Pharmacology Info Flashcards by Luke Chandler

Morphine

Opioid
Onset: 15-30 minutes
Duration: 3-6 hours
Depression of ventilation (ALL OPIOIDS)
PONV (post op nausea and vomiting)
Itching (pruritis)

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Fentanyl

Synthetic Opioid
Peak effect 3-5 minutes
Duration 30-60 minutes
100 x more potent than morphine
Synergism with midazolam

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Meperidine (Demerol)

Synthetic opioid
For Post-op shivering
Neurotoxic
Renal disease (metabolized by kidney)

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Hydromorphone (Dilaudid)

Semi-synthetic
Onset: 5 minutes
Duration: Greater than 5 hours

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Naloxone (Narcan)

Opioid antagonists
For Overdose of opioids, respiratory depression
N/V, pain, tachycardia, increased SNS

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Ketorolac (Toradol)

Same category as ibuprofen (NSAID)

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Propofol (Diprivan)

Onset time 30-60 seconds
Duration of action 5-10 minutes
Induction, Sedation, MAC 
Bacterial growth
Soy or egg allergy
Hypotension
BURNS on injection

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Etomidate (Amidate)

Induction/hypnosis
Onset time 30-60 seconds
Duration of action 5-10 minutes
Pain on injection
Myoclonus
PONV

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Ketamine (Ketalar)

Induction, analgesia, amnesia
Onset time 30-60 seconds
Duration of action 5-10 minutes
Emergence delirium

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Lidocaine

Amide

local anesthesia, cough, inhalation, cardiac arrythmias

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Succinylcholine (Anectine)

Depolarizing NMBD
Intubation, Paralysis, Laryngospasm
Onset: 30 seconds
Duration of Action: 3-5 minutes
Fasiculations (rocuronium will prevent (5-10mg))
Metabolism: Plasma cholinesterase
Malignant Hyperthermia

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Midazolam (Versed)

Class: Benzodiazepine
ANTEROGRADE AMNESIA
Hepatic disease (metabolized by liver)
Elderly
Synergy with narcotics

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Rocuronium (Zemuron)

Class: Aminosteroid, non-depolarizing
Oneset: 1-2 minutes (can be as short as 30 seconds)
Duration: 20-35 minutes
Metabolized: Liver and kidneys

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Vecuronium (Norcuron)

Class: Aminosteroid, non-depolarizing
Onset: 3-5 minutes
Duration: 20-35 minutes
Metabolism: Liver and kidneys

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Cisatracurium (Nimbex)

Class: Benzyl isoquinolinium,non-depolarizing
Onset: 3-5 minutes
Duration: 20-35 minutes
GOOD FOR RENAL/HEPATIC DYSFUNCTION

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Neostigmine

Class: Anticholinesterase
Causes BLUDS
Only Non-Depolarizers are reversed by neostigmine
inhibits the breakdown of acetlycholine

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Glycopyrrolate (Robinul)

Class: Anticholinergic
Use: Antisialigogue, NMB reversal
Used with neostigmine because of similar onset and duration times
Can also be used to increase heart rate (0.2 mg)

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Atropine

Class: Anticholinergic
Use: Bradycardia, NMB reversal

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Sugammadex (BRIDION)

Rapid reversal of rocuronium and vecuronium,
even from profound neuromuscular blockade
Sugammadex actually binds to rocuronium, blocking it from binding to receptors

Isoflurane

Very Stable
Highly Potent
A/W irritant
Min Metabolism-0.2%
CV Changes minimal

Deflurane

Pungent, A/W irritant
Carbon Monoxide formation
easily titratable

Sevoflurane

Least A/W irritant
Metabolized 2-5%
Creates Compound A

Nitrous Oxide

Sweet Smelling
Highly insoluble
Decrease MAC, Increases PONV
Analgesic

Epinephrine (adrenaline)

Class: Catecholamine
Use: Increase HR/BP, treat Anaphylaxis and bronchospasm

Ephedrine

Synthetic non-catecholamine Direct and indirect action Causes Tachyphylaxis and Depletion of Norepinephrine

Phenylephrine

Synthetic non-catecholamine Direct acting Use: Increases BP, Nasal decongestant Causes Increased afterload and reflex Bradycardia

Esmolol (Brevibloc)

``` Class- Cardioselective Beta blocker Decrease HR, Contractility, BP Onset: 5 minutes Duration 10-30minutes Metabolism: Plasma cholinesterases ```

Metoprolol (Lopressor)

``` Class: Beta-blocker Use: Decrease HR Supplied: 5 mg (1 mg/mL) Dose: 1-2 mg Duration can be in hours not minutes ```

Labetalol (normodyne)

Class: Mixed antagonist α1, β1, β2 Use: Control HR and BP Can decrease BP through beta effects on the heart but also through vascular dilation by alpha receptors Ashtma---B2 antagonist can cause broncho CONTRSTICTION

Nitroglycerin

Class: Hypotensive agent Use: Angina, HTN Principally Venous Dilator Decreases Ventricular Wall Tension

Hydralazine

``` Class: Hypotensive agent Use: HTN Onset: 20 minutes Duration: 6-8 hours Principal Arterial Dilator ```

Ondansetron (Zofran)

Class: Serotonin receptor antagonist Use: Antiemetic Decreased PONV in susceptible patients

Droperidol

Antiemetic | Can cause EKG changes due to blockade of alpha adrenoreceptors

Cefazolin (Ancef)

MUST be given within 60 minutes of skin incision. Redosed every 2-6 hours (institution dependent) This will be the most frequently encountered intraoperative antibiotic Cephalosporin antibiotic Derivative of penicillin

Cefoxitin

``` Another cephalosporin More gram negative coverage specific to GI flora 2g IV within 60 minutes Redose 2-6 hours (institution dependent) Again…beware of penicillin allergy ```

Ampicillin

Subacute bacterial endocarditis prophylaxis (SBE) | Mechanical heart valves, congenital heart disease

Gentamicin

Used often with ampicillin for SBE Common in urology cases See caution slide

Levaquin

Often used for additional gram negative coverage Abdominal cases, ENT involving the mouth Usually 500mg dose

Nafcillin (pcn cross reactive)

Often used for neuro cases | 2g q 2h

Clindamycin

Usually first choice for PCN allergy to avoid overuse of vancomycin Redose every 6 hours (often see abbreviation q6h)

Vancomycin

Increases risk of VRE (vancomycin resistant enterococci) Used as broad spectrum treatment against over hospital acquired infections due to drug resistant bacteria Cautions (see next slide)

Famotidine (Pepcid)

Dose: 20mg Relief of heartburn, acid indigestion, and sour stomach Treatment for gastric and duodenal ulcers

Heparin

Widely used injectable blood thinner | 80 units/kg IV bolus, THEN continuous infusion of 18 units/kg/hr

Metaclopramide (Reglan)

10 mg GI prokinetic GIVE SLOWLY (Can make you CRAZY)

Remifentanil

1 mcg/kg A potent, short-acting synthetic opioid analgesic drug Quick onset, quick recovery