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Basics of Anesthesia > Anesthesia Drug List > Flashcards

Anesthesia Drug List Flashcards

1
Q

What are all 6 medications typically given for sedation during an RSI? (Generic & Brand names)

A
  1. Etomidate (Amidate)
  2. Ketamine (Ketalar)
  3. Methohexital (Brevital)
  4. Propofol (Diprivan)
  5. Midazolam (Versed)
  6. Dexmedetomidine (Precedex)
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2
Q

What is the brand name for Etomidate?

A

Amidate

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3
Q

What is the brand name for Ketamine?

A

Ketalar

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4
Q

What is the brand name for Methohexital?

A

Brevital

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5
Q

What is the brand name for Propofol?

A

Diprivan

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6
Q

What is the brand name for Midazolam?

A

Versed

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7
Q

What is the brand name for Dexmedetomidine?

A

Precedex

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8
Q

What is the generic name for Precedex?

A

Dexmedetomidine

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9
Q

What is the generic name for Versed?

A

Midazolam

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10
Q

What is the generic name for Diprivan?

A

Propofol

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11
Q

What is the generic name for Brevital?

A

Methohexital

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12
Q

What is the generic name for Ketalar?

A

Ketamine

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13
Q

What is the generic name for Amidate?

A

Etomidate

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14
Q

What is the drug class, MOA, and indication for Etomidate (Amidate)?

A

Class: Short acting non-barbiturate hypnotic
MOA: GABA mimic- binds to GABAa receptors & ^ receptor affinity for GABA. inhibits postsynaptic GABA, causing prolonged sedation. acts on RAS system.
Indication: sedation for induction of anesthesia

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15
Q

What is the drug class, MOA, and indication for Ketamine (Ketalar)?

A

Class: NMDA Antagonist, rapid-acting general anesthetic
MOA: binds noncompetitively to NMDA (glutamate) receptors > inhibits receptor (glut is excitatory) > decreases presynaptic glutamate & potentiates GABA release
Indication: sedation for induction of anesthesia

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16
Q

What is the drug class, MOA, and indication for Methohexital (Brevital)?

A

Class: Short-acting Barbiturate
MOA: binds to GABA receptors & ^ receptor affinity for GABA. inhibits postsynaptic GABA, causing prolonged sedation.
Indication: induces deep sedation

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17
Q

What is the drug class, MOA, and indication for Propofol (Diprivan)?

A

Class: sedative/hypnotic agent
MOA: modulates GABA receptor > ^ transmem. Cl- conduction > hyperpolar postsynapse = sedation
Indication: induction and maintenance of anesthesia, management of refractory status epilepticus

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18
Q

What is the drug class, MOA, and indication for Midazolam (Versed)?

A

Class: Benzodiazepine
MOA: binds to GABA receptor (enhances inhibition) > increased influx of chloride > hyperpolarization of postsynaptic cell = sedation
Indication: sedation for induction of anesthesia, anxiolytic, seizure disorder

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19
Q

What is the drug class, MOA, and indication for Dexmedetomidine (Precedex)?

A

Class: Alpha 2a agonist
MOA: binds to pre & postsynaptic alpha 2a receptors > decreases norepi = sedation & analgesia
Indication: Sedation and anxiolytic

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20
Q

What is the most common “theme” MOA of sedative agents?

A

Some alteration on GABA/receptor/ increased cl- channel open (increased chloride influx) that results in hyperpolarization of the postsynaptic cell which directly results in sedation

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21
Q

What is the supplied dose of Etomidate (Amidate)?

A

2mg/mL

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22
Q

What is the supplied dose of Ketamine (Ketalar)?

A

10mg/mL OR 50mg/mL

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23
Q

What is the supplied dose of Methohexital (Brevital)?

A

10mg/mL

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24
Q

What is the supplied dose of Propofol (Diprivan)?

A

10mg/mL

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25
Q

What is the supplied dose of Midazolam (Versed)

A

1mg/mL OR 5mg/mL

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26
Q

What is the supplied dose of Dexmedetomidine (Precedex)?

