Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
104 Cards in this Set
- Front
- Back
|
Carbamazepine is used for
a) ETOH withdrawal b) Partial tonic/clonic seizures c) neuralgia d) Parkinsons |
ETOH withdrawal
Partial tonic/clonic seizures neuralgia |
|
|
GABA excitatory/inhibitory
Glutamate excitatory/inhibitory |
GABA Inhibitory
Glutamate Excitatory |
|
|
CNS Depressants
a) highly protein bound b) CYP inducers/inhibitors c) increase requirement of MAC, Opioids, NDMR's, STP, Propofol d) narrow therapeutic window |
highly protein bound
CYP inducers/inhibitors increase requirement of MAC, Opioids, NDMR's, STP, Propofol narrow therapeutic window |
|
|
Carbamazepine
a) induces it's own CYP b) Na channel blocker c) causes SIADH d) causes sedation, vertigo, ataxia |
Induces it's own CYP (active metabolites)
Na channel blocker causes SIADH causes sedation, vertigo, ataxia |
|
|
PONV Risk factors (4)
|
Female
Nonsmoker Hx of PONV/motion sickness Opioids |
|
|
Key Neurotransmitters in Vomiting center
a) Substance P b) Histamine c) Serotonin d) ACh e) Dopamine |
Substance P (NK1)
Histamine (H1) Serotonin (5 HT 3) ACh (muscarinic) Dopamine (D2) |
|
|
1st signal in PONV pathway
a) GI tract via vagus nerve (serotonin) b) CNS (ACh, Histamine) c) CTZ ( serotonin, dopamine) |
CNS (ACh, Histamine)
|
|
|
2nd signal in PONV pathway
a) GI tract via vagus nerve (serotonin) b) CNS (ACh, Histamine) c) CTZ ( serotonin, dopamine) |
GI tract via vagus nerve (serotonin)
|
|
|
3rd signal in PONV pathway
a) GI tract via vagus nerve (serotonin) b) CNS (ACh, Histamine) c) CTZ ( serotonin, dopamine) |
CTZ ( serotonin, dopamine)
|
|
|
D2 antagonists
a) prochloroperazine b) dolasetron c) Promethazine d) metoclopramide |
prochloroperazine & metoclopramide
also droperidol |
|
|
Which class of PONV drugs can cause Extrapyramidal effects?
|
D2 antagonists
|
|
|
Of the following which one is the least efficacious for PONV
a) Ondansetron b) Scopolamine c) Dexamethasone d) metoclopramide |
metoclopramide
|
|
|
How does oxygen work to decrease PONV?
|
increases O2 in GI tract which increases Serotonin
|
|
|
Arrests growth & replication, limits spread allows immune system to destroy pathogens
a) Bacteriostatic b) Bactericidal |
Bacteriostatic
|
|
|
Lowest concentration that will inhibit growth
a) Minimum inhibitory concentration b) Minimum bactericidal concentration |
Minimum inhibitory concentration
|
|
|
Lowest concentration that will kill 99.9% of organisms
a) Minimum inhibitory concentration b) Minimum bactericidal concentration |
Minimum bactericidal concentration
can take up to 48 hours |
|
|
Concentration dependent drugs
a) Cillins b) Cephalosporins c) Aminoglycosides d) Carbapenems |
Aminoglycosides
Carbapenems also fluroquinolones |
|
|
Time dependent drugs
a) Cillins b) Cephalosporins c) Aminoglycosides d) Carbapenems |
Cillins
Cephalosporins (beta lactams) |
|
|
Narrow spectrum antibx
a) effective against gram + & - b) effective on single or limited # of organisms c) effective against a variety of organisms |
effective on single or limited # of organisms
|
|
|
Extended Spectrum antibx
a) effective against gram + & - b) effective on single or limited # of organisms c) effective against a variety of organisms |
