Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ADVANCED PHARM TEST 2 > Things I cant remember for Pharm Test 2 > Flashcards

Things I cant remember for Pharm Test 2 Flashcards

1
Q

Opioid Withdrawal

Meperidine:
Onset-
Peak intensity
-DOA

A

Onset: 2-6 hrs
Peak intensity: 6-12 hrs
DOA: 4-5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Fentanyl Opioid withdraw

Onset:
Peak intensity:
Duration

A

Onset: 2-6hrs
Peak: 6-12 hrs
DOA: 4-5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Morphine Opioid withdrawal

Onset:
Peak:
DOA:

A

Onset: 6-18 hrs
Peak: 36-72 hrs
DOA: 7-10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Heroin Opioid Withdraw

Onset:
Peak:
DOA:

A

Onset: 6-18 hrs
Peak: 36-72 hrs
DOA: 7-10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Methadone Opioid Withdraw

Onset:
Peak:
DOA:

A

Onset: 24-48 hrs
Peak: 3-21 days
DOA: 6-7 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Morphine:

Intraop dose:
Post-op dose:

Onset:
DOA:
Bioavailability:

A

Intra: 1-10 mg
Post-op: 5-20 mg

Onset: 10-20 mins
DOA: 4-5 hrs

PO 1st pass - 25% is metabolized, so bioavailability = 75%.

Rapid accumulation in kidneys, liver, skel muscles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Fentanyl:

Intra op:
Onset:
DOA:
Equilibrium at: ____

Increase ICP by:

Fent ___ mcg/kg before 25-50 mins to decrease MAC iso/des by ___%.

1 mg PO fent = ___ mg IV morphine

A

Intra op: 1.5-3mcg/kg
Onset: 30-60 seconds
DOA: 1-1.5 hrs
Equlibrium: 6.4 mins

Increase ICP by 6-9 mmHg

3mcg/kg to decrease MAC iso/des by 50%

1 mg PO= 5 mg IV morphine

LARGEST VD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Sufentanil

Intra-op dose:
Analgesia dose:
Induction dose:
Onset:
DOA:

S/E: (2)

Brady, chest rigidity

A

Intra-op: 0.3-1mcg/kg

Analgesia: 0.1-0.4 mcg/kg

Induction: 18.9 mcg/kg

Onset: 30-60 seconds
DOA: 1-1.5hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Alfentanil

Induction Laryngoscopy:
Induction (alone):
Maintainence:
Onset:

Highest protein binding?
Lowest clearance?

A

Larygosocopy: 15-30 mcg/kg

Induction alone: 150-300 mcg/kg IV

Maintenance: 25-150 mcg/kg/hr (with inhaled anesthestics)

Onset: 1.4 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Meperidine

Dose:
Onset:
DOA:
E1/2:

Toxicity/S/e:

Similar to: (2)

A

Dose: 12.5mg
Onset: 5-12 mins
DOA: 2-4 hrs
E1/2: 3-5 hrs

Tox: delirum, halluciate, myoclonus, seizure

S/e:
Tachycardia, (-) inotrope, serotonin syndrome, impaired vent

Similar to: atropine, lidocaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hydropmorphone (dilaudid)

Intra-op dose:
Post op dose:
Onset:
DOA

A

Intra-op dose: 1-4mg
Post-op dose: 1.5-4 mg

Onset: 5-15 mins
DOA: 2-4 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Remifentanil:

Induction:
Maintain:
Infusion: ???!!!

Onset:
DOA:
E1/2:

No hepatic metabolism

S/E:
<3, neuro…, pain

A

Induction: 0.5-1 mcg/kg over 1 min

Maintain:
0.25-1mg/kg IV

Infusion: 0.125-0.375 mcg/kg/min

Onset: 30-60 seconds (FAST PEAK!)
DOA: 6-8 mins
E1/2: 6.3 mins

-Depressed cardiac + seizure like activity
-hyperanalgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Naloxone

Intra-op
Post-op

Dose:
Cont infusion:
Shock:
Epidural:

Onset: ????
DOA:
E 1/2:
Metabolism:??? how much left???
S/E:

A

Intraop: 40-80 mcg
Postop: 40-80 mcg

Dose: 1-4 mcg/kg
Cont infusion: 5 mcg/kg
Shock: >1 mcg/kt
Epidural: 0.25 mcg/kg

S/E: Reverse anesthesia/ N/V

Onset: 1-5 mins
DOA: 30-45 mins
E1/2: 60-90 mins
Metab: Glucuronic Acid -> 1/5 PO dose left :(