A

200mcg/2ml

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27
Q

What is the induction dose of Etomidate (Amidate)?

A

0.2-0.4mg/kg
70 kg dose: 7-14 mLs

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28
Q

What is the induction dose of Ketamine (Ketalar)?

A

1-2mg/kg IV OR 4-8mg/kg IM
70kg dose: 7-14 mL IV (10mg/mL)
1.4-2.8 mL IV (50mg/ml)
28-56 mL IM (10mg/ml)
5.6-11.2mL IM (50mg/mL)

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29
Q

What is the induction dose of Methohexital (Brevital)?

A

1mg/kg
70kg dose: 7 mLs

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30
Q

What is the induction dose of Propofol (Diprivan)?

A

2-2.5mg/kg
70kg dose: 14-17.5 mLs

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31
Q

What is the induction dose of Midazolam (Versed)

A

1-5mg OR 0.01-0.1mg/kg
70kg dose: 0.7-7 mL (1mg/mL con)
0.14-1.4 mL (5mg/mL con)

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32
Q

What is the induction dose of Dexmedetomidine (Precedex)?

A

loading dose: 1mcg/kg over 10 min
maintenance: 0.2-0.7mcg/kg/hr
70kg loading dose: 0.7 mL (200mcg/2mL)

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33
Q

Onset/PK/DOA of Etomidate (Amidate):

A

30s|1m|3-10m

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34
Q

Onset/PK/DOA of Ketamine (Ketalar):

A

30s|1m|5-15m

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35
Q

Onset/PK/DOA of Methohexital (Revital):

A

30s|30s|5-10m

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36
Q

Onset/PK/DOA of Propofol (Diprivan):

A

60s|1m|5-10m

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37
Q

Onset/PK/DOA of Midazolam (Versed):

A

1m|4m|15-20m

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38
Q

Onset/PK/DOA of Dexmedetomidine (Precedex):

A

NO INFO

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39
Q

What are other considerations r/t Etomidate (Amidate)?

A

CV stable, less myocardial depression that prop
S/E: myoclonus/pain w inject, epileptic foci
Metab: plasma esterase & hepatic enzymes
induct dose = inhibit Beta hydroxylase = sup adrenocortical

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40
Q

What are other considerations r/t Ketamine (Ketalar)?

A

hallucinations/^CO/^HR/^saliva/decr BP/ analgesia
Metab: redistribution

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41
Q

What are other considerations r/t Methohexital (Revital)?

A

porphyria (buildup of chemicals)
CI: asthma

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42
Q

What are other considerations r/t Propofol (Diprivan)?

A

pain w/ inject/antiemetic/decrease CV
Metab: liver & lungs
CI: egg/soy allergy

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43
Q

What are other considerations r/t Midazolam (Versed)?

A

decreased resp/amnesia
Metab: renal elim, 1/2 life 1-4hr, H2O sol

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44
Q

What are other considerations r/t Dexmedotomidine

A

Alpha A2 agonist

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45
Q

Which 3 sedatives are supplied in 10mg/ml concentrations?

A
  1. Ketamine (can also be 50mg/mL)
  2. Methohexital
  3. Propofol
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46
Q

What are the 7 Paralytic agents?

A
  1. Succinylcholine (Anectine)
  2. Mivacurium (Mivacron)
  3. Atracurium (Tracrium)
  4. Vecuronium (Norcuron)
  5. Rocuronium (Zemuron)
  6. Cisatracurium (Nimbex)
  7. Pancuronium (Pavulon)
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47
Q

What paralytic is a Depolarizing neuromuscular blocker, while all the others are Nondepolarizing?

A

Succinylcholine (Anectine)

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48
Q

What is the brand name for Succinylcholine?

A

Anectine

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49
Q

What is the generic name for Anectine?

A

Succinylcholine

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50
Q

What is the brand name for Mivacurium?

A

Mivacron

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51
Q

What is the generic name for Mivacron?

