Pharmacology quiz

Podcast Beta

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary reason for maintaining the potency and effectiveness of all drugs in perioperative care?

To ensure the quality of care provided to patients (correct)

To comply with the Controlled Drugs Regulations

To reduce the risk of administering the wrong drug

To prevent the misuse of controlled drugs

Which of the following drugs requires refrigeration to preserve its efficacy and therapeutic benefits?

Atracurium (correct)

Morphine

Alfentanil

Fentanyl

Why is it important to have an efficient organisation of drugs, especially those with similar labelling or packaging?

To comply with the Controlled Drugs Regulations

To reduce the risk of administering the wrong drug (correct)

To prevent the misuse of controlled drugs

To ensure the quality of care provided to patients

What is the primary purpose of the Controlled Drugs (Supervision of Management) Regulations (2013)?

To regulate the storage, record keeping, and disposal of controlled drugs Signup and view all the answers

Who is responsible for adhering to the 6 R's framework prior to administering medication to patients?

All healthcare professionals, including ODPs Signup and view all the answers

What is the minimum number of individuals required to be present during the checking process of controlled drug inventory?

Two Signup and view all the answers

What is the purpose of recording the disposal of controlled drugs in the controlled drugs book?

To prevent misuse of controlled drugs Signup and view all the answers

What is the primary purpose of the 6 R's framework?

To reduce the risk of administering the wrong drug Signup and view all the answers

What is the role of the HCPC in relation to controlled drug safety?

Recording the presence of individuals during the checking process Signup and view all the answers

What is the consequence of administering the wrong drug to patients?

Severe impact on patients and legal consequences for healthcare professionals Signup and view all the answers

Why is it crucial to confirm the patient's identity before administering drugs?

To avoid administering drugs to the wrong patient Signup and view all the answers

What is the purpose of labelling syringes in the administration of drugs?

To prevent confusion about which drugs are being administered Signup and view all the answers

What is the primary site of metabolism for propofol?

Liver Signup and view all the answers

What is the significance of using gloves when handling medications?

To prevent cross-contamination and infections Signup and view all the answers

What is the primary effect of propofol on the cardiovascular system?

Decreases blood pressure and cardiac output Signup and view all the answers

How is propofol primarily administered?

Intravenously Signup and view all the answers

What percentage of propofol is bound in the plasma?

Up to 98% Signup and view all the answers

What is the primary route of excretion for propofol?

Urine Signup and view all the answers

What is the significance of confirming allergies with the patient before administering drugs?

To avoid any reactions that may negatively affect a patient's health Signup and view all the answers

What is pharmacokinetics defined as?

How the body interacts with the drug Signup and view all the answers

What is the primary mechanism by which propofol inhibits the respiratory system?

Depression of the chemoreceptor response Signup and view all the answers

What is the recommended caution when administering propofol to patients with hypovolemia?

Exercise caution due to the risk of vasodilation Signup and view all the answers

What is the bioavailability of ondansetron when absorbed by the gastrointestinal tract?

50-70% Signup and view all the answers

What is the maximum dose of ondansetron recommended for IV administration?

16mg Signup and view all the answers

What is the primary mechanism by which alfentanil is metabolized?

Metabolism by the liver Signup and view all the answers

What is the typical dose of alfentanil for general anaesthesia?

30-50mcg/kg Signup and view all the answers

What is the primary concern when combining alfentanil with other drugs, such as benzodiazepines?

Risk of respiratory depression Signup and view all the answers

What is the primary storage requirement for alfentanil?

Store in a locked cupboard Signup and view all the answers

What is the primary reason for the rapid excretion of alfentanil in the urine?

Due to its short half-life Signup and view all the answers

What is the primary concern when using ondansetron in combination with other serotonergic medications?

Risk of serotonin syndrome Signup and view all the answers

What percentage of atracurium metabolism is non-enzymatic?

45% Signup and view all the answers

What is the recommended initial dose of atracurium for intubation in adults?

300-600mcg/kg Signup and view all the answers

What is the main reason for caution when using atracurium in patients with hypothermia?

Prolongation of the drug's activity Signup and view all the answers

What is the primary route of excretion for sevoflurane?

Lungs Signup and view all the answers

What is the maximum concentration of sevoflurane used during the induction phase?

