Quiz Flashcards
Rasburicase MOA
Recombinant urate oxidase that converts urate to inactive and solutble allantoin
Use of NSAIDs in acute gouty arthritis
Effective when used within 24 hours of symptom onset
Used in high doses for 3-4 days, then tapered for 7-10 days
Indomethacin, sulindac and naproxen FDA approved
ASA contraindicated
Etanercept and infliximab shared properties
- bind to TNF
- infliximab always combined with MTX; etanercept usually given with MTX
- side effects and precautions generally similar
Etanercept properties
- one of the first anti-TNF drugs
- soluble p75 subunit of human TNF receptor used as drug
- etanercept is a recombinant protein with 2 p75 receptors linked to Fc domain of IgG1
- binds to and prevents TNF from binding to cellular receptors
- inhibits all steps toward inflammation that are downstream of TNF
Hydroxychloroquine side effects
- possible retinal damage
- drug accumulates in melanin-containing tissues like the eye
Ester type hypersensitivity (anesthetics)
- loacl anestetic amino ester: procaine, tetracaine, cocaine, benzocaine
- formation of benzoic acid, PABA, methyl paraben (preservative) —> allergic dermatitis, asthma, anaphylaxis
Effect of tissues pH on anesthetic potency
- inhalation anesthetics: potency roughly correlates with oil:water partition —> no longer accepted theory
- no strict correlation between lipophilicity and potency
Dantrolene side effect and SOA
- direct muscle acting
- muscle weakness and fatigue
- binds to ryanodine receptors in SR to decrease Ca release
- acts on fast muscle fibers to block contraction
- no effect on smooth or cardiac muscles
- drowsiness and sedation
- hepatotoxicity BBW
- Hypotonia
- Muscle weakness
- Photosensitivity
Muscle relaxants with addition and dependence risk
- cyclobenazeprine
- methocarbamol
- diazepam
Baclofen MOA and administration
- GABA mimetic
- agonist at GABA-B receptors in brain and spinal cord
- presynpatic suppression of glutamate release
- postsynaptic activation of K channels to hyperpolarize neuron
- reduces substance P release from nocieptic afferent nerve terminal
- intrathecal: pump implanted
- oral
Etomidate advantage in patients with CV disease
Minimal CV and respiratory effects
Inhalation anesthetic potency and MAC
- potency defined by the minimal alveolar concentration
- 1 MAC = alveolar partial pressure that prevents movement in 50% (ED50) of adult patients in response to painful stimulats
- 1.3 MAC is ED 95; usually administered during surgery
Inhalation anesthetic partial pressure meaning
- inhaled concentration is expressed as partial pressure (% of total atmospheric pressure)
Sevoflurane advantage least pungent
- very low pungency: useful for induction of pediatric patients
- rapid induction and recovery
- good CV profile
Advantage of propofol vs etomidate
- propofol can be a post-op anti-emetic for patients with N/V after surgery
- etomidate can be used in patients with hypotension
