Pharmacology

Question 1

What is the danger of using flumazenil?

Answer 1

It has the shortest half life of the receptor, meaning that you can give it, reverse the effects of a benzo overdose, and then become re-sedated

Question 2

What is the name of the dihydropyridine receptor that is metabolized by plasma esterases?

Answer 2

Clevidipine

Question 3

Of the two, which is more alpha selective: Dexmedetomidine or Clonidine?

Answer 3

Dexmedetomidine!!

Question 4

What type of receptors mitigate diaphoresis?

Answer 4

mAchR, which means that an Ach esterase inhibitor can cause diaphoresis

Question 5

CYP450 inducers and inhibitors

Answer 5

*** look in FA

Question 6

What patients are at risk for accumulation of Morphine active metabolites? What is the metabolite called?

Answer 6

1. Renal failure patients

2. Morphine 6-glucuronide

Question 7

Describe the “gate theory”

Answer 7

1. A-beta nerve fibers inhibit C and A-delta nerve fibers

Question 8

How does cryotherapy work?

Answer 8

Slows nerve conduction

Question 9

What is the likely target of dexamethasone in PONV prophylaxis?

Answer 9

Targets the Nucleus tractus solatarii

Question 10

When using atropine, what AchEinh would be best?

Answer 10

Edrophonium

Question 11

What are the two factors that determine the speed of onset and offset of opioids?

Answer 11

1. Lipid solubility: the most lipid soluble will cross the BBB faster and clear faster (this is why morphine takes awhile to work and be cleared from the system: it is hydrophilic)
2. pKa (pKa < 7.4 will result in more of the drug being in unionized form at physiologic pH)

Question 12

What is the opioid with the lowest pKa? What is the opioid with the highest lipid solubility?

Answer 12

Alfentanil

Sufentanil

Question 13

How does mannitol cause hyperkalemia?

Answer 13

Translocational: as water efflux leaves the cell, it takes K with it

Question 14

What type of drug is Terbutaline? What is it used for? What electrolyte disturbance might be seen with its use?

Answer 14

1. B2 agonist
2. asthma and tocolysis
3. hypokalemia

Question 15

Describe the onset time of chlorprocaine. How is it metabolized? When is it used?

Answer 15

1. 6-12 minutes: this is due to the large volume that is utilized
2. Plasma esterases: this creates fast offset
3. utilized in labor when fast analgesia is required and an epidural is already in place

Question 16

What are the three drugs that are metabolized by CYP2D6? What class of drugs inhibits this receptor? Which drug is dependent upon its metabolism to form active metabolites?

Answer 16

1. Codeine, hydrocodne, oxycodone
2. SSRIs
3. Codeine. Hydrocodone and oxycodone are active alone, but become more potent when metabolized.