Pharmacy Exam Possible Questions Flashcards
how would you treat chest wall rigidity caused by a large dose of opioid that was rapidly administered?
give a NMB or an opioid antagonist
what to give for sphincter of oddi spasm?
- naloxone relieves pain caused by opioid induced biliary spasm but not MI
- Glucagon 1-2 mg IM or IV reduces opioid induced biliary spasm, does NOT antagonize the opioid effect
- NTG will relieve pain due to biliary spasm or MI
- Equal analgesic doses of fentanyl, MS, Demerol increase common bile duct pressure 99, 53, 61 % above pre drug levels respectively
drugs ok to use in open angle glaucoma
phenylephrine
epinephrine
what to give for asthma acute
Oxygen SaO2 + 95%
inhaled beta agonist albuterol 2-3 puffs q 15-0 min up to 3-4 doses
IV steriods: cortisol 2 mg/kg GTT 0.5 mg/kg/hr or methylprednisolone 60-125 IV q 6 hr
anticholinergics block muscarinic receptors in airway smooth muscle
ipatropium (atrovent) MDI (atropine derivative)
ephedrine/bronchospasm beta 2 effects 20 mg IV
epinephrine 1:1000 bronchospasm 0.1-0.5
(ketamine, sevo, propofol, lidocaine)
what to give for pheo in correct order
- Alpha adrenergic antagonist- phenoxybenzamine 10-20 mg PO BID non competitive agonist with irreversible alkylation of alpha receptors
- phentolamine: acute HTN emergencies that occur with pheochromocytoma manipulation 30-70 mcg/kg (5-20 mg) produces transient decrease in BP may need a continuous infusion
- Propranolol: beta blocker too in light of persistent tachycardia or cardiac dysrythmias in the presence of alpha blockade 40 mg PO BID
what not to give in Parkinson’s
Droperidol
Reglan
Promethazine
(these are all dopamine antagonists)
Histamine Release
SAM
Succynocholine
Atricurium
Mevicurium
Anticholinergic that causes sedtaion
Scopalamine
Non sedating anticholinergic
glycopyrolate
does not cross BBB
Anticholinergic that causes tackycardia
Atropine
scopolamine and glycopyrolate have minimal cardiac effect
What to give in a BB overdose?
Atropine Isoproterenol Dobutamine Glucagon Calcium Chloride Epinephrine Pace Transvenous
dose and ME in BB overdose: atropine
7 mcg/kg
vagolytic ie increases HR
dose and ME in BB overdose: isoproterenol
2-25 mcg/min IV
pure beta agonist + inotrope/chronotrope
dose and ME in BB overdose: Dobutamine
If OD was by selective B1 BB
pure beta agonist increase HR
dose and ME in BB overdose: Glucagon
1-10 mg IV followed by 5 mg/hr IV
(increases cAMP in cardiac cells, high doses = inotrope/chronotrope
dose and ME in BB overdose: calcium chloride
250-1000 mg IV (5-10 mg/kg)
dose and ME in BB overdose: Epi
2-10 mcg/min
Beta non selective agonist
If you do not have Neo/Glyco and about to extubate what could you use instead?
0/5 mg/kg Edrophonium and 7 mcg/kg Atropine
what s/e will you see if using Edrophonium/Atropine for reversal?
Delayed tackycardia
what are the clinical signs of methemoglobinemia?
Central Cyanosis
persistent Sa02 in the 80s
hypotension
what is the treatment for methemoglobinemia?
Methylene Blue: 1-2 mg/kg over 5 min
what is the max dose of methylene blue?
7-8 mg/kg
What drugs can cause methemoglobinemia?
Benzocaine prilocaine Nitrates/nitrites/napthalene Sulfonamides Dapsone Chlorates Aniline Aminophenones Nitrobenzene Phenazopyridine
What is the pH of thiopental?
pH >10 in solution to preserve it.
alkaline barbituate
What do you mix thiopental with and how much?
normal saline or sterile H20
20mg/ml stable for 24 hours
what can you not mix with thiopental?
basic drugs: it NMB- precipitate in tubing
what is the pH of barbiturates?
ACiDIC
Do acids or bases bind to albumin?
Acids bind to albumin (acid)
Do acids or bases bind to alpha- proteins?
Bases bind to alpha proteins (base)
what drugs keeps the PDA open?
endomethicin
what is the shortest acting local anesthetic?
chloroprocaine
What do you use 0.25% lidocaine for?
lower extremity (100-120 cc) Baer Block
What do you use 1-2% lidocaine for?
Antiarrythmic
Brachial plexus block (30-50cc)
what do you use 0.5% lidocaine for?
Upper Extremity block (40-50cc) Baer Block
what do you use 4 % lidocaine for
Transtracheal
how much epinephrine is in a concentration of 1:200?
5 mcg/cc
how much epinephrine is in a concentration of 1:200,000
5000 mcg/cc