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Nalmefene:
- Dose 1 and 2
E1/2:

USES:
Naltrexone:
Methylnatrexone
Alvimopan

A

Nalmefene:
-Dose=
15-25 mcg q2-5 mins :D
then 1mg/kg
E1/2: 10.8hrs

Naltrexone: Alcoholism (24 hrs)

Methylnatrexone: N/V, post op gastric emptying

Alvimopan: Post-op ileus… but long term= CV issues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Nalmefene:
- Dose/ E1/2:

USES:
Naltrexone:
Methylnatrexone
Alvimopan

A

Nalmefene:
-Dose=
15-25 mcg q2-5 mins :D
then 1mg/kg
E1/2: 10.8hrs

Naltrexone: Alcoholism (24 hrs)

Methylnatrexone: N/V, post op gastric emptying

Alvimopan: Post-op ileus… but long term= CV issues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Suboxone:
Embeda:
OxyNal:

A

Suboxone:
= Buprenorphine+ Naloxone

Embeda:
= ER morphine + Naltrexone

OxyNal:
=Oxycodone +Naltrexone

16
Q

Drugs decrease MAC by: ___
Sufentanil:
Alfentanil:
Remifentanyl:

MAC % for Volitiles:
Isoflurane:
Sevoflurane:
Desflurane:

Fentanyl 3mcg/kg IV by 30 mins before incision = decrease MAC of ISO/DESO by ____%

A

Sufentanil:
- with enflurance by 70-90%

Alfentanil: up to 70%

Remifentanyl: 50-91%

MAC % for Volitiles:
Isoflurane: 1.2%
Sevoflurane: 2%
Desflurane: 6%

Fent 3mcg = decrease MAC iso/des by 50%

17
Q

PCA Doses:

Morphine:
Dilaudid:
Fentanyl:

A

Morphine: 1-2 mg
Dilaudid: 0.2-0.4
Fent: 20-50 mcg

18
Q

Neuraxial Opioid

Give ___x more epidural dose

Lipophilic/lipophoic? + Peak times?
Fentanyl
Sufentanil
Morphine

A

Lipophilic/lipophoic?
-Fentanyl - lipophilic
-Sufentanil - lipophilic
-Morphine- more hydrophilic

Fent 800x> Morphine
Peak: 20 mins

Sufentanil 1600x> Morphine
Peak: 6 mins

19
Q

Neuraxial Opioid S/E;

Resp:
Urine:
CNS:
Pruritius tx:

OK TO BREAST FEED :D

A

Resp: depressed ventilation LOC + hypercapnia –> Give naloxone 0.25 mcg/kg

Urine Retention: more males

Pruritus: cephalic migration to trigeminal nucleus
–>Give Naloxone, anti-histamine, gabapentin, 10mg/1ml Prop?

CNS:
-Sedation
-CNS excite: Tonic skeletal muscle rigidity

Herpes reactivation 2-5 days

20
Q

TEAM MODEL DRUGS

Pre-op
-Tylenol:
-Gabapentin:

Intra-op
-Magnesium:
-Lidocaine:
-Ketorolac:
-Decadron:
-Zofran:
-Ibuprofen IV:

Post Op 1 week
-IV Tylenol
-SUPER- MAG:
-Gabapentin:
-Celebrex/Advil:

Note:
Magnesium:
-Pre-op/ LOADING: 30-50mg/kg IV
-Intra-op continue:8-10mg/kg/hr

A

Pre-op
-Tylenol: 1000mg PO/IV
-Gabapentin: 300-1200mg

Intra-op
-Magnesium: 8mg/kg
–> 30-60 mg/kg (max 6g?) over 1 hr

-Lidocaine: 1mg/kg
-Ketorolac: 15-30 (max 60-120)
-Decadron:8-10mg
-Zofran: 4-8mg
-Ibuprofen IV: 200-800 IV over 30 mins (3200 max)

Post Op 1 week
-IV Tylenol: 1000mg TID
-SUPER- MAG: 400 mg BID
-Gabapentin: 300 mg TID
-Celebrex/Advil: (if permitted)

21
Q

Fentanyl
Sufentanil
Morphine

CSF peak:
Plasma Peak:
Cervical level:

