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NZATS Registration Exam study flash cards > Pharmacology + fluids > Flashcards

Pharmacology + fluids Flashcards

1
Q

What is the IM adrenalin dose for adults?

A

0.5mg [0.5ml of 1:1000]

Repeat every 5 minutes as needed

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2
Q

What is the IM adrenalin dose for children?

A

10mcg [0.01ml/kg] of 1:1000

[min dose 0.1ml]

[max dose 0.5ml]

Repeat every 5 minutes as needed

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3
Q

What drugs are given during bronchospasm?

A

Salbutamol inhaled 8-12 puffs

Salbutamol IV bolus 250mcg [100mcg/ml]

Magnesium

Adrenalin

ketamine

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4
Q

What drug do you give for an adult cardiac arrest?

A

Adrenalin 1mg IV and repeat every 2nd cycle [3-5 minutes]

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5
Q

How do you treat hyperkalaemia?

A

Sodium bicarbonate

Insulin actrapid

Calcium chloride

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6
Q

What is the paediatric dose of adrenaline for a cardiac arrest Asystole/PEA

A

Adrenaline 0.01mg/kg of the 0.1mg/ml concentration

Max dose 1mg

Repeat every 3-5 minutes

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7
Q

What is the intubation dose of propofol for adults?

A

1-2mg/kg

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8
Q

What is the intubation dose for suxamethonium IV?

A

2mg/kg

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9
Q

What is the intubation dose for suxamethonium IM?

A

4mg/kg

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10
Q

How much propofol do you give to break a laryngospasm event?

A

20% of an induction dose 0.25-0.5mg/kg

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11
Q

What is the immediate bolus dose of 20% intralipid during a local anaesthetic emergency event?

A

1.5mg/kg over 1 minute [100ml for 70kg]

If remains unstable Repeat 2 more doses at 5-minute intervals max

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12
Q

What is the infusion dose of 20% intralipid?

A

15ml/kg/hr [1000ml/hr for 70kg]

If remains unstable double infusion rate

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13
Q

Is propofol a substitute for intralipid?

A

No

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14
Q

How do you prepare the dantrolene?

A

20mg vial mixed with 60mls sterile water

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15
Q

What is the dose of dantrolene

A

2.5mg/kg [60kg = 8 vials]

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16
Q

How long after immediate treatment of dantrolene should you consider giving another repeat bolus?

A

10 minutes if still symptomatic

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17
Q

How does dantrolene work?

A

Dantrolene directly interferes with muscle contraction by decreasing calcium in muscle cells

preventing electrical impulses traveling to muscles and preventing muscle contractions

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18
Q

What complications can MH cause?

A

Acidosis – treat with hyperventilation, sodium bicarbonate

Arrhythmias

Disseminated intravascular coagulation [DIC] -abnormal blood clotting

Hyperkalaemia – high potassium levels in blood

Hyperthermia – cold fluids, ice

Hypotension – fluid bolus, vasopressor

Cardiovascular collapse and cardiac arrest

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19
Q

Plasmalyte is ______ compared to body water

A

Isotonic

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20
Q

Sodium chloride 0.9% is ______ compared to body water?

A

Isotonic

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21
Q

0.45% sodium chloride is ______ compared to body water?

A

Hypotonic

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22
Q

What is the adult blood volume per kg in mls?

A

70

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23
Q

What is the paediatric blood volume per kg in mls?

A

80

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24
Q

True or false – hypotonic fluids might be used to treat diabetic ketoacidosis

A

True

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25
Q

True or false – Hypertonic fluids are not used in treatment of oedema

A

False

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26
Q

True or false – Albumin must be given through a blood pump set?

A

False

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27
Q

Fresh frozen plasma is used to treat coagulopathies and what other purpose?

A

increase circulating volume

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28
Q

Untreated haemorrhage or dehydration could lead to which of the 4H’s and 4T’s

A

Hypovolaemia

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29
Q

True or false – platelets are stored in the fridge

A

False

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30
Q

What is the micron size range for a blood filter?

A

170-200

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31
Q

Who is the universal blood donor?

A

O Negative

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32
Q

Who is the universal blood recipient?

A

AB positive

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33
Q

Who is the universal plasma donor?

A

AB

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34
Q

Who is the universal plasma recipient?

A

O

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35
Q

In normal use, how many units of blood should be given through a blood filter?

A

4

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36
Q

true or false – in a massive transfusion, it is acceptable to give more units than 4 through a filter

A

True

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37
Q

Can rhesus positive blood be given to rhesus negative patients?

A

No

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38
Q

What blood products should not be given in the same line as RBC’s

A

Platelets

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39
Q

A haemolytic transfusion reaction causes destruction of what?