effective against gram + & -
|
|
|
Carbamazepine is used for
a) ETOH withdrawal b) Partial tonic/clonic seizures c) neuralgia d) Parkinsons |
ETOH withdrawal
Partial tonic/clonic seizures neuralgia |
|
|
GABA excitatory/inhibitory
Glutamate excitatory/inhibitory |
GABA Inhibitory
Glutamate Excitatory |
|
|
CNS Depressants
a) highly protein bound b) CYP inducers/inhibitors c) increase requirement of MAC, Opioids, NDMR's, STP, Propofol d) narrow therapeutic window |
highly protein bound
CYP inducers/inhibitors increase requirement of MAC, Opioids, NDMR's, STP, Propofol narrow therapeutic window |
|
|
Carbamazepine
a) induces it's own CYP b) Na channel blocker c) causes SIADH d) causes sedation, vertigo, ataxia |
Induces it's own CYP (active metabolites)
Na channel blocker causes SIADH causes sedation, vertigo, ataxia |
|
|
Key Neurotransmitters in Vomiting center
a) Substance P b) Histamine c) Serotonin d) ACh e) Dopamine |
Substance P (NK1)
Histamine (H1) Serotonin (5 HT 3) ACh (muscarinic) Dopamine (D2) |
|
|
D2 antagonists
a) prochloroperazine b) dolasetron c) Promethazine d) metoclopramide |
prochloroperazine & metoclopramide
also droperidol |
|
|
Arrests growth & replication, limits spread allows immune system to destroy pathogens
a) Bacteriostatic b) Bactericidal |
Bacteriostatic
|
|
|
Lowest concentration that will inhibit growth
a) Minimum inhibitory concentration b) Minimum bactericidal concentration |
Minimum inhibitory concentration
|
|
|
Lowest concentration that will kill 99.9% of organisms
a) Minimum inhibitory concentration b) Minimum bactericidal concentration |
Minimum bactericidal concentration
can take up to 48 hours |
|
|
Concentration dependent drugs
a) Cillins b) Cephalosporins c) Aminoglycosides d) Carbapenems |
Aminoglycosides
Carbapenems also fluroquinolones |
|
|
Time dependent drugs
a) Cillins b) Cephalosporins c) Aminoglycosides d) Carbapenems |
Cillins
Cephalosporins (beta lactams) |
|
|
Narrow spectrum antibx
a) effective against gram + & - b) effective on single or limited # of organisms c) effective against a variety of organisms |
effective on single or limited # of organisms
|
|
|
Extended Spectrum antibx
a) effective against gram + & - b) effective on single or limited # of organisms c) effective against a variety of organisms |
effective against gram + & -
|
|
|
Broad Spectrum antibx
a) effective against gram + & - b) effective on single or limited # of organisms c) effective against a variety of organisms |
effective against a variety of organisms (including normal flora)
|
|
|
Delivery to BBB, Prostate depend on
a) lipid solubility b) molecule size c) protein binding d) all of the above |
lipid solubility
molecule size protein binding |
|
|
Prophyllactic antibx are given to
a) Bowel, GYN, ENT surgeries b) Joints, cardiovascular c) Dental proceed. in pt with prosthetic devices d) all OR cases (at least one dose) |
Bowel, GYN, ENT surgeries
Joints, cardiovascular Dental proceed. in pt with prosthetic devices |
|
|
Bowel, GYN, ENT surgeries are covered with
a) 1st generation cephalosporins b) 2nd or 3rd generation cephalosporins c) aminoglycosides |
2nd or 3rd generation cephalosporins
