A review of the material for second semester pharmacology, test #1.
A focus of hyperexcitable neurons that fire in the absence of appropriate stimuli
Too little dopaminergic input from the substantia nigra into the striam
5 HT serotonin in excess in the synaptic cleft.
Spending too much time standing under strobe lights
Controlls vomiting
Affected by parkinsons disease
Regulates prolactin release
Responsible for neurotransmission of norepinephrine and serotonin.
Pineal Body in the brain
In the intermediate lobe of pituitary gland
Enterochromaffin cells of small intestine
Serovessicle cells of large intestine
MAO-A
5 HT-1 and 5 HT-2 receptors
Nicotinic
Muscarinic
Gamma-amino butyric acid
Acetycholine
Glutamate
Dopamine
Fluoxetine
Lithium
Imipramine
Phenelzine
Potentiate effects biogenic amines by inhibiting reuptake of norepi and serotonin thus making more available in the synaptic space
Forms a stabe, irreversible complex with MAO to prevent demaination of monoamines.
Selectively block the reuptake of serotonin and thus enhance serotogenic activity.
Converts to dopamine by dopa decarboxylase enzyme to replenish stores in the basal ganglia
Seizures
Post-op delirium
Ataxia
Post op nausea and vomiting
4-6 days
1-3 days
6-16 days
12-24 hours
Discontinue medication 5 weeks prior to surgery
Continue to take medication as normal, but you will make sure to be aware of possible interactions.
Discontinue drug 4-6 days prior to surgery.
They should increase the dosage to relieve anxiety related to surgery.
Trazodone
Paroxetine
Bupropion
Venlafaxine
Venlafaxine
Paroxetine
Bupropion
Trazodone
Fluoxetine
Sertraline
Nefazodone
All the above
May prolong effects of muscle relaxants such as vecuronium
May make this patient more prone to bleeding.
Patient will be more prone to severe hypertension in response to ephedrine
This patient should NOT be given any opioids during the procedure.
Fluvoxamine
Imipramine
Phenelzine
Alprazolam
Potentiate effects biogenic amines by inhibiting reuptake of norepi and serotonin thus making more available in the synaptic space
Forms a stabe, irreversible complex with MAO to prevent demaination of monoamines.
Selectively block the reuptake of serotonin and thus enhance serotogenic activity.
Converts to dopamine by dopa decarboxylase enzyme to replenish stores in the basal ganglia
1-3 days
17-30 hours
4-6 days
1-2 weeks
Tachycardia and prolonged PR interval
Dry mouth and slowed gastric emptying
Insomnia and agitation
Impotence and orthostatic hypotension
Ephedrine, full dose since only indirect acting sympathomimetics are safe.
Levophed drip, you can not use either of your standard drugs on this patient.
Neosynephrine, but cut dose to 1/3 due to possibility of pronounced response.
Just keep giving fluid boluses to control the hypotension.
True
False
Naloxone 1-4 mcg/kg IV
Diazepam 0.1 mg/kg
IV infusion of Lidocaine at 1mg/min
Physostigmine 0.5-2 mg IV
Potentiate effects biogenic amines by inhibiting reuptake of norepi and serotonin thus making more available in the synaptic space
Forms a stabe, irreversible complex with MAO to prevent demaination of monoamines.
Selectively block the reuptake of serotonin and thus enhance serotogenic activity.
Converts to dopamine by dopa decarboxylase enzyme to replenish stores in the basal ganglia
Drug induced inhibition of norepinephrine uptake
Accumulation of serotonin in synaptic cleft
Accumulation of octopamine, a false neurotransmitter
Action on sodium channels which causes smooth muscle relaxation and dilation of vessels.
Ummm, pardon me but I have to leave. (Then, RUN LIKE HELL!!)
That sounds very nutritionally balanced! It sounds like you are properly adhering to all dietary restrictions.
You need to try to cut out the wine, but your other food choices are just fine.
Mr. Lector I am afraid you may not eat any of those foods anymore, they are all listed as very unsafe for you.
Lidocaine mixed with 25 mcg fentanyl
Tetracaine mixed with epi
Bupivicaine plain.