A

Haemoglobin

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40
Q

What is the adult cardiac arrest adrenaline dose? Include units

A

1mg

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41
Q

What is the adult anapahylaxis IM adrenaline dose? Include units

A

0.5mg

42
Q

What is the paediatric cardiac arrest adrenaline dose? mcg/kg

A

10 mcg/kg

43
Q

What is the paediatric amiodarone cardiac arrest dose? mg/kg

A

5 mg/kg

44
Q

What is the intralipid bolus dose in ml/kg?

A

1.5ml/kg

45
Q

Which medication can be given to reduce metabolic acidosis in malignant hyperthermia?

A

Sodium Bicarbonate

Insulin - acrapid

Calcium Choride

46
Q

Which blood test is used to confirm anaphylaxis after the incident?

A

Tryptase

47
Q

When should tryptase be taken after an anaphylaxis event?

A - Immediately and after 24 hours

B- 1 hour, 4 hours and 24 hours

C - Immediately, 2 hours and 6 hours

D - When I can be bothered doing a blood gas

A

B

48
Q

MTP box 1 contains what?

A) 4 RBC, 4 FFP

B) 2 RBC, 2 FFP

C) 4 RBC, 4 FFP, 3 Cryo

D) 4 RBC, 4 FFP, 1 Platelets

A

B

49
Q

MTP box 2 contains what?

A - 4 RBC, 4 FFP, 3 Cryo

B - 2 RBC, 2 FFP

C - 4 RBC, 4 FFP, 1 Platelets

D - 4 RBC, 4 FFP

A

A

50
Q

MTP box 3 contains what?

A 2 RBC, 2 FFP

B 4 RBC, 4 FFP, 1 Platelets

C 4 RBC, 4 FFP, 3 Cryo

D 4 RBC, 4 FFP, 1 Cryo

A

B 4 RBC, 4 FFP, 1 Platelets

51
Q

Which boxes are repeated in an MTP?

A - 1 & 2

B - 3 & 4

C - 1 & 4

D - 2 & 4

A

B

52
Q

What are the 4 H’s related to an emergency?

A

Hypovolemia,

Hypoglycaemia/Hyperkalaemia,

Hypo/Hyperthermia,

Hypoxia

53
Q

What are the 4 T’s related to an emergency?

A

Tension pneumothorax,

Tamponade,

Thrombosis,

Toxins

54
Q

What does MAC stand for?

A

Minimum alveolar concentration

55
Q

Five common causes of anaphylaxis?

A

Latex

Colloid

Antibiotics

Muscle relaxant

Chlorhexidine

Patient blue

sugamadex -[likelihood appears to be dose-related]

56
Q

What are 5 symptoms of anaphylaxis?

A

Difficult/noisy breathing

Wheeze/Persistent cough

Swelling of the face and tongue

Swelling/tightness in the throat

Difficulty talking

Persistent dizziness/ loss of consciousness

Abdominal pain and vomiting

Hives, welt and body redness/rash

Hypotension

Tachycardia

57
Q

What are the signs and symptoms of Local Anaesthetic Toxicity?

A

Tingling on the lips and fingers, metallic taste, ringing in the ears, confusion, and dizziness

Convulsions and loss of consciousness

Hypotension, bradycardia, and respiratory arrest

58
Q

What are the early signs and symaptoms of Malignant hyperthermia?

A

Prolonged muscle spasm after Suxamethonium

Tachycardia

Tachypnoea in a spontaneous breathing patient

Increased CO2

Cardiac arrhythmias

59
Q

What are the Developing Signs and Symptoms of Malignant hyperthermia?

A

Rapid increase in temperature (0.5 degrees every 15 minutes)

Respiratory and metabolic acidosis

Hyperkalaemia

Profuse sweating

Decrease SpO2

Mottled skin

Cardiac instability

Muscular rigidity

60
Q

What does TACO stand for and what is it?

A

Transfusion Associated Circulatory Overload

Pulmonary oedema primarily caused by volume excess

Symptoms = acute respiratory distress, cough, pink sputum, decreased SpO2, nausea, pulmonary oedema, raised CVP.

61
Q

What does TRALI stand for and what is it?

A

Transfusion Related Acute Lung Injury

Repaid onset of excess fluid in the lungs.

Symptoms = acute respiratory distress, fever, bilateral infiltrates on chest

62
Q

What is Acute Haemolytic Transfusion Reaction

AHTR

A

A life-threatening reaction to receiving a blood transfusion that results from the rapid destruction of donor red blood cells by host antibodies (Can be delayed)

63
Q

ESBL

A

Extended Spectrum Beta-Lactamase

64
Q

HELLP

A

Haemolysis Elevated Liver Enzyme and Low Platelets

65
Q

MRSA

A

Methicillin Resistant Staphylococcus Aureus

66
Q

What is the triad of anaesthesia

A

Amnesia

Analgesia

Muscle relaxation

67
Q

What are some examples of colloid substances?