8% Signup and view all the answers

What is a potential complication of using sevoflurane in patients with head injuries?

Increased intracranial pressure Signup and view all the answers

What is the primary use of sodium chloride 0.9% in this scenario?

To treat hypovolaemia Signup and view all the answers

What is the minimum oxygen saturation level to be maintained?

94% Signup and view all the answers

What is the risk associated with storing oxygen cylinders near electrical equipment?

Fire hazard Signup and view all the answers

What is the primary method of administering alfentanil?

Intravenous infusion Signup and view all the answers

What percentage of atracurium metabolism is accounted for by non-enzymatic degradation?

45% Signup and view all the answers

What is the primary reason for caution when using atracurium in patients with cardiovascular disease?

Risk of hypotension Signup and view all the answers

What is the maximum concentration of sevoflurane used during the induction phase?

8% Signup and view all the answers

What is the primary route of excretion for sevoflurane?

Lungs via expiration Signup and view all the answers

What is the primary purpose of administering sodium chloride 0.9% in this scenario?

To treat hypovolaemia Signup and view all the answers

What is the minimum oxygen saturation level to be maintained?

94% Signup and view all the answers

What is the risk associated with storing oxygen cylinders near electrical equipment?

Fire hazard Signup and view all the answers

What is the primary concern when using sevoflurane in patients with head injuries?

Increased intracranial pressure Signup and view all the answers

What is the recommended initial dose of atracurium for intubation in adults?

300-600 mcg/kg Signup and view all the answers

What is the primary mechanism of action of atracurium?

Blocking the nicotinic receptors Signup and view all the answers

What is the primary mechanism by which alfentanil is metabolized in the body?

Liver enzymes Signup and view all the answers

What is the primary concern when combining alfentanil with other drugs, such as benzodiazepines?

Respiratory depression Signup and view all the answers

What is the typical dose of atracurium for endotracheal intubation in adults?

1-2mg/kg Signup and view all the answers

What is the primary route of excretion for alfentanil?

Urinary excretion Signup and view all the answers

What is the primary storage requirement for alfentanil?

Locked cupboard with limited access Signup and view all the answers

What is the protein binding extent of alfentanil in the body?

92% Signup and view all the answers

What is the typical onset of action for atracurium?

2 minutes Signup and view all the answers

What is the primary reason for the rapid excretion of alfentanil in the urine?

Short half-life Signup and view all the answers

What is the primary concern when using alfentanil in patients with hypothyroidism?

Increased risk of respiratory depression Signup and view all the answers

What is the typical dose of alfentanil for general anaesthesia?

30-50mcg/kg Signup and view all the answers

What is the primary reason for storing alfentanil in a locked cupboard?

To comply with the Controlled Drugs (Supervision of Management) Regulations (2013) Signup and view all the answers

What percentage of alfentanil is bound to proteins in the body?

92% Signup and view all the answers

What is the primary route of excretion for alfentanil?

Urine Signup and view all the answers

What is the typical dose of alfentanil for general anaesthesia?

30-50mcg/kg Signup and view all the answers

What is the primary concern when combining alfentanil with other drugs, such as benzodiazepines?

Respiratory depression Signup and view all the answers

What is the primary mechanism of action of atracurium?

Non-depolarising neuromuscular blocking agent Signup and view all the answers

What is the onset of action of atracurium?

Within 2 minutes Signup and view all the answers

What is the primary reason for caution when using atracurium in patients with hypothermia?

Risk of prolonged neuromuscular block Signup and view all the answers

What percentage of atracurium metabolism is non-enzymatic?

90% Signup and view all the answers

What is the recommended initial dose of atracurium for intubation in adults?

0.5mg/kg Signup and view all the answers

What percentage of atracurium metabolism is accounted for by non-enzymatic degradation?

45% Signup and view all the answers

What is the primary purpose of administering sodium chloride 0.9% in this scenario?

To offset hypotension due to fluid and blood loss Signup and view all the answers

What is the maximum concentration of sevoflurane used during the induction phase?

8% Signup and view all the answers

What is the primary route of excretion for sevoflurane?

Lungs via expiration Signup and view all the answers

What is the primary concern when using sevoflurane in patients with head injuries?

Increased intracranial pressure Signup and view all the answers

What is the recommended initial dose of atracurium for intubation in adults?

300-600mcg/kg Signup and view all the answers

What is the primary mechanism of action of atracurium?

Acts as a competitive antagonist at the nicotinic receptor Signup and view all the answers

What is the main reason for caution when using atracurium in patients with hypothermia?

Prolonged activity of the drug Signup and view all the answers

What is the primary purpose of administering oxygen in this scenario?

To prevent hypoxia and maintain oxygen saturation above 94% Signup and view all the answers

What is the risk associated with storing oxygen cylinders near electrical equipment?

Fire hazard Signup and view all the answers

What percentage of atracurium metabolism is non-enzymatic?

45% Signup and view all the answers

What is the primary concern when using sevoflurane in patients with head injuries?

Increased intracranial pressure Signup and view all the answers

What is the primary mechanism of action of alfentanil?

Blockage of opioid receptors Signup and view all the answers

Why is it important to be cautious when administering atracurium to patients with hypothermia?

It slows down the metabolism of atracurium Signup and view all the answers

What is the primary route of excretion for sevoflurane?

Lungs Signup and view all the answers

What is the primary route of excretion for alfentanil?

Urine Signup and view all the answers

What is the recommended initial dose of atracurium for intubation in adults?

300-600mcg/kg Signup and view all the answers

What is the typical dose of alfentanil for general anaesthesia?

30-50mcg/kg Signup and view all the answers

What is the primary concern when combining alfentanil with other drugs, such as benzodiazepines?

Respiratory depression Signup and view all the answers

What is the primary purpose of administering sodium chloride 0.9% in this scenario?

To treat hypovolemia Signup and view all the answers

What is the primary storage requirement for alfentanil?

Locked cupboard Signup and view all the answers

What is the minimum oxygen saturation level to be maintained?

94% Signup and view all the answers

What is the primary mechanism of action of atracurium?

Relaxation of the muscles Signup and view all the answers

What is the risk associated with storing oxygen cylinders near electrical equipment?

Fire hazard Signup and view all the answers

What is the primary route of administration for atracurium?

Intravenous Signup and view all the answers

What is the primary method of administering atracurium?

Intravenously Signup and view all the answers

What is the primary concern when using atracurium in patients with hypothermia?

Prolonged muscle relaxation Signup and view all the answers

What is the primary mechanism of action of atracurium?

Binding to nicotinic receptors Signup and view all the answers

What is the primary reason for the rapid excretion of alfentanil in the urine?

Short half-life Signup and view all the answers

What percentage of alfentanil binds to proteins in the body?

92% Signup and view all the answers

Study Notes

Perioperative Care and Drug Administration

Ensuring correct storage of drugs is crucial in perioperative care to maintain potency and effectiveness.
Organising drugs in their appropriate locations is essential to prevent administering the wrong drug.
Controlled drugs, such as alfentanil, must be kept locked in a cupboard and accounted for regularly.

Controlled Drug Safety

Controlled drug safety is regulated by the Controlled Drugs (Supervision of Management) Regulations (2013).
The disposal of controlled drugs should be recorded in the controlled drugs book and confirmed by a second witness.
NICE guidelines (2016e) emphasize the need for a thorough check of controlled drug inventory.

6 R's Framework

The 6 R's framework ensures the safe administration of drugs: Right patient, Right drug, Right route, Right dose, Right time, and Right documentation.
Failure to perform these checks may result in harm to the patient and legal consequences for staff.

Patient Safety Checks

Before administering medication, confirm the patient's identity, allergies, and prescription.
Check the drug's name, stock strength, and dosage against the prescription.
Handle medications properly to prevent administering incorrect drugs.

Pharmacokinetics and Pharmacodynamics

Propofol

Pharmacokinetics: Propofol is absorbed by the body through IV administration, bound to albumin and erythrocytes, and metabolized by the liver.
Pharmacodynamics: Propofol is an intravenous anaesthetic that causes a decrease in blood pressure and cardiac output, and impairs baroreceptor response.

Ondansetron

Pharmacokinetics: Ondansetron is absorbed by the gastrointestinal tract, distributed into tissues, and metabolized by the liver.
Pharmacodynamics: Ondansetron is an anti-emetic that prevents nausea and vomiting, with a dose-dependent effect on the prevention of PONV.