All the above would be fine, none of the listed meds are known to cause problems here
May have prolonged effects due to inhibition of cytochrome P 450
It is OK to give these, no interactions are listed.
May have shortened effect due to P 450 enzyme induction
STOP ASKING ME QUESTIONS!!! MY BRAIN IS GOING TO EXPLODE!
Bipolar Disorder
Schizophrenia
Epilepsy
Parkinsons
Patient may not receive epinephrine or opioids during regional anesthesia
Action of Neuromuscular blockers may be prolonged
Interferes with exogenously admistered dopamine
Patient will be more prone to seizure due to lowered seizure threshold
Potentiate effects biogenic amines by inhibiting reuptake of norepi and serotonin thus making more available in the synaptic space
Blockade of dopamine D2 receptors in the basal ganglia and the limbic portions of the forebrain.
Selectively block the reuptake of serotonin and thus enhance serotogenic activity.
Converts to dopamine by dopa decarboxylase enzyme to replenish stores in the basal ganglia
Asthma
Renal Insufficiency
Parkinsons
Schizophrenia
Increased risk of seizures, compazine will severely lower seizure threshold
Severe nausea and vomiting due to a paradoxical effect caused by this combination of drugs.
Extreme anxiety, hyperactivity, and restlessness.
A decrease in systemin BP and hypothermia.
Neuroleptic malignant syndrome
Malignant Hyperthermia
Status Epilepticus
All the Above
They are cerebral vasoconstrictors and may be undesirable for patients with cerbrovascular disease.
Produce amnesia and work as anticonvulsants.
May make patient more prone to laryngospasm
Benadryl may be given to treat extrapyramidal effects.
Depolarizing muscle relaxants will have a shorter duration due to enzyme induction
Non-depolarizing muscle relaxants may have shorter duration due to enzyme induction
You should not give ephedrine due to exaggerated response.
All the above.
It saunters up to the hot chic at the bar, really smoothly, then softly murmurs “Hey baby, are you a parking ticket? Because you have FINE written all over you!”
Blockade of dopamine D2 receptors in the basal ganglia and the limbic portions of the forebrain.
Selectively block the reuptake of serotonin and thus enhance serotogenic activity.
Converts to dopamine by dopa decarboxylase enzyme to replenish stores in the basal ganglia
Metaclopromide
Furosemide
Odansetron
Ephedrine
Aldosterone
Cortisol
Prednisolone
ACTH
Production of an anti-inflammatory response
Immunosuppression following organ transplants
Evoke distal renal tubular reabsorption of sodium in exchange for potassium ions
All the above
5 mg
30 mg
150 mg
10 mg
No, ask the surgeon is he wants 100mg hydrocortisone IV every 8 hours starting this evening.
No, plan to administer 25 mg hydrocortisone at induction and 100 mg as an infusion after the surgery.
No, give Dexamethasone 4-8 mg just prior to surgery.
Yes, since she is already taking prednisolone she has sufficient cortisol.
Dexamethasone may worsen her joint pain and make her more susceptible to post op pain and muscle weakness
Her blood glucose levels may be elevated and she will need to be checked more frequently
She may be more prone to post-op bleeding since the dexamethsone will potentiate the effects of the anticoagulant she takes for DVT prevention.
All the above.
Osteoporosis
Cataracts
Increased bleeding
Trouble healing from surgery
Dexamethasone
Famotidine
Metaclopromide
Odansetron
Hyperkalemia
Hypernatremia
Hypercalcemia
Hypermagnesemia
Those with Renal Failure
Those with a PCN allergy
Those with history of PONV
Those with a Fish allergy
Dexamethasone
Penicillin G
Carbenicillin
Vancomycin
Ampicillin
Cefoxitin
Clindamycin
Cefazolin
Cefoxitin
Cefazolin
Clindamycin
Vancomycin
Lovenox will still increase the risk of bleeding significantly. You should have FFP ready.
Gentamicin will increase the duration of nondepolarizing neuromuscular blockers.
Pre-op Cefazolin will cause hyperglycemia.
None of the above, these meds are fine.
Tetracycline
Cefoxitin
Vancomycin
Ciprofloxacin
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