Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cumulative Pharmacology > [1 question/flashcard] Intraop Meds - EVERYTHING > Flashcards

[1 question/flashcard] Intraop Meds - EVERYTHING

1
Q

Midazolam dose range

A
  1. 02 - 0.04 mg/kg IV
  2. 4-0.8 mg/kg PO
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Midazolam syringe size

A

3 mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Midazolam concentration

A

1 mg/mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Midazolam preparation

A

2 mL = 2 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Midazolam metab

A

hepatic CYP 450 - oxidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Midazolam T1/2

A

2 hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Midazolam onset, peak, duration

A

Onset 30-60 seconds

half-time to peak effect 5 minutes

DOA 30-60 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Midazolam sticker color

A

(duller) orange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Fentanyl dose range

A

1-3 mcg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Fentanyl syringe size

A

3 or 5 mL

(comes in 2, 5, 10 mL vials) - sim notes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Fentanyl concentration

A

50 mcg/mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Fentanyl preparation

A

(2 mL = 100 mcg)

3 mL = 150 mcg or 5 mL = 250 mcg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Fentanyl onset, peak, duration

A

onset 3-5 minutes (Even tho Falyar said 1-3 minutes)

peak _____

duration 60 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Fentanyl sticker color

A

Carolina Blue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Lidocaine dose range

A

1-1.5 mg/kg IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Lidocaine syringe size

A

5 mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Lidocaine concentration

A

1% = 10 mg/mL

2% = 20 mg/mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Lidocaine preparation

A

2% → 20 mg/mL → 5 mL = 100 mg

1% → 10 mg/mL → 5 mL = 50 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Lidocaine metab

A

amide local anesthetic: liver metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Lidocaine onset, peak, duration

A

onset 45-90sec

peak 1-2 min

duration 10-20 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Lidocaine onset, peak, DOA

A

onset: 45-90 sec
peak: 1-2 min

DOA: 10-20 minutes

“lido is 1-2, 1-2 min 10-20 min”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Lidocaine sticker color

A

gray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Propofol dose range

A

1.5-2.5 mg/kg IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Propofol syringe size

A

20 mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Propofol concentration

A

10 mg/mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Propofol preparation

A

20 mL = 200 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Propofol onset, peak, duration

A

onset 30-60 sec

peak _____

duration 5-15 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Propofol T1/2

A

30-90 min

(Falyar said 11.5 hrs LOLOL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Propofol metabolism

A

hepatic glucuronidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Propofol sticker color

A

yellow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Etomidate dose range

A

0.2 - 0.4 mg/kg IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Etomidate syringe size

A

10 mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Etomidate concentration

A

2 mg/mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Etomidate preparation

A

10 mL = 20 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Etomidate onset, peak, duration

A

onset 30-60 seconds

(1 arm-to-brain circulation)

peak 1 minute

duration 5-15 min (OTHER CHART SAID 3-10 min)

AN ATOM BOMB TAKES 1 minute to go off, you know withni 5- 15 minutes if you want to end a date

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Etomidate T1/2

A

2-5 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Etomidate metabolism

A

hydrolysis by plasma esterases

and hepatic metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Ketamine dose range (IV)

A

1-2.5 mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Ketamine syringe size

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Ketamine concentration

A

“5-100 mg/mL”

5 mg/mL

10 mg/mL

50 mg/mL

100 mg/mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Ketamine preparation

A

often diluted to 10 mg/mL

50 mg/mL → 1 mL + 4 mL NS = 10 mg/mL

100 mg/mL → 1 mL + 9 mL = 10 mg/mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Succinylcholine is dosed based on…

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Ketamine onset, peak, duration

A

onset 30-60 seconds

peak _____

duration 5-10 minutes

“keta-mine, 5-TEEN (southern accent)”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Ketamine T1/2

A

2-3 hrs

(Nagelhout)

45
Q

Ketamine metabolism

A

*CYP 450 - demethylation primary metab → norketamine

then hydroxylation → other metabolites form a glucuronidation derivative (H2O-soluble) → renal excretion

46
Q

Succinylcholine dose range

(Trade: Anectine)

A

1 mg/mL

47
Q

Succinylcholine syringe size

(Trade: Anectine)

A

10 mL

48
Q

Succinylcholine concentration

(Trade: Anectine)

A

20 mg/mL

49
Q

Succinylcholine preparation

A

10 mL = 200 mg

50
Q

Succinylcholine onset, peak, duration

A

onset 30-60 seconds

peak 1 minute

duration 3-5 minutes (sim drug guide)

5-15 minutes (drug chart)

