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GME - Residency > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What is one potential “cross reaction” of fentanyl patches?

A

They can melt with heating pads and release too much fentanyl.

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2
Q

Side effects of isoniazid include ______________.

A

seizures, acidosis, and glove-and-stocking neuropathy (if B6 is not given)

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3
Q

What is the mechanism of TXA?

A

It is a lysine derivative that reduces the conversion of plasminogen to plasmin by displacing plasminogen from fibrin.

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4
Q

What are the duration of actions of lorazepam and midazolam?

A

Lorazepam: 6+ hours

Midazolam: 1-2 hours

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5
Q

What is the onset of action of IM Haldol?

A

15-30 minutes

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6
Q

What is the onset of action of IM lorazepam?

A

20 minutes

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7
Q

Compare the onset times of IM and IV ketamine.

A

IM: 3-10 minutes
IV: 1-2 minutes

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8
Q

What are the doses of IM and IV ketamine for sedation?

A

IM: 2-5 mg/kg

IV: 1-2 mg/kg

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9
Q

A prehospital study showed that IM ketamine led to higher risks of what upon hospital arrival?

A

Intubation

As many as 49% of patients given 5 mg/kg of ketamine by EMS were intubated.

Note, another trial showed 2 mg/kg IM ketamine led to fewer safety events.

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10
Q

Why is succinylcholine contraindicated in those with neuromuscular disorders?

A

Succinylcholine depolarizes the neuromuscular membrane which raises the serum potassium 0.5 - 1.0 mEq/L. Those with neuromuscular disorders can have upregulation of nicotinic acetylcholine receptors (due to insufficient stimulation). Thus, succinylcholine has an exaggerated effect and can raise potassium to life-threatening levels.

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11
Q

Which of the paralytics is non-depolarizing and is degraded in the serum (i.e., not dependent on liver or kidney)?

A

Cisatracurium

Thus, if you know someone has severe kidney and liver disease and you don’t want prolonged paralysis (like for repeated neuro exams) then consider this.

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12
Q

The rash of red man syndrome most commonly affects which parts of the body?

A

Head, face, neck, and upper torso

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13
Q

What are the phenanthrene and non-phenanthrene opioids?

A
  • Phenanthrene: oxycodone, morphine, hydrocodone, hydromorphone
  • Non-phenanthrene: fentanyl, meperidine, methadone

Patients who have side effects or allergic reactions to one group will likely be ok receiving another group.

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14
Q

What patient population can’t get acetazolamide?

A

Sickle cell (because of the acidosis)

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15
Q

Medication percent means what?

A

grams per 100 mL

So D50 is 50 grams per 100 mL (which is why a 50 mL amp is 25 grams of sugar).

Likewise, 1% lidocaine is 1 gram per 100 mL or 1000 mg per 100 mL (which equals 10 mg/mL)

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16
Q

What class of medicine is Tamiflu?

A

Neuraminidase inhibitor

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17
Q

Sumatriptans should be avoided in patients with which comorbidities?

A

CAD, uncontrolled HTN, CVA

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18
Q

What is the deal with droperidol and torsades?

A

There was a concern based on a small number of case reports. In more recent years studies have shown this risk to be extremely small and thus the medicine is now back on the market.

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19
Q

What is the dose and administration guidelines for analgesic ketamine?

A

0.2 - 0.5 mg/kg IV over 15 minutes

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20
Q

What medication can cause hiccups?

A

Glucocorticoids

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21
Q

1:1,000 means what?

A

How many g in mL

So 1:1,000 is 1000 mg in 1000 mL or 1 mg/mL.

22
Q

What are the 4th- and 5th-generation cephalosporins?

A

4th: cefepime
5th: ceftaroline

23
Q

True or false: cefuroxime is a 3rd-generation cephalosporin.

A

False

It’s a 2nd.

24
Q

True or false: cetazidime covers PsA.

A

True

25
Q

What is the oral-to-IV conversion of morphine?

A

1:3

26
Q

What is the conversion of IV morphine to IV Dilaudid?

A

1:6.5

So 2 mg IV Dilaudid is equivalent to 13 mg IV morphine

27
Q

True or false: DRESS usually spares the mucous membranes early in the disease.

A

True

It usually presents with fever, exanthem, and internal organ involvement.

28
Q

What is the reason IV phenytoin can’t be given as a bolus?

A

It contains propylene glycol that can cause cardiovascular collapse if given too fast.

29
Q

Why is meperidine not routinely used in the ER?

A

It has a half-life of 48 hours.

30
Q

What medication can cause PRES?

A

Tacrolimus

31
Q

Which beta blocker is renally cleared?

A

Atenolol

32
Q

By what mechanism does octreotide suppress insulin release?

A

It blocks calcium intake into islet cells, which decreases endogenous insulin release.

33
Q

Propofol dosing…

A

Procedural sedation: 0.5 - 1.0 mg/kg with follow up boluses 0.2 - 0.5 mg/kg

RSI: 1.5 - 2.0 mg/kg

Sedation (gtt): usual is 40-100 mcg/kg/min

34
Q

Which common condition is a contraindication to tramadol?

A

Seizures

35
Q

How do neuraminidase inhibitors work?

A

They prevent release of virion from infected cells.

36
Q

What common medication increases the concentration of apixaban?

A

Diltiazem

37
Q

Other than antipsychotics, ___________ can also cause neuroleptic malignant syndrome.

A

antiemetics (Reglan and Phenergan)

38
Q

What antibiotics are the most common culprits of drug-induced neutropenia?

A

Cephalosporins, penicillins, and macrolides

39
Q

True or false: acetazolamide causes metabolic alkalosis.

A

False

It causes a non-anion gap metabolic acidosis. Inhibiting carbonic anhydrase induces increased urination of HCO.

40
Q

True or false: according to the boards it is ok to give cephalosporins to someone with confirmed beta-lactam anaphylaxis.

A

False

41
Q

Which muscle relaxer is not on the Beers criteria?

A

Cyclobenzaprine

42
Q

How do macrolides effect cyp?

A

They inhibit it.

43
Q

What chemotherapy can cause cholinergic toxicity?

A

Etoposide

44
Q

What are the mechanisms of sirolimus and tacrolimus?

A

Tacrolimus: calcineurin inhibitor (like cyclosporine)

Sirolimus: mTOR inhibitor

45
Q

At what level INR do you begin oral vitamin K in asymptomatic people?

A

Greater than 10

46
Q

In which patients should you not give diltiazem (for pharmacological reasons)?

A

Those taking drugs metabolized by cyp450.

47
Q

True or false: any degree of CKD is a contraindication to colchicine.

A

False

Those with GFRs greater than 30 (CKD 1-3) can receive normal dose colchicine. CKD 4 can get a dose adjustment.

48
Q

Other than PUD, what GI complication can long-term steroid use cause?

A

Pancreatitis

49
Q

Which antiemetic carries a risk of digital necrosis when given IV?

A

Promethazine

50
Q

Which NSAID does not cause gastric bleeding?

A

Celebrex (celecoxib)

Celecoxib is a COX-2 selective inhibitor.

The others NSAIDs – meloxicam, ibuprofen, aspirin, naproxen – are nonselective COX-2 and COX-1 inhibitors.

GME - Residency (112 decks)

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