Cefoxitin or Ceftriaxone |
|
|
Cell Wall Synthesis Inhibitors
a) Tetracyclines b) Cillins c) Cephalosporins d) aminoglycosides |
Cillins
Cephalosporins (these are Beta Lactam antibx) Vancomycin is also a Cell Wall drug |
|
|
Protein Synthesis Inhibitors
a) Cillins b) Clindamycin c) Aminoglycosides d) Tetracylines |
Clindamycin
Aminoglycosides Tetracylines as well as Macrolides & Chloramphenicol |
|
|
Folate Synthesis Inhibitors
a) Vancomycin b) Sulfonamides c) Tetracyclines d) Cephalosporins |
Sulfonamides
as well as Trimethoprim |
|
|
What is the MOA of Isoniazid used to treat TB
a) Inhibits Synthesis of Mycolic Acid b) Blocks RNA Synthesis c) Creates Holes in cell wall d) Inhibits cell growth |
Inhibits Synthesis of Mycolic Acid
Rifampin is also used to treat but it blocks RNA synthesis |
|
|
What is MOA of amphotericin
a) Inhibits Synthesis of Mycolic Acid b) Blocks RNA Synthesis c) Creates Holes in fungal cell wall d) Inhibits cell growth |
Creates Holes in fungal cell wall
|
|
|
Describe the side effects of Amphotericin
|
Infusion fever shakes, N/V
pretreat with antipyretics, antihistamines, steroids, & demerol |
|
|
Metronidazole
a) AntiViral b) AntiProtozoal c) Herpes simplex d) Antifungal |
AntiProtozoal
|
|
|
Oseltamivir, Zanamivir, Amantidine, Rimatidine
a) HIV drugs b) AntiViral drugs c) AntiProtozoal drugs d) AntiFungal drugs |
AntiViral drugs
|
|
|
Oseltamivir, Zanamivir
a) Neuramidase Inhibitors b) Inhibitors of Viral coating c) AntiFluenza drugs |
Neuramidase Inhibitors
AntiFluenza drugs |
|
|
Amantidine, Rimatidine
a) Neuramidase Inhibitors b) Inhibitors of Viral coating c) AntiFluenza drugs |
Inhibitors of Viral coating
AntiFluenza drugs A MANtidine RIMatidine (A man's coat has a Rim) |
|
|
Acyclovir
a) Tx Herpes Simplex, Varicella Zoster b) AntiFungal c) Inhibits DNA Synthesis d) forms a "fake guanosine" |
Tx Herpes Simplex, Varicella Zoster
Inhibits DNA Synthesis forms a "fake guanosine" |
|
|
Nucleoside Reverse Transcriptase Inhibitors (NRTI)
a) Zidovudine (AZT) b) interfere with DNA Synthesis c) Prevent Assembly of Virion d) Block fusion of virus on Host membrane |
Zidovudine (AZT)
interfere with DNA Synthesis |
|
|
Protease Inhibitors
a) used in combo with other drugs b) Prevent Assembly of Virion c) Interfere with DNA Synthesis d) Enfuvirtide |
used in combo with other drugs
Prevent Assembly of Virion |
|
|
Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI)
a) Interfere with DNA Synthesis b) Prevent Assembly of Virion c) Delaviridine d) Elavirenz e) Nevirapine |
Interfere with DNA Synthesis
Delaviridine Elavirenz Nevirapine |
|
|
Viral Fusion Inhibitors
a) Prevent Assembly of Virion b) Block Fusion of virus to host membrane c) Enfuvirtide d) Elavirenz |
Block Fusion of virus to host membrane (FUsion)
Enfuvirtide (enFUviritide) |
|
|
Chronic use of Amphetamines, QAT, St. John's Wort
a) increase anesthetic requirement b) decrease anesthetic requirement c) labile BP d) decreased response with indirect vasopressors |
decrease anesthetic requirement
labile BP decreased response with indirect vasopressors |
|
|
Acute use of Amphetamines, QAT, St. John's Wort, Cocaine