  • call it even and say 5-10 min - Nagelhout’s #*
  • (full recovery in 12-15 minutes - Nag)*
51
Q

Succinylcholine T1/2

A

2-4 minutes

52
Q

Succinylcholine metabolism

A

(quick) hydrolyzed by plasma esterases

remember PChE deficiency

53
Q

Succinylcholine sticker color

A

neon orange

neon orange = muscle relaxers

54
Q

Succinylcholine (Anectine) considerations:

who would you give to

who would you avoid it in

A

Give:

  • RSI: 1.5 mg/kg

Avoid:

  • peds < 5 yrs (risk for DMD)
  • hyperK+ patients
  • can give in renal pts if their K+ is normal (nagelhout)
  • lower motor neuron disease (upregulation of nAChRs) = give less or avoid in all of them except for MG
  • MG pts are resistant to succ bc they have less nAChRs (antibodies blocking the reeceptor)
  • lower PChE activity: advanced liver dz, age, malnutrition, pregnancy, burns, PO laxatives, MAOIs, echothiopate, cytotoxic drugs, anticholinesterase drugs

don’t have to avoid, but need much lower doses of nondepolarizers for all of them

55
Q

Succinylcholine (Anectine) considerations:

side effects

A
  • neuro: ↑ ICP/IOP
  • CV: tachycardia, but could cause sudden bradycardia in peds (or repeat doses in adults), falyar said bradycardia/junctional/sinus arrest
  • labs: intubating dose increases K+ by 0.5-1 mEQ/dL
  • GI/GU: ↑ gastric pressure/lower esophageal pressures, myoglobinuria
  • MSK: myalgia, masseter spasm - could be d/t MH or inadequate dosing
  • decreased synth of PChE in hepatitis/cirrhosis
  • dibucaine number
    • normal = 80% of PChE was inhibited by dibucaine
    • 40-60 = prolongs block 1.5-2x longer
    • <30 = prolongs block for 4-8 hrs!
56
Q

Glycopyrrolate Dose

A

5-10 mcg/kg

= .005 - 0.01 mg/kg

so just stick to 0.01 mg/kg

(other chart says 0.01-0.02 mg/kg)

“glyco-pyro, starts with 5 yo”

57
Q

glycopyrrolate syringe

A

3 or 5 mL

58
Q

Glycopyrrolate onset, peak, duration

A

onset < 1 minute

peak 5 minute

duration 2-4 hrs

glyco and neostigmine are slower onset, but sustained effect

59
Q

Glycopyrrolate T1/2

A

Nagelhout: less than 10% of drug is in the serum after 5 minutes

85% of IV dose is excreted in urine within 48 hrs

60
Q

Glycopyrrolate metabolism

A

Nagelhout: excreted in the feces/urine, primarily as unchanged drug

(makes sense bc highly charged)

“small amts are metabolized into inactive metabolites”

61
Q

Glycopyrrolate sticker color

(Trade: Robinul)

A

lime green

“Lime green, Atropine → lime green = antimuscarinics”

62
Q

glycopyrrolate concentration

A

0.2 mg/mL

63
Q

Atropine Dose

A

7-10 mcg/kg (Falyar)

= 0.007-0.01 mg/kg

(other chart says 0.01-0.03 mg/kg)

“Atro-pine, 7-to-ten”

64
Q

Atropine syringe size

A

3 mL

65
Q

Atropine concentration

A
  1. 04% = 0.4 mg/mL
  2. 01% = 0.1 mg/mL

or 1 mg/mL

66
Q

Atropine Preparation

A

1 mL = 0.4 mg

(2 vials) 2 mL = 0.8 mg

1mL = 1 mL

67
Q

Atropine onset, peak, duration

A

onset 45-60 seconds

peak 2 minutes

duration 30 minutes

(somewhere else said DOA is 1-4 hrs)

(Remember that glyco-neo are slower than atropine/edrophonium - but they last longer)

68
Q

Atropine T1/2

A

2-3 hrs

69
Q

Atropine metabolism

A

both liver and kidney:

metabolism by liver, and 30-50% excreted unchanged in the urine

70
Q

Atropine sticker color

A

lime green

“Lime green, Atropine → lime green = antimuscarinics”

71
Q

Neostigmine Dose

A

0.05 mg/kg

(range 0.04-0.08 mcg/kg)

Max dose 5 mg

72
Q

Neostigmine concentration

A

0.5 - 1 mg/mL

Ex: 70 kg person x 0.05 mg/kg = 3.5 mg

3.5 mg = 3.5 mL or 7 mL

73
Q

Neostigmine preparation

A

5 mL = 5 mg

(70 kg person at 0.05 mg/kg = 3.5 mg)

