Drugs (s/e, dosing, MOA, onset, peak, etc) & some cardiac Flashcards Preview

Board Review CRNA (Sweat Book) > Drugs (s/e, dosing, MOA, onset, peak, etc) & some cardiac > Flashcards

Flashcards in Drugs (s/e, dosing, MOA, onset, peak, etc) & some cardiac Deck (93)
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1

Trade name for Succinylcholine?

Anectine

2

Trade name for Mivacurium?

Mivacron

3

Trade name for Atracurium?

Tracurium

4

Trade name for Cisatracurium?

Nimbex

5

Trade name for Vecuronium?

Norcuron

6

Trade name for Rocuronium?

Zemuron

7

Trade name for d-Tubocurarine?

Tubarine

8

Trade name for Pancuronium?

Pavulon

9

Name the following (ultrashort, short, intermediate, or long):
1) Succinylcholine
2) Pancuronium
3) Mivacurium
4) Cisatracurium
5) d-Tubocurarine
6) Rocuronium
7) Atracurium
8) Vecuronium

1) Succinylcholine: ultra short
2) Pancuronium: long
3) Mivacurium: short
4) Cisatracurium: intermediate
5) d-Tubocurarine: long
6) Rocuronium: intermediate
7) Atracurium: intermediate
8) Vecuronium: intermediate

10

Name the onset time for the following:
1) Succinylcholine: ultra short
2) Pancuronium: long
3) Mivacurium: short
4) Cisatracurium: intermediate
5) d-Tubocurarine: long
6) Rocuronium: intermediate
7) Atracurium: intermediate
8) Vecuronium: intermediate

1) Succinylcholine: 0.5-1.5 min
2) Pancuronium: 2-4 min
3) Mivacurium: 3-4 min
4) Cisatracurium: 5-7 min
5) d-Tubocurarine: 2-4 min
6) Rocuronium: 1-1.5 min
7) Atracurium: 3-4 min
8) Vecuronium: 3-4 min

11

Name the duration to 25 % recovery for the following:
1) Succinylcholine: ultra short
2) Pancuronium: long
3) Mivacurium: short
4) Cisatracurium: intermediate
5) d-Tubocurarine: long
6) Rocuronium: intermediate
7) Atracurium: intermediate
8) Vecuronium: intermediate

1) Succinylcholine: 6-8 min
2) Pancuronium: 60-120 min
3) Mivacurium: 15-20 min
4) Cisatracurium: 35-45 min
5) d-Tubocurarine: 60-120 min
6) Rocuronium: 30-40 min
7) Atracurium: 35-45 min
8) Vecuronium: 35-45 min

12

Name the ED95 for the following:
1) Succinylcholine: ultra short
2) Pancuronium: long
3) Mivacurium: short
4) Cisatracurium: intermediate
5) d-Tubocurarine: long
6) Rocuronium: intermediate
7) Atracurium: intermediate
8) Vecuronium: intermediate

1) Succinylcholine: 0.30 mg/kg
2) Pancuronium: 0.06 mg/kg
3) Mivacurium: 0.08 mg/kg
4) Cisatracurium: 0.05 mg/kg
5) d-Tubocurarine: 0.50 mg/kg
6) Rocuronium: 0.30 mg/kg
7) Atracurium: 0.20 mg/kg
8) Vecuronium: 0.05 mg/kg

13

Name the primary route of elimination of the following:
1) Succinylcholine
2) Pancuronium
3) Mivacurium
4) Cisatracurium
5) d-Tubocurarine
6) Rocuronium
7) Atracurium
8) Vecuronium

1) Succinylcholine: metabolism (plasma cholinesterases)
2) Pancuronium: 85% RENAL/ 15% BILIARY
3) Mivacurium: metabolism
4) Cisatracurium: metabolism (HOFFMAN ONLY)--> nonspecific esterases are NOT involved
5) d-Tubocurarine: primary renal, secondary biliary
6) Rocuronium: 80% Biliary/ 20% renal
7) Atracurium: metabolism (2/3 by hydrolysis--> nonspecific esrterases, 1/3 by Hoffman elimination)
8) Vecuronium: 60% BILIARY/ 40% RENAL/ some metabolism
**the termination of atracurium, cisatricurium, vec, and roc is by redistribution

14

Place the following NMB's into the appropriate category:
vec, roc, pancuronium, atracurium, cisatracurium
1) monoquaternary aminosteroids
2) bisquaternary aminosteroids
3) bisquaternary benzylisoquinolines

1) monoquaternary aminosteroids: vec, roc
2) bisquaternary aminosteroids: panc
3) bisquaternary benzylisoquinolines: atrac, cisatra
**aminosteroids= "curonium"
**benzylisoquinolines= "curium"
**ALL are quaternary ammonium compounds

15

Which NMB's produce autonomic ganglionic blockade? (2)

d-tubocurarine and metocurine block nicotinic receptors at the autonomic ganglia

16

Which NMB's elicit the release of histamine? (5)

sux, mivacurium, atracurium, d-tubocurarine, and metocurarine

17

Which NMB's produce bradycardia and why? (1)

succinylcholine mimics the action of acetylcholine and directly stimulates muscarinic receptors of the sinoatrial node

18

Which NMB's produce tachycardia and why? (5)

-atracurium, d-tubocurarine, metocurine produce reflex tachycardia
-pancuronium and gallamine competitively antagonize acetylcholine, which are referred to as direct vagolytic, or more specifically antimuscarinic, actions

19

Which NMB's produce significant hypotension? (3)

succinylcholine, d-tubocurarine, metocurarine

20

Which NMB's produce significant hypertension? (2)

pancuronium and gallamine

21

The acronym "M-SAC" is my way to remember NMB's that are primarily eliminated by METABOLISM. What does it stand for?

M- mivacurium
S- succinylcholine
** BOTH of the above are by plasma cholinesterase
A- atracurium
2/3 hydrolysis, 1/3 Hoffman
C- cisatricurium
ALL by Hoffman

22

I am a long acting non-selective alpha adrenergic antagonist used to control blood pressure in patients with pheochromocytoma.

phenoxybenzamine
* another non-selective alpha adrenergic antagonist is phentolamine

23

I am a selective alpha 2 adrenergic antagonist used to treat impotence.

yohimbine

24

How is prazosin different from other alpha adrenergic antagonists?

unlike non-selective alpha blockers, prazosin (a selective alpha 1 adrenergic antagonist) lowers BP without increasing release of NE from postganglionic sympathetic nerve terminals b/c it doesn't block alpha 2

25

Name one of the primary non-selective beta antagonists, and why it isn't usually used for with irritable airways.

propanolol--> beta 2 adrenergic receptor blockade can induce bronchoconstriction

26

I am a competitive antagonist of beta 1 adrenergic receptors. I am also very short acting and am metabolized in the _______ by __________ of the red blood cell.

Esmolol. in the plasma by non-selective esterases of the red blood cells

27

What are some uses of esmolol?

1) treat intraop SVT
2) treat intraop HTN
3) blunt reflex cardiovascular responses to DL and produce controlled hypotension

28

What receptors does labetalol competitively antagonize?

alpha 1, beta 1, beta 2

29

Name 2 uses of labetalol?

1) treat HTN emergencies
2) produce controlled hypotension
*decreases HR, myocardial contractility, and SVR

30

What is the alpha to beta ratio of the block produced by labetalol?

7:1 beta to alpha (so stronger beta than alpha)