a) increase anesthetic requirement b) decrease anesthetic requirement c) labile BP d) decreased response with indirect vasopressors |
increase anesthetic requirement
|
|
|
Caffiene
a) increased catechol release b) used to prevent apnea in preemies c) Tx for PDPH d) increases CSF production |
a) increased catechol release
b) used to prevent apnea in preemies c) Tx for PDPH d) increases CSF production |
|
|
Acute use of ETOH
a) increases anesthetic need b) decreases anesthetic need |
decreases anesthetic need
|
|
|
Chronic use of ETOH
a) increases anesthetic need b) decreases anesthetic need |
increases anesthetic need
|
|
|
T/F Vitamin B12 deficiency can be caused by long OR cases using N2O and then lead to Neurologic syndrome
|
True, parasthesias and weakness
CNS demyelination (this is real Dr. Coyle took care of someone with this) can also cause anemia |
|
|
T/F 5-Flurouracil (chemo drug) decreases plasma cholinesterase
|
True
|
|
|
Most important anesthetic concern in someone who has received Chemo is
a) Immunosuppression b) Friability of tissues c) bleeding d) nutrition |
Immunosuppression
|
|
|
With Chemo drugs
a) less barbiturates b) more barbiturates c) less NMBD d) more NMBD |
less barbiturates
more NMBD |
|
|
Alkylating Chemo Drugs
a) Antimetabolites b) Interfere with DNA Synthesis c) high incidence PONV d) Pulmonary Fibrosis |
Antimetabolites
Interfere with DNA Synthesis high incidence PONV Pulmonary Fibrosis Nucleic Acid Synthesis Inhib. cause Fibrosis also |
|
|
Bleomycin
a) Pulmonary Fibrosis b) Antibx c) Fibrosis can worsen 6 -12 mths later d) made worse with high flow O2 & hypervolemia |
Pulmonary Fibrosis
Antibx Fibrosis can worsen 6 -12 mths later made worse with high flow O2 & hypervolemia |
|
|
DNA Topoisomerase Inhibitors
a) Pulmonary Fibrosis b) Cardiac ischemia c) SIADH d) CNS effects |
Cardiac ischemia
CNS effects |
|
|
Microtubule Inhibitors
a) Pulmonary Edema b) Cardiac myopathy c) SIADH, Ortho. HOTN d) Vincristine |
SIADH
Ortho. HOTN Vincristine (Chemo) |
|
|
Heparin
a) binds to Factor X b) binds to Antithrombin III c) binds to Antithrombin II d) Blocks Intrinsic Pathway |
Factor X
Antithrombin III Blocks Intrinsic Pathway |
|
|
LMWH
a) binds to Factor X b) mol. wt 6000 - 8000 c) Prolongs PTT d) has no effect on PTT |
binds to Factor X
mol. wt 6000 - 8000 has no effect on PTT |
|
|
Warfarin
a) Blocks Extrinsic Pathway b) Interferes with Vit K Synthesis c) Many drug interactions d) monitored with PT/INR |
Blocks Extrinsic Pathway
Interferes with Vit K Synthesis Many drug interactions monitored with PT/INR |
|
|
Warfarin has it's biggest effect on
a) Antithrombin II b) Antithrombin III c) Antithrombin VII d) Factor X |
Antithrombin II but also has an effect VII, IX, X
|
|
|
Protamine
a) binds to heparin 1:1 (1mg/100units) b) heparin reversal c) can cause myocardial depression d) anaphyllaxis |
a) binds to heparin 1:1 (1mg/100units)
b) heparin reversal c) can cause myocardial depression d) anaphyllaxis |
|
|
Heparin Protamine Complex
a) noted at end of infusion b) noted at start of infusion c) an anaphyllactic reaction |
noted at start of infusion
an anaphyllactic reaction Tx with steroids, H1 & H2 blockers, fluids |
|
|
Why would Protamine cause myocardial depression?
