Nagelhout Pharmacology 2 Exam 2 |
163 Questions with Solutions
What does mixing LAs do to your toxic doses? - -decreases them; the
toxicity is additive so if you have used 50% of your lidocaine dose and watch
to switch to bupivacaine- you can only give 50% of your toxic bupivacaine
dose
- How is the spread of epidural and spinal anesthesia different in pregnant
women? - -the spread and depth is greater; the fetus is pushing back so you
have decreased epidural space
- How does pregnancy change the dosage of LA given? - -give decreased
dose; they are more sensitive to LA d/t increased hormone (progesterone)
levels
- Lidocaine for tumescent anesthesia - -they use large amounts of diluted
LA for liposuction; doses from 35-55mg/kg (if not lipo 28mg/kg)
- What is Hyaluronidase - -an enzyme that helps break down tissue matrix;
breaks down hyaluronic acid so fluids can go further;
*helps spread LA*
this also increases the risk of toxicity
- Synthesis of catecholamines - -phenylalanine--> tyrosine (tyrosine
hydroxylase)--> dopa--> dopamine--> NE--> Epi
increased NE will inhibit the change from tyrosine to dopa (tyrosine
hydroxylase)
- increased catecholamines - -sympathomimetic
- decreased catecholamines - -sympatholytic
- 2 enzymes that break down catecholamines - -MOA- stored in nerves
COMT- stored in synapse
- PNS preganglionic and postganglionic NTs - -pre: nACh
post mACh
- SNS preganglionic and postganglionic NTs - -pre: nACh
post: NE (adrenergic)
, - pre-synaptic alpha 2 agonists: sympathomimetic/sympatholytic? - -
sympatholytic; activates the negative feedback so nerve does not release
any more catecholamine
- post-synaptic alpha2 agonists: sympathomimetic/sympatholytic? - -
sympathomimetic; it reached its destination so it will cause the effects
- MOA: interference with synthesis of neurotransmitter:
sympathomimetic/sympatholytic? - -sympatholytic
- MOA: metabolic transformation by same pathway as precursor of
transmitter: sympathomimetic/sympatholytic? - -sympatholytic
- MOA: blockade of transport system at nerve terminal membrane:
sympathomimetic/sympatholytic? - -sympathomimetic;
block reuptake
- MOA: blockade of transport system of storage vesicles - -sympatholytic;
not safely in vesicle so more will be broken down my MAO or COMP
- MOA: promotion of exocytosis or displacement of transmitter from axonal
terminal: sympathomimetic/sympatholytic? - -sympathomimetic
- MOA: prevention of release of transmitter:
sympathomimetic/sympatholytic? - -sympatholytic
- MOA: mimicry of transmitter at post junctional sites:
sympathomimetic/sympatholytic? - -sympathomimetic; aka: direct agonist
- MOA: blockade of postsynaptic receptor: sympathomimetic/sympatholytic?
- -sympatholytic; aka direct antagonist
- MOA: inhibition of enzymatic breakdown of transmitter:
sympathomimetic/sympatholytic? - -parasympathomimetic
- MOA: interference with second messenger system:
sympathomimetic/sympatholytic? - -sympathomimetic; prevents breakdown
of second messenger--> increased catecholamines
- MOA: interference with synthesis of transmitter: cholinergic and adrenergic
agents - -sympatholytic
cholinergic: choline acetyl transferase inhibitors
adrenergic: a-methyl tyrosine
- MOA: metabolic transformation by same pathway as precursor: adrenergic
agents - -sympatholytic
163 Questions with Solutions
What does mixing LAs do to your toxic doses? - -decreases them; the
toxicity is additive so if you have used 50% of your lidocaine dose and watch
to switch to bupivacaine- you can only give 50% of your toxic bupivacaine
dose
- How is the spread of epidural and spinal anesthesia different in pregnant
women? - -the spread and depth is greater; the fetus is pushing back so you
have decreased epidural space
- How does pregnancy change the dosage of LA given? - -give decreased
dose; they are more sensitive to LA d/t increased hormone (progesterone)
levels
- Lidocaine for tumescent anesthesia - -they use large amounts of diluted
LA for liposuction; doses from 35-55mg/kg (if not lipo 28mg/kg)
- What is Hyaluronidase - -an enzyme that helps break down tissue matrix;
breaks down hyaluronic acid so fluids can go further;
*helps spread LA*
this also increases the risk of toxicity
- Synthesis of catecholamines - -phenylalanine--> tyrosine (tyrosine
hydroxylase)--> dopa--> dopamine--> NE--> Epi
increased NE will inhibit the change from tyrosine to dopa (tyrosine
hydroxylase)
- increased catecholamines - -sympathomimetic
- decreased catecholamines - -sympatholytic
- 2 enzymes that break down catecholamines - -MOA- stored in nerves
COMT- stored in synapse
- PNS preganglionic and postganglionic NTs - -pre: nACh
post mACh
- SNS preganglionic and postganglionic NTs - -pre: nACh
post: NE (adrenergic)
, - pre-synaptic alpha 2 agonists: sympathomimetic/sympatholytic? - -
sympatholytic; activates the negative feedback so nerve does not release
any more catecholamine
- post-synaptic alpha2 agonists: sympathomimetic/sympatholytic? - -
sympathomimetic; it reached its destination so it will cause the effects
- MOA: interference with synthesis of neurotransmitter:
sympathomimetic/sympatholytic? - -sympatholytic
- MOA: metabolic transformation by same pathway as precursor of
transmitter: sympathomimetic/sympatholytic? - -sympatholytic
- MOA: blockade of transport system at nerve terminal membrane:
sympathomimetic/sympatholytic? - -sympathomimetic;
block reuptake
- MOA: blockade of transport system of storage vesicles - -sympatholytic;
not safely in vesicle so more will be broken down my MAO or COMP
- MOA: promotion of exocytosis or displacement of transmitter from axonal
terminal: sympathomimetic/sympatholytic? - -sympathomimetic
- MOA: prevention of release of transmitter:
sympathomimetic/sympatholytic? - -sympatholytic
- MOA: mimicry of transmitter at post junctional sites:
sympathomimetic/sympatholytic? - -sympathomimetic; aka: direct agonist
- MOA: blockade of postsynaptic receptor: sympathomimetic/sympatholytic?
- -sympatholytic; aka direct antagonist
- MOA: inhibition of enzymatic breakdown of transmitter:
sympathomimetic/sympatholytic? - -parasympathomimetic
- MOA: interference with second messenger system:
sympathomimetic/sympatholytic? - -sympathomimetic; prevents breakdown
of second messenger--> increased catecholamines
- MOA: interference with synthesis of transmitter: cholinergic and adrenergic
agents - -sympatholytic
cholinergic: choline acetyl transferase inhibitors
adrenergic: a-methyl tyrosine
- MOA: metabolic transformation by same pathway as precursor: adrenergic
agents - -sympatholytic
