Shared Flashcard Set

Details

Pain medication/anesthesia
Pharm test 1
15
Pharmacology
Undergraduate 1
02/20/2012

Additional Pharmacology Flashcards

 


 

Cards

Term
When to provide doses of medications
Definition

Before pain returns, attempt to keep dosage in therapeutic range.

 

Before pain becomes too severe (inhibits healing process)

Term
Tolerance vs addiction
Definition

o   Tolerance

§  Larger and larger doses need for same effect

·         (i.e. analgesic, euphoric, sedative and respiratory depression effects)

§  Tolerance to respiratory depression is good because when a higher dose of drug is used, the risk of resp. dep. Remains relative

§  There can be a cross tolerance between drugs

o   Physical Dependence

§  Physical dependence is an addiction of the substance, this can lead to tolerance.

§  Withdraws can results from taking a smaller dose or abstinence completely.

Term
SE of opiates
Definition

o   Respiratory depression

§  If given IV onset within minutes

§  Persists for 4-5 hours

o   Constipation

o   Orthostatic hypotension

o   Urinary retention

o   Cough suppression

o   Biliary colic

o   Emesis

o   Elevation of intracranial pressure

o   Eupohoroia/Dysphoria

o   Sedation

o   Miosis

o   Neurotoxicity

o   Prolonged use

§  Hormonal changes

§  Alter immune function

o   Decrease in blood pressure

o   Coma

o   Pinpoint pupils

Term

Overdose of narcotics

S&S and treatment

Definition

§  S&S:

·         Respiratory depression

·         Blood pressure drop

·         Pinpoint pupils

·         Coma

·         Death

§  Treatment:

·         Opioid antagonist (Narcan)

Term
ASA overdose
Definition

§  Main S&S

·         Acidosis

·         Hyperthermia

·         Sweating

·         Dehydration

·         Electrolyte imbalance

·         Stupor and coma

§  Mild (salicylism)

·         Tinnitus, HA, dizziness, drowsiness, confusion, paresthesias, ventilator stimulation, GI distress

§  Salicylate poisoning

·         Altered resp (increased rate, then depression)

·         Altered fluid/lytes and acid-base balance (alkalosis to acidosis)

§  Watch for possible GI bleeding

§  Expect effects of severe anticoagulation

§  Renal failure if already renal insufficiency

§  Treatment:

·         The sooner the better, no antidote

·         Induce emesis

·         Ventilator support

·         Correct acid-base balance

·         External cooling

·         Hasten excretion

Term
NSAID overdose
Definition

§  S&S:

·         Produces less gastric bleeding than Aspirin

·         Produces less inhibition of platelet aggregation

·         May pose a risk of MI and stroke

·         Impair renal function

o   Can cause hypertension and edema

§  Treatment:

·         Entirely supportive 

Term
Tylenol overdose
Definition

§  S&S:

·         LIVER DAMAGE!!!!

·         Increased by fasting, chronic alcohol use, taking more than 4gm/day

·         Principle: hepatic overdose

·         Early: N/V, diarrhea, sweating, abdominal discomfort

§  Treatment:

·         Antidote: acetylcysteine

Term
Non-pain uses of ASA
Definition

o   Anti-inflammatory

§  Suppresses inflammation (antiprosaglandin)

o   Antipyretic

§  Inhibits formation of fever causing substances that raise body’s thermostatic controls

o   Antiplatelet

§  Decreases the stickiness of platelets ~ 7 days

o   Prevents colon cancer

o   Prophylaxis of recurrent MI or stroke

Term
Uses of Tylenol vs NSAIDs
Definition

o   Tylenol:

§  No anti-inflammatory and antirheumatic actions

§  Does not suppress platelet aggregation

§  Does not cause gastric ulceration

§  Does not decrease renal blood flow or cause renal impairment

§  Preferred to NSAIDs for use by children with chickenpox/influenza because of its lack of association with Reye’s syndrome

§  Preferred for pt with peptic ulcer disease

Term
General anesthesia (4 stages)
Definition

§  Stage 1—analgesia

·         Administration to loss of consciousness

§  Stage 2—excitement

·         Reflexes still present, may be exaggerated

§  Stage 3—surgical anesthesia

·         Increasing depth of anesthesia, affects respiration, loss of reflexes, flaccidity, lower body temp

§  Stage 4—medullary paralysis (toxic)

·         Respiratory arrest and vasomotor collapse

Term
Regional/Local anesthesia (action, effect and types)
Definition

§  Action

·         Stabilizes or elevates threshold of excitation of nerve cells, prevents depolarization and transmission of nerve impulses

§  Effect

·         Loss of sensation without skeletal muscle involvement

§  Types

·         Topical, infiltrates—tissue, nerve, spinal

Term
Issues of balanced anesthesia
Definition
adverse drug-drug interactions
Term
issues of spinal anesthesia
Definition

§  Can awaken with HA

§  Cannot be released if cannot void

§  Shaking and moving extremities does not hasten recovery (can cause joint injury)

§  High falls risk

Term
Issues of inhaled anesthesia
Definition
  • respiratory and cardiac depression
  • sensitization of the heart to catecholamines
  • malignant hyperthermia!!! genetic disposition
  • aspiration of gastric contents
  • hepatotoxicity
  • toxicity to operating room personnel
Term
Propofol (Diprivan)
Definition

§  IV sedative-hypnotic used for induction and maintenance of anesthesia

§  SE: PROFOUND respirations and hypotension

§  Increase risk of bacterial infection due to medium drug is in, very bacteriogenic

§  Cant be used with pt with egg allergies

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