Alfentanil

Pharmacokinetics: Alfentanil is absorbed by the body, bound to proteins, and metabolized by the liver.
Pharmacodynamics: Alfentanil is a short-acting opioid that causes respiratory depression, and must be used with caution in patients with COPD.

Atracurium

Pharmacokinetics: Atracurium is metabolized by non-enzymatic degradation and enzymatic metabolism, with less than 5% excreted in the urine.
Pharmacodynamics: Atracurium is a non-depolarising neuromuscular blocking agent that causes muscle paralysis, with a recommended initial dose for intubation in adults.

Sevoflurane

Pharmacokinetics: Sevoflurane is absorbed by the lungs, distributed by the lungs, and metabolized into inorganic fluoride and HFIP.
Pharmacodynamics: Sevoflurane is an inhalation agent that causes malignant hyperthermia, increases intracranial pressure, and has common side effects.

Sodium Chloride 0.9%

Sodium Chloride 0.9% is a crystalloid solution used to rehydrate fasted patients, treat mild hypotension, and hypovolaemia.
It can cause swelling, oedema, and renal damage if too much is given.

Oxygen

Oxygen is administered via a face mask to prevent hypoxia and maintain oxygen saturations above 94%.
It can be used as a carrier gas for volatile agents, such as sevoflurane.
Respiratory failure can occur if the flow and percentage are too high.

Alfentanil

Controlled drug that must be stored in a locked cupboard with access restricted to ODP
Records of dose administered, used, and wasted must be kept and countersigned by an anaesthetist
Short-acting opioid used for short procedures, administered via IV
Completely absorbed by the body, with effects occurring immediately
92% bound to proteins in the body
Metabolized by the liver, with 1% unchanged in urine
Rapidly excreted in urine due to short half-life
Typical dose: 30-50mcg/kg for general anaesthesia, additional doses: 15mcg/kg for short procedures
Side effects: arrhythmias, confusion, constipation, euphoria, headaches, nausea, respiratory depression
Contraindications: elderly, hypotension, hypothyroidism, COPD, drug addictions

Atracurium

Non-depolarising neuromuscular blocking agent used to facilitate endotracheal intubation
Administered via IV as a single bolus or infusion
Onset of action: around 2 minutes
Acetylcholine antagonist, blocking nicotinic receptors in the postsynaptic membrane
Metabolism: 45% non-enzymatic degradation, rest metabolized by plasma enzymes
Recommended initial dose: 300-600mcg/kg for intubation in adults
Side effects: flushing, hypotension, tachycardia, bronchospasm
Contraindications: cardiovascular disease, hypothermia

Sevoflurane

Inhalation agent used for induction and maintenance of general anaesthesia
Administered via inhalation, distributed by lungs, and enters bloodstream
Onset rate depends on concentration and pulmonary blood flow
Metabolized into inorganic fluoride and HFIP, excreted via expiration
Administered in two stages: induction (up to 8%) and maintenance (0.5-3%)
Can cause malignant hyperthermia, increases intracranial pressure
Side effects: arrhythmias, agitation, apnea, hypertension, hypotension, vomiting
Contraindications: pregnancy, as it crosses the blood-brain barrier and can depress foetal heart rate

Sodium Chloride 0.9%

Crystalloid solution stored in pharmacy cupboard
Administered IV to offset hypotension due to fluid and blood loss
Rehydrates fasted patients, treats mild hypotension and hypovolaemia
Can cause: swelling, oedema, and renal damage if too much is given

Oxygen

Administered via face mask
Prevents hypoxia, maintains oxygen saturations above 94%
Can be used as a carrier gas for volatile agents (e.g., Sevoflurane)
Respiratory failure if flow and percentage are too high
Stored in cylinders in safe spaces away from electrical equipment due to fire hazard

Alfentanil

Controlled drug that must be stored in a locked cupboard with access restricted to ODP
Records of dose administered, used, and wasted must be kept and countersigned by an anaesthetist
Short-acting opioid used for short procedures, administered via IV
Completely absorbed by the body, with effects occurring immediately
92% bound to proteins in the body
Metabolized by the liver, with 1% unchanged in urine
Rapidly excreted in urine due to short half-life
Typical dose: 30-50mcg/kg for general anaesthesia, additional doses: 15mcg/kg for short procedures
Side effects: arrhythmias, confusion, constipation, euphoria, headaches, nausea, respiratory depression
Contraindications: elderly, hypotension, hypothyroidism, COPD, drug addictions

