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Exam 2 Pharm

QuestionAnswer
Depolarizing NMBA for quick paralysis Succinylcholine
Use cases for Succinylcholine Emergent intubation
Half-life of Propofol Very short
Requirement for RN titrating Propofol in AR Stable airway
How non-depolarizing NMBAs work Block ACh at NM junction
Effect of non-depolarizing NMBAs Relax muscles + ↓ BP
Key NMBA limitation No sedation or pain relief
Why sedation is needed with NMBA Prevent inhumane paralysis
When NMBA + gas are used Induction of anesthesia
Emergency NMBA use ICU/ER intubation
Procedures using NMBAs TEE, bronchoscopy, seizures
Danger of Succinylcholine Malignant hyperthermia
Succinylcholine reversal agent None
Duration of Succinylcholine effect 5–10 min
Reversal for Cysatracurium Neostigmine
Reversal for Pancuronium, Vecuronium, Rocuronium Sugammadex
Most severe NMBA risk Respiratory arrest
RN monitoring duty with NMBAs Continuous vitals + crash cart
MH symptoms from gas + Succinylcholine Severe muscle rigidity
Cause of MH heat Muscle overactivity
Max core temp in MH ~110°F
Electrolyte concern in MH Hyperkalemia
Electrolytes affecting heart muscle K+, Mg2+, Ca2+
First treatment for MH Rapid cooling
Drug used in MH Dantrolene
MH cooling measures IV saline, blanket, groin/axilla ice
Who should avoid Succinylcholine Burns, trauma, SCI, MG
Common complaint after Succinylcholine Muscle aches
Sedatives definition CNS depressants for calm
Hypnotics definition Induce sleep
Sedative-hypnotic drug classes Benzos, barbs, benzo-likes
Barbiturate risk Dependence + resp. depression
Benzo caution in elderly ↓ metabolism → oversedation
Benzodiazepine name ending -pam or -lam
Benzo uses Anxiety, seizures, ETOH, sedation
Signs of CNS depression Drowsy, uncoordinated, lightheaded
Benzo taper instruction Reduce dose slowly
Midazolam (Versed) effect Amnesia
Benzo overdose antidote Flumazenil
Benzo contraindications Sleep apnea, dementia, etc.
Zolpidem adverse effect Amnesia (sleep-driving)
IV concern with Diazepam Precipitates easily
Pentobarbital use Induced coma for ↑ ICP
Appearance of Propofol White and oily
Ingredients in Propofol Soybean oil + egg yolk
Propofol vial risk Bacterial growth
Why lidocaine is mixed with Propofol Reduces injection burn
Ketamine anesthesia type Dissociative
Ketamine mental health use Depression
Ketamine contraindications Schizophrenia, elderly, very young
Adenosine’s heart effect AV node block → pause
Adenosine treats SVT
Adenosine admin method Rapid IV push + flush
IV opioids in hospital Fentanyl, Morphine, Dilaudid
Opioid overdose antidote Naloxone
Why Fentanyl > Morphine sometimes Morphine harms kidneys
Low dose Fentanyl for small elderly pt 12.5 mcg
Common opioid GI effect Constipation
Why Morphine causes low BP Vessel relaxation
Opioid to avoid in biliary colic Morphine
Opioid safe in biliary colic Meperidine
Thrombolytic vs. anticoagulant Break clot vs. prevent clot
Example anticoagulant Heparin
Heparin dosing requires Weight + PTT
Thrombolytic drug suffix -lase
Diuretic nursing checks I&Os, lytes, BP, weight
Inotrope action ↑ Myocardial contractility
Low-dose Dopamine effect ↑ Renal perfusion
High-dose Dopamine risk Renal vasoconstriction
Norepinephrine nursing concern Extremity perfusion
Antiarrhythmic antidote None
Most used antiarrhythmic Amiodarone
Amiodarone lung risk Pulmonary toxicity
Why avoid beta blockers in asthma Bronchospasm
HR to hold beta blocker < 50 bpm
Class III antiarrhythmic effect Delay repolarization
Side effect of CCBs Edema, HF risk
Digoxin’s action ↓ AV node + ↑ contractility
Assessment before Digoxin Apical pulse 1 min
Sign of Digoxin toxicity Nausea + feeling bad
Created by: KantStop
 



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