A

Mivacurium

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52
Q

What is the generic name for Tracrium?

A

Atracurium

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53
Q

What is the brand name for Atracurium?

A

Tracrium

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54
Q

What is the generic name for Norcuron?

A

Vecuronium

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55
Q

What is the brand name for Vecuronium?

A

Norcuron

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56
Q

What is the generic name for Zemuron?

A

Rocuronium

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57
Q

What is the brand name for Rocuronium?

A

Zemuron

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58
Q

What is the generic name for Nimbex?

A

Cisatracurium

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59
Q

What is the brand name for Cisatracurium?

A

Nimbex

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60
Q

What is the generic name for Pavulon?

A

Pancuronium

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61
Q

What is the brand name for Pancuronium?

A

Pavulon

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62
Q

What is the supplied dose of Succinylcholine (Anectine)?

A

20mg/mL (makes sense bc induction dose is largest of all paralytics)

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63
Q

What is the supplied dose of Mivacurium (Mivacron)?

64
Q

What is the supplied dose of Atracurium (Tracrium)?

65
Q

What is the supplied dose of Vecuronium (Norcuron)?

A

1mg/mL after diluted

66
Q

What is the supplied dose of Rocuronium (Zemuron)?

67
Q

What is the supplied dose of Cisatracurium (Nimbex)?

68
Q

What is the supplied dose of Pancuronium (Pavulon)?

A

1mg/mL OR 2mg/mL

69
Q

What 3 paralytics are supplied in 2mg/mL concentrations?

A
  1. Mivacurium (Mivacron)
  2. Cisatracurium (Nimbex)
  3. Pancuronium (Pavulon) (can also be 1mg/mL)
70
Q

What 2 paralytics are supplied in 1mg/mL concentrations?

A
  1. Vecuronium (Norcuron)
  2. Pancuronium (Pavulon) (can also be 2mg/mL)
71
Q

What 2 paralytics are supplied in 10mg/mL concentrations?

A
  1. Atracurium (Tracrium)
  2. Rocuronium (Zemuron)
72
Q

Which paralytic agent is supplied in 20mg/mL concentration?

A

Succinylcholine (Anectine)

73
Q

What is the induction dose for Succinylcholine (Anectine)?

A

1-1.5mg/kg IV
3-4mg/kg IM
70kg dose: 3.5-5.25 mL IV, 10.5-14 mL IM

74
Q

What is the induction dose for Mivacurium (Mivacron)?

A

0.25mg/kg
70kg dose: 8.75 mL

75
Q

What is the induction dose for Atracurium (Tracrium)?

A

0.4-0.5mg/kg
70kg dose: 2.8-3.5 mL

76
Q

What is the induction dose for Vecuronium (Norcuron)?

A

0.1mg/kg
70kg dose: 7mL

77
Q

What is the induction dose for Rocuronium (Zemuron)?

A

0.6-1.2mg/kg
70kg dose: 4.2-8.4 mL

78
Q

What is the induction dose for Cisatracurium (Nimbex)?

A

0.15mg/kg
70kg dose: 5.25 mL

79
Q

What is the induction dose for Pancuronium (Pavulon)?

A

0.1mg/mL
70kg dose: 7 mL (1mg/mL), 3.5 mL (2mg/mL)

80
Q

Which two paralytic agents have the same induction dose (0.1mg/kg)?

A

Vecuronium (Norcuron) & Pancuronium (Pavulon)
Cisatracurium (Nimbex) is close, at 0.15mg/mL

81
Q

Which 2 paralytic agents are short acting?

A

Succinylcholine (Anectine) & Mivacurium (Mivacron)

82
Q

What are the 4 intermediate acting paralytic agents?

A
  1. Atracurium (Tracrium)
  2. Cisatracurium (Nimbex)
  3. Rocuronium (Zemuron)
  4. Vecuronium (Norcuron)
    ACRV: like the car… a honda CRV
83
Q

Which paralytic agent is long acting?

