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Surgery…good Lord when will it stop! > Pharmacotherapeutics (38-43) > Flashcards

Pharmacotherapeutics (38-43) Flashcards

1
Q

Most common fluid used within 48hrs post surgery

A

LR

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2
Q

Good fluid for post resuscitation.

A

D5 1/2 NS

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3
Q

Used commonly with hypovolemic hypernatremia.

A

1/2 NS

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4
Q

The only fluid to be used with administration of blood products.

A

NS

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5
Q

With acute and massive hemorrhage, give this colloid

A

Whole blood

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6
Q

What is commonly give to raise hematocrit in chronic or acute bleeding, anemia, trauma, or an aortic dissection?

A

Packed RBC’s

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7
Q

What are the 5 primary effects of general anesthesia?

A

Unconsciousness, amnesia, analgesia, inhibition of autonomic reflexes, and skeletal muscle relaxation

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8
Q

T/F General anesthesia is usually a combination of inhaled and IV medications

A

TRUE

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9
Q

Which is not a risk factor for general anesthesia? A) Smoking B) Sleep apnea C) Obesity D)HTN E) Sexiness

A

E) Sexiness. Nothing about being sexy makes you at increased risk during general anesthesia…oh wait…I take that back…all of them are risk factors;)

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10
Q

T/F N/V is not common with general anesthesia.

A

FALSE. 20-30% That’s why you are allowed to eat anything pre-op

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11
Q

A Bier block is a form of what?

A

Regional anesthesia

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12
Q

What is a bier block used for?

A

Short operative procedures on extremities

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13
Q

T/F A spinal is faster to take affect than an epidural

A

TRUE

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14
Q

What S/E is really common, especially in women, after spinal anesthesia?

A

HA

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15
Q

T/F A spinal offers longer pain control than an epidural.

A

FALSE. Spinal = Faster, Epidural = Longer

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16
Q

What happens if you inject epinephrine into someones blood stream accidentally during a local anesthesia attempt by a rookie?

A

Sympathetic response…it’s effing epi people!!!

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17
Q

What’s one thing to look out for when doing local anesthesia?

A

Unintentionally injecting into a vessel and causing cardiovascular issues and/or CNS problems (seizure)

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18
Q

When might topical anesthetics cause systemic issues?

A

If it’s used on broken skin or mucus membranes

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19
Q

Most common PCA medication used.

A

Morphine

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20
Q

How much does morphine is usually infused in a PCA when the button is pressed? How long until it can be pressed again?

A

1-3mg. 6-8min

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21
Q

The MOA of local anesthetics

A

Blocking sodium channels making it harder for nerve cells to reach action potential…LESS FIRING = LESS PAIN

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22
Q

T/F Using local with epi is good because it causes the anesthesia to wear off faster

A

FALSE. It causes vasoconstriction in the area and making the anesthesia take longer to wear off.

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23
Q

What do you ALWAYS want to do with the syringe prior to injecting with local anesthetic?

A

Aspirate to ensure you are not in a vessel!!!

24
Q

The highest potency and longest lasting local anesthetic

A

Bupivacaine

25
Q

Rapid onset medium duration local anesthetic

A

Lidocaine

26
Q

Rapid onset short duration local anesthetic

A

Chloroprocaine

27
Q

Moderate onset medium duration local anesthetic

A

Mepivacaine

28
Q

Slow onset local anesthetic

A

Bupivacaine

29
Q

You should use this local anesthetic with caution in myasthenia gravis

A

Chloroprocaine

30
Q

You should NOT use this local anesthetic during labor or obstetrical events

A

Mepivacaine

31
Q

This local anesthetic has cardiotoxicity potential

A

Bupivacaine

32
Q

A combo drug using _____ and _____ is used as a topical cream to numb skin prior to venipuncture, LP, lido injection, minor burn procedures, or vaccinations.

A

Lidocaine/prilocaine

33
Q

What might be an adverse effect associated with lidocaine/prilocaine cream use?

A

Methemoglobinemia (whatever the eff that is). Something to do with hemoglobin that can’t carry O2 or something.

34
Q

Most common adverse reaction to morphine

A

Constipation

35
Q

T/F Morphine is a pure opiate

A

TRUE

36
Q

Brand name for hydromorphone

A

Dilaudid

37
Q

What is hydromorphone

A

Morphine and codeine

38
Q

Hydromorphone is ____x more potent than morphine

A

5x

39
Q

T/F You should NOT use hydromorphone with MAOI’s

A

TRUE

40
Q

Tylenol with codeine is (more/less) potent than morphine

A

Less

41
Q

Tylenol with codeine is used for mild to moderate pain and is effective against what other symptom?

A

Cough

42
Q

Hydrocodone has a similar potency to what other drug?

A

Morphine

43
Q

What OTC medication would you want a person to discontinue taking with many of the opioid analgesics?

A

Acetaminophen as many of them contain it.

44
Q

Brand name of hydrocodone.

A

Vicodin

45
Q

Brand name for oxycodone

A

Percodan/percocet

46
Q

Percocet consists of what two drugs?

A

Oxycodone and acetaminophen

47
Q

What will happen if you crush sustained release tablets of oxycodone?

A

OD and death

48
Q

Meperidine’s brand name is?

A

Demerol

49
Q

Meperidine is not recommended for long term pain care, why?

A

Due to its active metabolite toxic metabolites, normeperidine, which has neurotoxic properties

50
Q

You should not take meperidine within ____ days of taking an MAOI

A

14

51
Q

A pt has all the symptoms of a negative response to opioids plus anxiety, tremors, muscle twitches, and anticholinergic effects.

A

Meperidine use

52
Q

Oh no…his pupils are HUGE! But you’re sure he took some opioids and not a benzo. What might he have taken?

A

Meperidine

53
Q

This drug is good and very commonly used for chronic pain

A

Methadone

54
Q

What opioid commonly used can cause Torsades as well as other ventricular cardiac arrhythmia’s

A

Methadone

55
Q

One advantage to this opioid mediation in acute pain is the rapid onset and short duration of action making it good for the evaluation of pts pain level more often.

A

Fentanyl

56
Q

This opiate is 100x more potent than morphine.

A

Fentanyl

57
Q

Contraindications to topical anesthetics are…

A

Allergy to medication.

Surgery…good Lord when will it stop! (4 decks)

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