A

Fent:
-CSF: 20 mins
-Plasma: 5-10 mins
-Cervical: minimal

Sufentanil:
-CSF: 6 mins
-Plasma Peak: <5 mins
-Cervical: Minimal

Morphine:
-CSF: 1-4 hrs
-Plasma: 10-15 mins
-Cervical: 1-5 hrs

22
Q

Pentazocine:

Recepter:

IV:
IM:
PO:
E1/2:

Metabolism: ____, % left?
Naloxone work?:
L> S/E: <3,*** (2 drugs that do this effect)
neuro

A

Recepter: delta, kappa

IV: 10-20mg
IM: 20-30 mg (eq: 10 mor)
PO: 60 mg (eq: 60 codeine)
E1/2: 2-3 hrs
Metab: Glucoronide conjugation
Extensive hepatic 1st pass= 20% avail after PO

Yes Naloxone

L> ^ Heart stuff
-Dysphoria, diaphoresis, sedate, dizzy

23
Q

Butorphanol

Recepters:
Dose:—- compare to morphine
ROUTE: ????

E1/2: ??

Metab: where excreted the most?
L> S/E: <3, resp

A

Recepter: mu, delta, kappa*

Dose: 2-3mg IM =10 mor

E1/2: 2.5-3.5hrs
Metab: Bile>urine

L> ^BP,^CO
-**Depressed vent
-Dysphoria

24
Q

Nalbuphine

Recepter:
Dose:—– compare to morphine
Strength:??
E1/2: (pretty long)

Best used for: ????

A

Mu
Dose: 10 mg= 10 mor
1/4 Nalorphine strength

E1/2: 3-6 hrs

Cardiac Cath pt! Cardiac STABLE

25
Q

Buprenorphine

Recepter:
Strength:
Dose:??
Potency:…………. to morphine

Onset: ???
DOA:——–work shift? LONG
Fast/slow??

Does Naloxone work?

S/E: D:< RESP??

A

Mu
50x affinity> morphine

Analgesic potency: 0.3 mg IM= 10mg Mor

Onset: 30 mins
DOA: 8 hrs

Prolong resistence to naloxone

S/E: **decrease vent, Pul edema,
drowsy, N/V

26
Q

Potency compared to morphine
Nalorphine
Bremazocine:

Doses compared to morphine
Dezocine: **
Meptazinol:

A

Nalorphine:

Bremazocine:
2x potent> morphine. NO naloxone effective

Dezocine:
0.15mg/kg= morphine
10-15 mg IM RAPID ABSORPTION

Meptazinol:
100 mg= 8 mg morphine
(Low protein binding 25%)

27
Q

Thiopental
IV:
% non-ionized

Methohexital
IV:
Rectal:
%non-ionized:

E1/2?

BARBS:
Protein binding %:
S/E:
Cardiac, neuro, resp

A

Thiopental:
IV: 4mg/kg
% non-ionized: 61%
longer E/12

Methohexital: Seizures
IV: 1.5mg/kg
Rectal: 20-30mg/kg
% non-ionized: 76%
Faster metab/recovery

BARBS:
Protein binding 70-85%
S/E:
-Histamine
-Lack barceptor response:
-^HR, decrease BP
-* intra-arterial: lido/papa
-Cerebral vasoconstricter 55%
-*Depression of vent (dose)

28
Q

Barb Drug interactions:

Enzyme induction after ____ days:

Accelerated metab of :
(7)

A

2-7 days

(INCREASE DOSE)
Anti-coagulant
Vitamin K
Phenytoin
TCAs
Corticosteroids
Bilesalts

29
Q

Lidocaine

Type LA:

-Dose initial bolus:
-Drip Dose:
Stop at ___ hrs

Plasma levels:
1-5=
5-10=
10-15= XX
15-25=
>25=

A

Amide LA

Initial does: 1-2 mg/kg IV over 2-4 mins

Drip dose (post-op): 1-2 mg/kg/hr

Stop 12-72 hrs!

Plasma levels:
1-5= Analegsia
5-10= Muscle twitch, tinnitus, oral numb, hypo <3
10-15= Seizure/unconsious
15-25= Apnea/Coma
>25= Cardiovascular depression

30
Q

Ketamine:

Pre-incision:
Intra-op:

Stop 1 hr prior end surgery

Post-op:

A

Pre-incision: 0.25-0.5 mg/kg
Intra op: 0.25-0.5 mg/kg

Post-op:
0.12 mg/kg/hr for 24 hrs
OR
5 mg Bolus between 0.3-0.5 mg/kg/hr

ADVANCED PHARM TEST 2 (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions