the same (0.2mg/kg/hr) per hour.
What 3 benefits does IV Lidocaine have ?
What effect does it have on the gut ?
It is a potent anti-inflammatory, analgesic and ANTI-HYPERALGESIC. It promotes peristalsis.
What is the dose of IV Lidocaine for analgesia ?
1 to 1.5 mg/kg initial and infusion of 1 to 2mg/kg/hr.
How do Beta-2 agonists decrease potassium levels?
What is the approximate range of change in potassium with Beta-2 agonist use?
They work by increasing cAMP via the adrenergic Beta-2 receptor, stimulating the Na-K-ATP’ase pump, moving K intracellularly.
They can move the potassium down by 0.5mEq/L to as much as 1.5mEq/L (with repetitive/continuous dosing).
How does TXA Actually work?
It binds a site on the Plasmin where Plasmin would otherwise bind and ‘snip’ the cross-linked fibrin. Hence, even though tPA can activate PlasminOGEN to active Plasmin, it still cannot then bind the cross-linked Fibrin and cut it. It’s binding site is occupied with a null agent (TXA).
What is the mechanism for Etomidate (what receptor does it affect) ?
What is the dose for RSI?
It Is a GABA-A receptor agonist.
0.3mg/kg
What is the induction dose for propofol ?
What receptor(s) does it affect ?
How long does an induction dose last ?
2 to 2.5mg/kg
GABA and endocannabinoid
Less than 10 minutes.
Which induction agents are ideal for seizures?
Propofol and Ketamine both are suppressive of seizures.