74
Q

Neostigmine syringe

A

5 mL

(if using 1 mg/mL concentration)

(10 mL if using 0.5 mg/mL concentration)

75
Q

Neostigmine onset/peak/duration

A

Onset 5 minutes

Peak 7 minutes

DOA 1-2 hrs

(as opposed to Edrophonium DOA only up to 1 hr)

76
Q

Neostigmine sticker color

A

white, with red candy stripe border

77
Q

Neostigmine T1/2

A
78
Q

Edrophonium dose range

A

0.5-1 mg/kg

79
Q

Rocuronium dose range

(Trade: Zemuron)

A
  1. 6 mg/kg - standard induction
  2. 2 mg/kg - RSI
80
Q

Rocuronium syringe size

A

5 mL

81
Q

Rocuronium concentration

A

10 mg/mL

82
Q

Rocuronium/Zemuron sticker color

A

neon orange

neon orange = muscle relaxers

83
Q

Rocuronium preparation

(Trade: Zemuron)

A

5 mL = 50 mg

(might need 2 vials and syringes)

84
Q

Rocuronium Onset, Peak, Duration

A

Onset: 45-90 seconds minute

Peak: 1-3 minutes

Duration: 30-60 min

85
Q

Rocuronium metabolism

A

hepatic and renal

33% renal (nagelhout)

86
Q

Rocuronium (Zemuron) T1/2

A

1-2 hrs

87
Q

Rocuronium (Zemuron) anesthetic considerations:

when would you use it

when would you avoid it

A

Use: RSI, need muscle paralysis <30-60 min

Avoid: renal pts

88
Q

Vecuronium dose

(Trade: Norcuron)

A

0.1 mg/kg

89
Q

Vecuronium syringe size

(Trade: Norcuron)

A

10 mL

90
Q

Vecuronium concentration

(Trade: Norcuron)

A

1 mg/mL

91
Q

Vecuronium sticker color

A

neon orange

neon orange = muscle relaxers

92
Q

Vecuronium preparation

(Trade: Norcuron)

A

10 mg powder into 10 mL NS

10 mL = 10 mg

93
Q

Vecuronium (Norcuron) T1/2

A

51-90 min (Nagelhout)

94
Q

Vecuronium (Norcuron) metabolism

A

liver and kidneys

95
Q

Vecuronium onset, peak, DOA

A

onset: 3 minutes
peak: 3-5 minutes

DOA: 25-30 minutes

“3-3-30”

96
Q

Vecuronium (Norcuron) anesthetic considerations

A

liver > kidney metabolism … but still avoid in renal pts

slower onset (3-5 min)

97
Q

Cisatricurium dose range

(Trade: Nimbex)

A

0.1-0.2 mg/kg

“Sis, you have 0.1 seconds to get out of my face” idk it works

98
Q

CIsatricurium syringe size

(Trade: Nimbex)

A

5 mL (may need 2 vials)

99
Q

CIsatricurium concentration

(Trade: Nimbex)

A

2 mg/mL

100
Q

Cisatricurium onset, peak, duration

A

onset: 2 minutes
peak: 2 minutes

DOA: quick! 20-35 min

(same DOA as VEC)

(another source says 6-16 min)

101
Q

CIsatricurium preparation

(Trade: Nimbex)

A

5 mL = 10 mg

(might need 2 vials)

example calculation 70 kg person = 7 mg, or 14 mg

102
Q

Cisatricurium metabolism

A

Hoffman Elimination in plasma and tissues

pH and temperature dependent

Hoffman accounts for 77% of elim of cis, and the other 23% is from plasma esterases

103
Q

Cisatracurium considerations

A

Laudanosine liberation (although 1/5 as much as atracurium). This means that the pt is at risk for convulsions, bc it crosses the BBB!

Laudanosine requires liver for metabolism, excreted in the bile and urine (so biliary obstructed pts will have an issue with this)

This is more a consideration for atracurium tbh.

104
Q

Cisatracurium T1/2

A

1 hr

105
Q

Phenylephrine sticker color

(Trade: Neosynephrine)

A

purple

pressors = purple

106
Q

dose range

syringe size

concentration

preparation

onset, peak, duration

T1/2

metabolism

A
107
Q

signs of MH

A

increase in EtCO2

muscle rigidity (↑ peak pressures)

metabolic acidosis

high temperature (late sign)

108
Q
A

Cumulative Pharmacology (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions