INBDE Pharmacology Study Guide Solution With Solved Answers/2024.

Ester Local Anesthetics - correct answer Procaine, Tetracaine and Cocaine Amide Local Anesthetics - correct answer Anything that is NOT Procaine, Tetracaine or Cocaine and ends in "-caine" Lidocaine - correct answer 1. SAFEST to use in children 2. 2% 3. pKa = 7.8 Bupivacaine - correct answer 1. LEAST SAFE to use in children 2. 0.5% 3. pKa = 8.1 Mepivicaine - correct answer 1. Causes LEAST amount of Vasodilation, thus can be packaged WITHOUT Epinephrine 2. 2% or 3% 3. pKa = 7.6 Articaine - correct answer 1. Has an Ester Chain and Amide Chain, thus can be metabolized in BOTH Liver and Plasma 2. 4% 3. pKa = 7.8 Where are Amides metabolized? - correct answer Liver Where are Esters metabolized? - correct answer Plasma via Esterases What toxic effect can Prilocaine cause? - correct answer Methemoglobinemia How do Local Anesthetics work? - correct answer Block Na+ Channels What form of Local Anesthetics can cross membrane? - correct answer Free Base or NON-Ionized Short Acting Local Anesthetics - correct answer Procaine Moderate Acting Local Anesthetics - correct answer Prilocaine, Mepivacaine and Lidocaine Long Acting Local Anesthetics - correct answer Bupivacaine, Tetracaine and Etidocaine What does increased blood flow do to drug duration? - correct answer SHORTENS What does increased lipid solubility/hydrophobicity do to drug potency and duration? - correct answer INCREASES What does lower pKa do to drug activation time? - correct answer Makes it FASTER What does increased protein binding do to drug duration? - correct answer INCREASES MAX Epi for ASA I Patient - correct answer 0.2mg MAX Epi for Cardiac Patient - correct answer 0.04mg (1x 1:50,000 or 2x 1:100,000 or 4x 1:200,000) MAX Lido with Epi - correct answer 4.4mg/kg MAX Lido without Epi - correct answer 7.0mg/kg What is the injection technique that has highest risk of hematoma? - correct answer PSA How much of needle is required to enter for PSA? - correct answer 16mm Lidocaine and Propranolol - correct answer 1. Propranolol DECREASES Lidocaine Breakdown 2. Compete for SAME Enzyme Initially, Local Anesthetics inhibit... - correct answer Central Inhibitory Neurons At greater doses, Local Anesthetics inhibit... - correct answer BOTH Central Inhibitory and Excitatory Neurons Local Anesthesia and Graves Disease (Hyperthyroidism) - correct answer Graves Disease = Hyperthyroidism, which makes patient MORE SENSITIVE to LA Cardiovascular collapse due to high dose of LA may be caused by - correct answer Myocardial Depression What is the only Local Anesthesia that causes vasoconstriction? - correct answer Cocaine What Local Anesthesia can produce powerful stimulation of cerebral cortex? - correct answer Cocaine because it BLOCKS reuptake of NE, which potentiates nerve endings Which antibiotics are not cross-allergenic with Penicillin? - correct answer Macrolides like Erythromycin Penicillin prescription - correct answer 250-500mg, dispense 30 (loading dose) or 28 and take 1 every 6 hrs until gone Clindamycin prescription - correct answer 150-300mg, dispense 21 and take 1 every 8 hrs until gone Amoxicillin prescription - correct answer 500mg, dispense 21 and take 1 every 8 hrs until gone How do bactericidal antibiotics such as penicillin work? - correct answer INHIBIT Cell Wall Synthesis How do bacteriostatic antibiotics such as tetracycline work? - correct answer INHIBIT Protein Synthesis via BINDING to Ribosomes Sulfonamides - correct answer 1. Start with "Sulfa-" and Bactrim 2. Bacteriostatic 3. Compete with PABA, causing Folic Acid DEFICIENCY Bactrim - correct answer 1. Sulfa Drug 2. Combination of Sulfamethoxazole and Trimethoprim Bacteriocidal Drug Classes - correct answer 1. Penicillins 2. Fluoroquinolones 3. Monobactams 4. Carbapenems 5. Cephalosporins Fluoroquinolones - correct answer 1. End in "-Floxacin" 2. Bacteriocidal 3. DNA Synthesis INHIBITOR