Atracurium

Non-depolarising neuromuscular blocking agent used to facilitate endotracheal intubation
Administered via IV as a single bolus or infusion
Onset of action: around 2 minutes
Acetylcholine antagonist, blocking nicotinic receptors in the postsynaptic membrane
Metabolism: 45% non-enzymatic degradation, rest metabolized by plasma enzymes
Recommended initial dose: 300-600mcg/kg for intubation in adults
Side effects: flushing, hypotension, tachycardia, bronchospasm
Contraindications: cardiovascular disease, hypothermia

Sevoflurane

Inhalation agent used for induction and maintenance of general anaesthesia
Administered via inhalation, distributed by lungs, and enters bloodstream
Onset rate depends on concentration and pulmonary blood flow
Metabolized into inorganic fluoride and HFIP, excreted via expiration
Administered in two stages: induction (up to 8%) and maintenance (0.5-3%)
Can cause malignant hyperthermia, increases intracranial pressure
Side effects: arrhythmias, agitation, apnea, hypertension, hypotension, vomiting
Contraindications: pregnancy, as it crosses the blood-brain barrier and can depress foetal heart rate

Sodium Chloride 0.9%

Crystalloid solution stored in pharmacy cupboard
Administered IV to offset hypotension due to fluid and blood loss
Rehydrates fasted patients, treats mild hypotension and hypovolaemia
Can cause: swelling, oedema, and renal damage if too much is given

Oxygen

Administered via face mask
Prevents hypoxia, maintains oxygen saturations above 94%
Can be used as a carrier gas for volatile agents (e.g., Sevoflurane)
Respiratory failure if flow and percentage are too high
Stored in cylinders in safe spaces away from electrical equipment due to fire hazard

Alfentanil

Controlled drug that must be stored in a locked cupboard with access restricted to ODP
Records of dose administered, used, and wasted must be kept and countersigned by an anaesthetist
Short-acting opioid used for short procedures, administered via IV
Completely absorbed by the body, with effects occurring immediately
92% bound to proteins in the body
Metabolized by the liver, with 1% unchanged in urine
Rapidly excreted in urine due to short half-life
Typical dose: 30-50mcg/kg for general anaesthesia, additional doses: 15mcg/kg for short procedures
Side effects: arrhythmias, confusion, constipation, euphoria, headaches, nausea, respiratory depression
Contraindications: elderly, hypotension, hypothyroidism, COPD, drug addictions

Atracurium

Non-depolarising neuromuscular blocking agent used to facilitate endotracheal intubation
Administered via IV as a single bolus or infusion
Onset of action: around 2 minutes
Acetylcholine antagonist, blocking nicotinic receptors in the postsynaptic membrane
Metabolism: 45% non-enzymatic degradation, rest metabolized by plasma enzymes
Recommended initial dose: 300-600mcg/kg for intubation in adults
Side effects: flushing, hypotension, tachycardia, bronchospasm
Contraindications: cardiovascular disease, hypothermia

Sevoflurane

Inhalation agent used for induction and maintenance of general anaesthesia
Administered via inhalation, distributed by lungs, and enters bloodstream
Onset rate depends on concentration and pulmonary blood flow
Metabolized into inorganic fluoride and HFIP, excreted via expiration
Administered in two stages: induction (up to 8%) and maintenance (0.5-3%)
Can cause malignant hyperthermia, increases intracranial pressure
Side effects: arrhythmias, agitation, apnea, hypertension, hypotension, vomiting
Contraindications: pregnancy, as it crosses the blood-brain barrier and can depress foetal heart rate

Sodium Chloride 0.9%

Crystalloid solution stored in pharmacy cupboard
Administered IV to offset hypotension due to fluid and blood loss
Rehydrates fasted patients, treats mild hypotension and hypovolaemia
Can cause: swelling, oedema, and renal damage if too much is given

Oxygen

Administered via face mask
Prevents hypoxia, maintains oxygen saturations above 94%
Can be used as a carrier gas for volatile agents (e.g., Sevoflurane)
Respiratory failure if flow and percentage are too high
Stored in cylinders in safe spaces away from electrical equipment due to fire hazard

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.