1
Q
Meds that cause reflex bradycardia
A
Phenylephrine
Dopamine
2
Q
Drugs that are Racemix Mixtures
A
Dobutamine Verapamil Sotalol Mepivacaine Bupivacaine
3
Q
+/- isotomiers of Dobutamine
A
(-) potent alpha agonist; weak beta agonist
(+) competative agonist at alpha; potent Beta agonist
4
Q
+/- isotomiers of Verapamil
A
(-) reason CCB classification
(+) Na-channels –> LA effect
5
Q
+/- isotomiers of Sotalol
A
(-) beta blocker (+) class III
6
Q
(+) S of bupivacaine
A
less toxic than that of mepivacaine?
7
Q
Drugs to avoid with LHF
A
“CBL”
- CCB (verapamil)
- Beta blockers
- left sided HF
8
Q
Drugs to avoid in RHF
A
“DNR”
- Dopamine
- Norepi
- right sided HF
9
Q
Drugs that have Tachyphylaxis
A
- Dobutamine (beta)
- Ephedrine ( alpha inhibition p first dose)
- NTG – more of a tolerance
10
Q
Drugs it’s important to HYDRATE before administering :
A
- Phenoxybenzamine
- CCB’s
- BB’s
11
Q
Drugs known to cause ORTHOSTATIC hypotension
A
- Phenoxybenzamine
- Prazosin
- Labetalol
12
Q
Prodrugs:
A
- SNP
- Enalipril
- Lovastatin
- Simvastatin
- ASA
- Clopidegrel (Plavix)
- Parsurgrel (effient)
- T4 to T3
- Fenofibrate?
13
Q
Drugs to decrease w/Liver dx
A
- cardizem
- Labetalol
14
Q
Interactions with volitiles:
A
Yohimbine (alpha 2)
15
Q
Interactions with NMBD:
A
CCB - decrease AcH at presynaptic cleft
16
Q
Interactions with LA:
A
Verapamil
Diltaizem
17
Q
Increase IOP:
A
Dopamine
Versed?
Fenoldopam
Succ
18
Q
DUMBELLS
A
For Cholinergics – “Wet”
19
Q
what increases ACh but is breaking on the heart?
A
cholinergics
20
Q
Anti-Cholinergics (antimuscarinics) are:
A
- atropine
- Scopolamine
- glycopyrrolate
- Ipartropium
- Oxybutinin
21
Q
Protein binding Greatest to least - Beta Blockers:
A
“-PENAMA”
- Propranolol
- Esmolol
- Nadolol
- Acebutolol
- Metoprolol
- Atenolol
22
Q
Vd of Opioids greatest to least:
A
“FMMSRA”
- Fentanyl
- Meperidine
- Morphine
- Sufentanil
- Remifentanil
- Alfentanil
23
Q
Protein binding (greatest to least) - LA:
A
“LBRMTLPPC”
- Levo
- Bupivacaine
- Ropivacaine
- Mepivacaine
- Tetracaine
- Lidocaine
- Prilocaine
- Chloroprocaine (zero)
24
Q
LA Metabolism fastest to slowest (esters)
A
“PLEB”
- Prilocaine
- Lidocaine/Mepivacaine
- Etiocaine
- Bupivacaine/Ropivacaine
RPM - “start slow and speed up”
Ropiviacaine, Prilocaine = Metabolism
25
Protein binding of antiarrhymics (greatest to least)
- Amiodarone
- Propranolol
- Verapamil
- Quinidine
- Lidocaine
- Procainanide
- Sotalol (zero)
26
Gases - hepatic effects greatest to least:
"HEIDes"
H > E> I > Des
27
NMB's in order of R/O anaphylaxis (greatest to least)
-Succ> Atracurium >Cis > Roc > Vec
28
Gases that potentiate NMB (most to least)
Des > Sevo > Halo > N2O
29
Order of NMD's Sugammadex works on (best to least):
Roc > Vanc >> Panc
30
CO equation =
CO = SV x HR
31
Ficks Principle Equation
CO = [ O2 consumption / (O2 pulm vein) - (O2 pulm artery) ]
32
SV =
EDV - ESV
33
SV alternative (CO and HR)
SV = CO/HR
34
EF =
SV/EDV
35
SVR =
[ (MAP - CVP) / CO] x 80
36
MAP = (with SVR)
MAP = [ (CO x SVR) / 80 ] + CVP
37
MAP (with TPR)
MAP = CO x TPR
38
MAP (pulse pressure)
MAP = Diastolic Pressure + 1/3 Pulse Pressure
39
pulse pressure =
Systolic - Diastolic
*** aprox. = SV
40