|
D/t the amount of free protamine circulating after all heparin is bound
Tx alpha adrenergics & Ca |
|
|
Reversal of Warfarin
a) Vit K b) Protamine c) FFP d) Warfarin is irreverisbly bound & the body must build new factors (like ASA and platelets) |
Vit K (takes about 24 hours)
FFP (4-6 units be wary of hypervolemia with higher number of units) |
|
|
Parkinson's Disease
a) loss of dopamine receptors /dopamine b) increase in dopamine c) loss of ACh d) treat with dopamine |
loss of dopamine receptors /dopamine
receptors are found in Substantia Nigra, dopamine controls motor movement. When there is enough dopamine ACh is kept in "check" when there isn't ACh rules and causes muscle rigidity and inc. tone |
|
|
Causes of Parkinson's Disease
a) Encephalitis b) CVA's c) Ideopathic d) all of the above |
Encephalitis
CVA's Ideopathic |
|
|
Levodopa
a) must be given with Carbidopa b) crosses BBB c) converted to dopamine once in BBB d) causes Nausea d/t stimulation of CTZ |
must be given with Carbidopa
crosses BBB converted to dopamine once in BBB causes Nausea d/t stimulation of CTZ |
|
|
Why must Levidopa be given with Carbidopa
a) Levodopa doesn't cross BBB & Carbidopa will bind with it and help it across b) Levodopa is absorbed in the GI tract, but Carbidopa will decrease absorption of Levodopa allowing it to cross BBB c) Carbidopa stops the breakdown of Levodopa by COMT |
Levodopa is absorbed in the GI tract, but Carbidopa will decrease absorption of Levodopa allowing it to cross BBB
|
|
|
Selegiline
a) COMT inhibitor b) MAO Type B Inhibitor c) Precursor of Dopamine d) Prevents breakdown of dopamine |
MAO Type B Inhibitor
Prevents breakdown of dopamine (this enhances the effect of Levodopa) |
|
|
Side effects of Selegiline
a) HOTN b) HTN c) metabolite is amphetamine d) insomnia |
HTN (in high doses will effect MAO type A which increase NE)
metabolite is amphetamine insomnia (caused by the amphetamine) |
|
|
COMT Inhibitors
a) Entacapone b) enhance dopamine availability c) prevents breakdown of dopamine d) Rasagiline |
Entacapone
enhance dopamine availability prevents breakdown of dopamine |
|
|
Anesthetic Considerations r/t Parkinson's
a) lack of airway tone b) Labile BP c) NMBD's may be unpredictable c) No Reglan |
lack of airway tone
Labile BP (r/t Levodopa) NMBD's may be unpredictable (may have decreased # of receptors) No Reglan (dopaminergic antagonist) |
|
|
Sleep aid drugs
a) short duration b) long duration c) GABA receptor |
short duration
GABA receptor |
|
|
Reversal of Benzo's
a) Flumazenil b) Aminophylline c) Physostigmine d) a only |
Flumazenil
Aminophylline Physostigmine |
|
|
Of the following drugs which has NO effect on Norepi re-uptake
a) Venlafaxine b) Imipramine c) Fluoxetine d) Trazadone |
Fluoxetine
Selective Seretonin Re-uptake Inhibitor Trazadone (atypical antidepressant) |
|
|
Of the following which have effect on both Norepi & Seretonin Re-uptake
a) Venlafaxine b) Imipramine c) Fluoxetine d) Duloxetine |
Venlafaxine
Imipramine Duloxetine |
|
|
Bupropion
a) Seretonin, Norepi, & dopamine re-uptake inhibitor b) anti-depressant c) smoking cessation d) seizures with high doses |
Seretonin, Norepi, & dopamine re-uptake inhibitor
anti-depressant smoking cessation seizures with high doses |
|
|
With long term use of SSRI's & SNRI's
a) inhibitory receptors are upregulated b) inhibitory receptors are downregulated c) increased neurotransmitter in synaptic cleft d) decreased neurotransmitter in synaptic cleft |
inhibitory receptors are downregulated
increased neurotransmitter in synaptic cleft |
|
|
SNRI's
a) Venlafaxine b) Duloxetine c) Mirtazapine d) Doxepin |
VenlafaXine
DuloXetine |
|
|
Tricyclic Antidepressants
a) amitriptylline b) imipramine c) block Norepi & Seretonin re-uptake d) block Norepi, Dopamine & Seretonin re-uptake |
