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FINALS revision - @medicbotanist > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What is pharmacodynamics?

A

How the drug affects the body

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2
Q

What is pharmacokinetics?

A

How the body affects the drug

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3
Q

What is first line anti-hypertensive in a patient who is under 55 or has diabetes?

A

ACE inhibitor

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4
Q

What is your first line anti-hypertensive medication in a patient over 55 yrs old and of Black or Afro Caribbean descent?

A

CCB

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5
Q

What is illness behaviour?

A

How an individual responds to illness. Highly variable

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6
Q

Where are two places that opioids work?

A

Pre-synapses and 4th ventricle

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7
Q

What are 3 ways that tolerances to opioids occur?

A

Increased metabolism of opioids

Downregulation of opiod receptors

Neuroplasticity of CNS target areas

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8
Q

What fibres are involved in chronic pain?

A

Small unmyelinated C fibres

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9
Q

Give an example of a drug that works on cytoplasmic receptors?

A

Steroids

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10
Q

Give an example of a drug that works on nuclear receptors?

A

Thyroid receptor hormone

Oestrogen

Vit D

Vit A

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11
Q

Describe the 4 Hypersensitivity reactions..

A
  1. IgE mediated
  2. Cytotoxic Reactions complement activation
  3. Deposition of immune complexes
  4. Delayed hypersensitivity i.e. T cell mediated so Steven Johnson syndrome
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12
Q

Define the following different types of pain:

  1. Nociceptive
  2. Neuropathic
  3. Nociplastic:
A
  1. Nociceptive: Pain in response to actual or threatened damage
  2. Neuropathic: pain causes by lesion or disease of the somatosensory nervous system.
  3. Nociplastic: pain that arises from altered nociception despite having no actual threatened tissue damage.
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13
Q

What is allodynia?

A

Pain due to a stimulus that doe not normally provoke a pain response.

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14
Q

Describe the 4 parts of the pain pathway:

A
  1. You cut yourself
  2. Stimulate peripheral nociceptors and pain mediators
  3. Travels to the dorsal ganglion to the ipslateral spinothalmic tract
  4. Thalamus -> cerebrum (Broadman’s area 3,2,1)
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15
Q

Describe what type of pain travels along the following also if they are myelinated or unmyelinated:

Large C fibres
A delta fibres
A beta fibres
A alpha fibres

A

Large C fibres: unmyelinated and things travel slowly. Transport mechanical, chemical and thermal pain.

A alpha fibres : myelinated transport proprioception

A beta fibres: myelinated and transport touch

A delta fibres: myelinated and transport mechanical and thermal pain

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16
Q

Is pain transported via the dorsal or ventral ganglion?

A

Dorsal

17
Q

What is noticed in the insular cortex?

A

The degree of pain

18
Q

What is noticed in the cingulate cortex?

A

Emotional content that relates to pain

19
Q

What triggers the amygdala?

A

Emotions and stress

20
Q

Where is the descending inhibitory pathway found?

A

Peri aqueductal Grey area

21
Q

How can we treat pain? How does pain relief work?

A

Stimulates the descending inhibitory pathway.

Found in the periaqueductal grey area that releases noradrenaline and serotonin.

22
Q

What is a calculation that you can use to work out a

Males idea body weight IBW

Female IBW

A

Male: 0.9H -88

Female: 0.9H-92

23
Q

What is the % fluid intracellular vs extra cellular?

A

%intracellular 2/3rd

%extracellular: 1/3rd

24
Q

What are the following fluid requirements in these groups of people?

A. Adults

B. Children

C. Neonates

A

A. Adults 70mls/kg remember via the average 70kg male

B. Children 80mls/kg

C. Neonates 90mls/kg

25
Q

Describe what you would see in the following WHO dehydration criteria:

No dehydration
Some dehydration
Severe dehydration

A

No dehydration: not enough signs

Some dehydration: restless, irritable, sunken eyes, thirsty, eager drinker, slight reduced skin turgur

Severe dehydration: lethargy, sunken eyes, unable to drink, significant skin pinch

26
Q

What is normal urine output in an adult?

A

> 0.5 ml/kg/hour

27
Q

What are the issues associated with having a full stomach when going to surgery?

A

Increased risk of Aspiration and thus aspiration pneumonia

28
Q

If a patient does have a full stomach. What anaesthetic method would you have to do to put them to sleep?

A

Rapid Sequence Induction

29
Q

What medications should be avoided pre operative?

A
  1. ACE inhibitor
  2. Aspirin, Clopidogrel, DOACs
  3. NSAIDs
  4. Metformin.
  5. COCP
30
Q

What system does anaesthetic work on?

A

The reticulocytes activating system

31
Q

What are the two steps involved in anaesthetising a patient?

A
  1. IV injection propofol to induce anaesthesia

2. Continued inhalation with desflurane

32
Q

How do muscle relaxants work?

A

They have a short rapid onset

They work by mimicking acetylcholine

33
Q

How can you reverse muscle relaxants?

A

By using an acetylcholinesterase like Sugammadex

34
Q

Give an example of a depolarising and a non depolarising muscle relaxant.

A
  1. Depolarising: Suxmeathonium

2. Non depolarising: Rocuronium this is a competitive inhibitor. No fasculations. takes a while to work.

35
Q

What is the sequence start to finish of putting someone to sleep under anaesthetics?

A
  1. Oxygen
  2. Propofol (anaesthetic)
  3. Suxmeathonium (muscle relaxant)
  4. Intubate and ventilate. Put cricoid pressure to obstruct the larynx
  5. Keep under with: desflurane, morphine and muscle relaxant rocuronium.
  6. Wake up using sugammadex
36
Q

Are inhaled medications hydrophilic or hydrophobic?

A

Hydrophobic

FINALS revision - @medicbotanist (20 decks)

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