Factors that Increase VENOUS Return (Increase CO):
- Venoconstriction by smpathetic stimulation
- muscle pump
- body posture (trend; raised legs)
- Respiratory (Decreased intrathoracic pressure)
41
Factors that Decrease VENOUS return (decrease CO):
- Standing
- PEEP (increases intrathoracic pressure)
- Pneumothorax
- Acure/severe asthma
42
Preload is directly proportional to
SV
Increased Preload = Increased SV and vis versa
43
SV is indirectly proportionate to:
Afterload
Decrease afterload = increase SV
44
SV is directly proportionate to:
Contractility
45
If your PCWP is high (normal is 8-14) what is harmful:
FLUIDS
46
Normal CVP
5-8 mmHG
47
L II, III, aVF indicate
inferior MI / RCA
48
V1-V4 indicate
anterior
anterior septal MI
LAD
49
V5 - V6, I and aVL indicate
Lateral Left circumflex
| LAD?
50
ST depression in V1, V2
Posterior
| Left Circ or RCA
51
RCA seen in
Leads II, III, aVF
| sees RA and ventricle
52
LCA supplies LAB and circumflex --- then feeds?
septal anterior and lateral
53
LAD in leads
V1-V4
54
small box on ekg paper measures:
1mm x 1mm = .45
55
Big box on ekg paper measures;
5mm x 5mm = .20 sec
56
vertical small box on ekg measures:
0.1mV
57
vertical large box on ekg paper measures:
0.5 mV
58
R Prime indicates
RBBB
59
T wave
asymmetrical and upright
60
T wave in hypokalemia
low amplitude
61
T wave in yperkalemia
tall and peaked
62
leads on the upper body are
negative
63
leads on the lower body are
positive
64
```
a = augmented
V= voltage
R= right arm
L= left arm
F =
```
left foot
65
aVR does not view any
cardiac wall
66
aVF views
Left Leg - inferior LV
67
R axis normal in
| abnormal in?
normal in young
| abn change inspiration - COPD, WPW, RVH
68
L axis normal in?
normal in old or obese
69
P Wave is known as
P-Pulmonale
lung disease Right Atrial strain
70
Poor R wave poor progression
anteroseptal infart
| young women
71
Q wave indicated
old MI
| -not permanent
72
u wave
hypokalemia
73
ST elevation all leads but aVR may indicate
Pericarditis
74
inferior MI
| RCA is seen in
ST elevation in L II, III, aVF
75
anterior septal MI
| LAD is seen in leads?
LV1-V4
76
ST Depression in leads V1 and V2 indicate
posterior MI
| LCA or RCA
77
systolic murmur heard b/w what heart sounds
S1 and S2
78
what sound is heard with closure of tricuspid and mitral valves?
S1
79
what sound is heard with the closure of the aortic and pulmonic valves?
S2
80
S3 heart sound is normal in? abn?
normal in children <30 yrs old
| heard with **Bell at Left sternal border
81
S4 Heart sound indicates:
abn Stiff non-compliant ventricle
82
PMI is heard at:
5th Intercostal Space
| Left midclavicular line
83
Diastolic Murmur
Mitral stenosis
| -low open snamp after S2 before Murmur
84
Aortic stenosis
loud harsh enection click; at 2nd intercostal space, diminished S2, CRACKLES
85
Bell used to hear
LOW sounds
S3
Mitral stenosis
86
Diaphragm used to hear
HIGH
| S1, S2 & S4
87
+ Thrill in grades
4-6
88
Order of Nerve Blockade for Spinal or Epidural Anesthesia
The order in which nerves are blocked following epidural administration of a local anesthetic are:
1. B fibers (preganglionic sympathetic efferents)
| 2. C and A-delta (A
Amanda CRNA
flashcards
Decks in class (8)
# Cards