amitriptylline
imipramine block Norepi & Seretonin re-uptake |
|
|
Acute administration of TCA's
a) increased SNS response b) decrease in catechol stores c) exaggerated response to direct acting drugs d) exaggerated response to indirect acting drugs |
increased SNS response
exaggerated response to indirect acting drugs (unpredictable response) ( A Cute little TCA likes SNS & exaggerates INDIRECTly) |
|
|
Chronic use of TCA's
a) increased SNS response b) decrease in catechol stores c) may require higher dose of direct acting drugs d) exaggerated response to indirect acting drugs |
DECREASE in catechol STORES
may require HIGHER dose of DIRECT acting drugs (decreased receptor function) |
|
|
T/F TCA's have increased incidence of cardiac dysrhythmias esp. with halogenated anesth. gases
|
True
|
|
|
T/F TCA's can cause increased anticholinergic delirium
|
True
|
|
|
Monamine Oxidase
a) acts as a safety valve to get rid of extra catchols (NE, Dop. Seret) b) can be inhibited by Phenelizine c) both of the above |
acts as a safety valve to get rid of extra catchols (NE, Dop. Seret)
can be inhibited by Phenelizine also Tranylcypromine, Selegiline |
|
|
MAOI's for treatment of depression
a) Phenelizine b) Tranylcypromine c) Selegiline d) Fluoxetine |
Phenelizine
Tranylcypromine Selegiline (also used in the treatment of Parkinson's because it increases amount of dopamine) |
|
|
MAOI's
a) competitively bind with MAO b) irreversibly bind with MAO c) require avoidance of tyramine containing foods |
irreversibly bind with MAO
require avoidance of tyramine containing foods |
|
|
Which of the following drugs can cause both an excitatory and depressive response when given with MAOI's
a) Morphine b) Demerol c) Dilaudid d) all of the above |
Demerol b/c it inhibits seretonin uptake (fentanyl, sufenta, alfenta may have the same effect)
type I excitatory = H/A, agitation, high temp, muscle rigidity (seretonin syndrome) type 2 depressive = HOTN, dec. ventilation, coma |
|
|
MAOI's
a) Exaggerated response to catecholamines esp. w/ indirect acting drugs b) require avoidance or dec. dosing of epi. in epidurals c) cause excessive response to surgical stimuli d) all of the above |
Exaggerated response to catecholamines esp. w/ indirect acting drugs
require avoidance or dec. dosing of epi. in epidurals cause excessive response to surgical stimuli |
|
|
Of the following neurotransmitters which one is the only one that is both excitatory and inhibitory
a) Norepinephrine b) Dopamine c) Seretonin d) Substance P |
Seretonin
|
|
|
Which of the following neuroleptic drugs have the highest potential for causing extrapyramidal effects
a) Haloperidol b) Fluphenazine c) Thioridazine d) Clozapine |
Haloperidol
Fluphenazine Thioridazine These drugs are all Typical neuroleptic drugs |
|
|
Typical Neuroleptics
a) treat positive symptoms (thought disorders, delusions, agitation) b) treat negative symptoms ( social withdrawal, blunted emotions) c) cause extrapyramidal effects d) low potential for extrapyramidal effects |
treat positive symptoms (thought disorders, delusions, agitation)
cause extrapyramidal effects |
|
|
Atypical Neuroleptics
a) treat positive symptoms (thought disorders, delusions, agitation) b) treat negative symptoms ( social withdrawal, blunted emotions) c) cause weight gain d) low potential for extrapyramidal effects |
treat negative symptoms ( social withdrawal, blunted emotions)
cause weight gain low potential for extrapyramidal effects |
|
|
T/F Neuroleptic Drugs can cause Neurolept Malignant Hyperthermia
|
True
Rigidity, fever, rhabdomyolysis, coma Can be treated with Dantrolene & Bromocryptine (dopaminergic agonist) |
|
|
Atypical Neuroleptics
a) Clozapine b) Haloperidol c) Aripiprazole d) Risperidone |
Clozapine
Aripiprazole Risperidone |
