BT_GS 1.16 Describe alterations to drug response due to obesity

Ok, I’ve paraphrased that LO a bit, so that we can stay with the topic for one more day.

We give drugs to people with a high BMI on a daily basis (at least at the institution I work in..), so it is important that we know what the implications of a larger lipid load are and how to adjust our dosing…

For today’s picture I have chosen another one of Andy Paiko’s amazing glass works.

andy-paiko-glass-syringe

 

BT_PO 1.16  Describe alterations to drug response due to physiological change with particular reference to the elderly

This is a complicated issue [I’m giving you a free true statement]

It is appropriate to dose muscle relaxants, such as vecuronium and rocuronium, based on ideal body weight (IBW)    TRUE/FALSE

When using propofol for maintenance of anaesthesia, calculate the infusion rate based on total body weight (TBW)    TRUE/FALSE

The increased cardiac output seen in morbid obesity, will hasten recovery from volatile anaesthesia TRUE/FALSE

Plasma levels of pseudocholinesterase are increased with morbid obesity TRUE/FALSE

Suxamethonium doses should be based on TBW  TRUE/FALSE

2017.1 : SAQ 4

Outline the genetic variations in the cytochrome P450 2D6 enzyme and discuss the clinical relevance for drugs used in the perioperative period.

BT_GS 1.20

This enzyme is responsible for much of the variation in efficacy and toxicity of some commonly used drugs.

This enzyme metabolises tramadol into a more active metabolite   TRUE/FALSE

Ondansetron may be ineffective with poor metabolisers  TRUE/FALSE

Patients from the middle east are more likely to be ultrarapid metabolisers  TRUE/FALSE

Approximately 90% of caucasians are poor metabolisers  TRUE/FALSE

This enzyme metabolises codeine into a more active metabolite  TRUE/FALSE

 

SS_OB 1.9 Drug Variability in Pregnancy

SS_OB 1.9 Describe the influence of pregnancy on the pharmacokinetics and pharmacodynamics of drugs commonly used in anaesthesia and analgesia

TRUE/FALSE In pregnancy the average gain of 8 litres of total body water significantly increases the volume of distribution of hydrophilic drugs.

TRUE/FALSE Foetal and placental tissues provide another compartment for drug distribution.

TRUE/FALSE Pseudocholinesterase activity is decreased in pregnancy causing prolongation of succinylcholine block.

TRUE/FALSE Pregnancy reduces MAC by 25-30%.

TRUE/FALSE Nociceptive response thresholds are elevated in pregnancy.