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8 Cards in this Set
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SNP pharmaceutics |
vial: reddish brown lypholized powder. Reconstitute with 5% dextrose discard: when exposed to sunlight turns blue/dark brown as CN- have been liberated |
colour and mixing substance discard when: |
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dose
onset duration of action |
0.5-6mcg/kg/min onset within 3 mins duration: short lived |
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MOA |
SCN enters RBC interacts with oxyHb produces Nitric oxide, CN, metHB Nitric oxide-> increases enzyme guanylate cyclase -> increased intracellular cGMP-> reduced Ca influx into vasc SM -> vasodilation. |
enters RBC.... |
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PD- CVS |
CVS: arterial vasodilation (fall in SVR, MAP venodilation (fall in preload) reflex tacchycardia CO maintained |
CVS |
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PD - Resp, CNS |
Resp: inhibit pulm hypoxic vasoconstriction-> worsens V/Q mismatch CNS: increased CBF-> increased ICP |
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PK- metabolism |
M: SNP enters RBC, interacts with oxyHb-> NO, CN-, metHb 3 things happen to CN- a. metHb + CN- -> cyanomethaemoglobin (non toxic) b. CN- in liver/kidney -> SCN - SCN converted by RBC -> CN- or SCN excreted in urine c. CN- + VitB12 -> cyanocobalamin |
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PK toxicity |
CN>8mcg/ml
Cyanide toxicity: CN- bind to cytochrome oxidases -> interfer with normal oxygen utilisation = anaerobic metabolism. = metabolic acidosis Rx: stop infusion. - chelating agent (dicobalt edetate) - sodium thiosulphate - sodium nitrite or amyl nitrite |
cyanide tox SCN tox |
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PK tox (SCN) |
SCN tox: 100x less toxic. causes anorexia, sedation,
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