A

RBC

Albumin

FFP

68
Q

Name some crystalloid fluids

A

Heartmans

Sodium Chloride

Plasmalyte

Dextrose saline

manitol

69
Q

Do crystalloids have high or low cell permeability?

A

High

70
Q

Do colloids have high or low cell permeability

A

Low

71
Q

What temperature is FFP stored at?

A

-30’C

72
Q

What temperature is RBC stored at?

A

2- 6’C

73
Q

What are the signs and symptoms of a blood transfusion reaction?

A

Increased temperature

Hypotension

Tachycardia

Anaphylaxis

Elevated ventilation pressure

74
Q

List fractionated blood products available;

A

Plasma

Cryoprecipitate

Platelets

Immunoglobins

Albumin

Irradiated and leuko depleted red blood cells

75
Q

What are leukocytes and what is their main purpose?

A

White blood cells

Main immune system cell

76
Q

Name a depolarising muscle relaxant;

A

Suxamethonium

77
Q

Name non-depolarising muscle relaxants;

A

Rocuronium

Vecuronium

Atricurium

78
Q

What are the 5 R’s of drug administration?

A

Right drug

Right patient

Right dose

Right route

Right time

79
Q

What are some induction agents?

A

Propofol

Thiopentone

Etomidate

80
Q

What medications can provide analgesia?

A

Fentanyl

Alfentanil

Remifentanil

Morphine

Paracetamol

Parecoxib

81
Q

What are some antiemetics?

A

Ondansetron

Dexamethasone

82
Q

Define a half-life regarding medications;

A

It is the time taken for half of the drug to be broken down by biological processing

83
Q

Define agonist;

A

Is a chemical that binds to a receptor on a cell to cause activation thus causing a response

84
Q

Define antagonist;

A

A chemical substance that binds to and blocks the activation of receptors on cells preventing a biological response

85
Q

Define toxicity;

A

Chemicals or drug concentrations are at such high levels in the body that they can damage organs and tissues

86
Q

Define bioavailability;

A

The rate and extent to which the rate a drug is absorbed and reaches circulation

IV administration has a bioavilability of 100%

87
Q

What items can contain chlorhexidine in operating theatres?

A

Skin antiseptic wipes

Hand gels and hand wash solutions

Surgical skin disinfectants

Pre-surgery wash sponges and wipes

Lubricant preparations

Central venous lines

Surgical dressings and mesh

Mouth wash

88
Q

Outline the guidelines for fluid maintenance relating to body weight in paediatric anaesthesia;

A

0-10kg = 4ml/kg/hr

10-20kg = 2ml/kg/hr

> 20kg = 1ml/kg/hr

4-2-1 rule

89
Q

Do children require higher weight-adjusted doses of most medications compared to adults?

A

Yes

Children have higher rates of metabolism and elimination than adults which means they require a higher weight-adjusted dose of medication

90
Q

Define pharmacodynamics;

A

The study of the molecular, biochemical and physiologic effects and actions on the body

91
Q

Define pharmacokinetics;

A

The study of how the body interacts with administered substances for the entire duration of exposure

92
Q

Discuss 3rd spacing in relation to fluid shifts during a major laparotomy;

A

3rd spacing describes the movement of bodily fluid from the blood into the spaces between the cells

This can lead to problems such as oedema, reduced cardiac output and hypotension

3rd space fluid shifts are calculated as 4-6ml/kg/hr which can be compensated with fluids

93
Q

What muscle relaxant produces a rise in ICP and is commonly avoided for neurosurgical patients?

A

Suxamethonium

94
Q

What are 3 contraindications for suxamethonium

A

Neurosurgery due to increase in intracranial pressure is not ideal

Muscular disorders

MH history

95
Q

What are the side effects of suxamethonium?

A

Bradycardia

Hypotension

Increased intracranial / Intraocular pressure

MH

Post operative muscle pain

96
Q

why should GTN spray be available in an obstetric theatre?

A

GTN is a smooth muscle relaxant and vasodilator

97
Q

What medication is commonly given for preeclampsia?

A

Magnesium sulfate

98
Q

why is oxytocin given in an obstetric case and what is the infusion dose?

A

Oxytocin prevents excessive postpartum bleeding by helping the uterus contract.

The medication works immediately when given IV

40IU Oxytocin in a 500 ml saline bag running at 125 ml/hr for 4 hours

99
Q

List two drugs used for gastric emptying;

A

Ranitdine

Metoclopromide

sodium Citrate

100
Q

What type of rhythm, and what dose and when during the CPR is amiodarone given?

A

VF / VT - 300mg IV after 3rd cycle

NZATS Registration Exam study flash cards (8 decks)

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