A

Pancuronium (Pavulon)

84
Q

Onset/DOA of Succinylcholine (Anectine):

A

~60s|5-10m

85
Q

Onset/DOA of Mivacurium (Mivacron):

A

2-3m|20-30m

86
Q

Onset/DOA of Atracurium (Tracrium):

A

3-5m|30-60m

87
Q

Onset/DOA of Vecuronium (Norcuron):

A

3-5m|30-60m

88
Q

Onset/DOA of Rocuronium (Zemuron):

A

1-2m|30-60m

89
Q

Onset/DOA of Cisatracurium (Nimbex):

A

3-5m|30-60m

90
Q

Onset/DOA of Pancuronium (Pavulon):

A

3-5m|60-90m

91
Q

Which paralytic agent acts quickest?

A

Succinylcholine (Anectine)

92
Q

Which non-depolarizing muscular blocker works quickest?

A

Rocuronium (Zemuron)

93
Q

Metab/consids for Succinylcholine (Anectine):

A

Metab: Plasma pseudocholinesterase
Locks NA channel

94
Q

Metabolism for Mivacurium (Mivacron):

A

Plasma cholinesterase

95
Q

Metabolism for Atracurium (Tracrium):

A

Hoffman/Ester Hydrolysis

96
Q

Metab/consids for Vecuronium (Norcuron):

A

Metab: Liver>Kidney, ^ lipid soluble

97
Q

Metab/consids for Rocuronium (Zemuron):

A

Metab: Liver>Kidney, painful injection

98
Q

Metabolism for Cisatracurium (Nimbex):

A

Hoffman/Ester Hydrolysis

99
Q

Metabolism/consids for Panacurium (Pavulon):

A

Renal, ^ HR due to blocking Norepi reuptake

100
Q

Which paralytic agent can induce MH?

A

Succinylcholine (Anectine)

101
Q

Which 2 paralytic agents cause histamine release?

A
  1. Mivacurium (Mivacron)
  2. Atracurium (Tracrium)
102
Q

What are the 7 opioids/analgesics used in anesthesia?

A
  1. Fentanyl (Sublimaze)
  2. Sufentanil (Sufenta)
  3. Remifentanil (Ultiva)
  4. Meperidine (Demerol)
  5. Ketorolac (Toradol)
  6. Morphine
  7. Hydromorphone (Dilaudid)
103
Q

Generic for Sublimaze:

104
Q

Brand name for Fentanyl:

105
Q

Generic for Sufenta:

A

Sufentanil

106
Q

Brand name for Sufentanil:

107
Q

Generic for Ultiva:

A

Remifentanil

108
Q

Brand name for Remifentanil:

109
Q

Generic for Demerol:

A

Meperidine

110
Q

Brand name fo Meperidine:

111
Q

Generic for Toradol:

112
Q

Brand name for Ketorolac:

113
Q

Generic for Dilaudid:

A

Hydromorphone

114
Q

Brand name for Hydromorphone:

115
Q

Which opioid/analgesic does not have a “Brand name”?

116
Q

Which two opioids/analgesics are supplied in 50mcg/mL concentration?

A

Fentanyl (Sublimaze)
Sufentanil (Sufenta)

117
Q

Supplied dose of Fentanyl (Sublimaze):

A

50mcg/mL (I’ve seen 100mcg/2mL)

118
Q

Supplied dose of Sufentanil (Sufenta):

A

50mcg/mL (when reconstituted)

119
Q

Supplied dose of Remifentanil (Ultiva):

A

1-2mg/mL (when reconstituted)

120
Q

Supplied dose of Meperidine (Demerol):

121
Q

Supplied dose of Ketorolac (Toradol):

122
Q

Supplied dose of Morphine:

123
Q

Supplied dose of Hydromorphone (Dilaudid):

124
Q

Fentanyl (Sublimaze) induction dose:

A

1-2mcg/kg
70kg dose: 1.4-2.8 mL

125
Q

Sufentanil (Sufenta) induction dose:

A

0.1-0.5mcg/kg
70kg dose: 0.14-0.7mL

126
Q

Remifentanil (Ultiva) induction dose:

A

0.5-1mcg/kg/min
70kg continuous dose: doesn’t come out right, very small #s

127
Q

Meperidine (Demerol) induction dose:

A

1mg/kg
70kg dose: 7 mL

128
Q

Ketorolac (Toradol) induction dose:

A

30mg/IV OR 60mg/IV

129
Q

Morphine induction dose:

A

0.1mg/kg
70kg dose: 0.7-7 mL, depending on concentration

130
Q

Hydromorphone (Dilaudid) induction dose:

A

0.01-0.04mg/kg
70kg dose: 0.35-1.4 mL

131
Q

2 considerations for Fentanyl (Sublimaze):

A
  1. Pulm 1st pass
  2. Rigid chest
132
Q

3 considerations for Sufentanil (Sufenta):

A
  1. Rigid chest
  2. Most potent
  3. Pulm 1st pass
133
Q

How does Remifentanil (Ultiva) have such a short 1/2 life? (Metabolism)

A

Metabolism via Hydrolysis Esterase = ultra short 1/2 time of 6 mins

134
Q

What are considerations for Meperidine (Demerol)?

A

metabolite = seizure, CI w/ MAOIs, crosses placenta, ^ HR
Treats shivering

135
Q

What is a consideration for Ketorolac (Toradol)?

A

^ Bleeding risk/inhibits COX

136
Q

Morphine considerations:

A

S/E: N/V, histamine = most allergies
treats cough/antitussive
Biliary spasm

137
Q

Hydromorphone (Dilaudid) considerations:

A

S/E: n/v, histamine reaction = allergic
1mg = 7mg of MSO4

138
Q

Dilaudid is ___ times stronger than Morphine

139
Q

What are the shortest and longest acting analgesics?

A

Short: Remifentanil
Long: Morphine

140
Q

Onset/PK/DOA of Fentanyl (Sublimaze):

A

30s|5-15m|30-60m

141
Q

Onset/PK/DOA of Sufentanil (Sufenta):

A

1-3m|3-5m|20-45m

142
Q

Onset/PK/DOA of Remifentanil (Ultiva):

A

30s|0|5-10m

143
Q

Onset/PK/DOA of Meperidine (Demerol):

A

1m|5-20m|2-4h

144
Q

Onset/PK/DOA of Ketorolac (Toradol):

A

30s|60-120m|4-6h

145
Q

Onset/PK/DOA of Morphine

A

1-5m|5-20m|2-7h

146
Q

Onset/PK/DOA of Hydromorphone (Dilaudid):

A

10-15m|15-30m|2-3h

147
Q

What are 5 most common sympathomimetics used?

A
  1. Ephedrine
  2. Phenylephrine (Neosynephrine)
  3. Epinephrine (Adrenaline) (1:1000; 1mg/mL)
  4. Dopamine (Intropin)
  5. Dobutamine (Dobutrex)
148
Q

What are the two first line sympathomimetics?

A

Ephedrine and Phenylephrine

149
Q

Which 3 sympathomimetics increase myocardial contractility?

A
  1. Epi
  2. Dopamine
  3. Dobutamine
150
Q

What are the 2 anticholinergics/antimuscarinics used in anesthesia?

A
  1. Atropine
  2. Glycopyrrolate
151
Q

What does Naloxone (Narcan) reverse?

152
Q

What does Flumazenil (Romazicon) reverse?

153
Q

What 3 antihypertensives are most commonly used in anesthesia? (generic & brand)

A
  1. Hydralazine (Apresoline)
  2. Labetalol (Trandate)
  3. Esmolol (Brevibloc)
154
Q

What medication is most commonly used for stress ulcer prevention?

A

Famotidine (Pepcid)
can also be used during allergic reaction with Diphenhydramine (Benadryl)

155
Q

What 4 antiemetics are most commonly used?

A
  1. Ondansetron (Zofran)
  2. Droperidol (Inapsine)
  3. Dexamethasone (Decadron)
  4. Scopolamine (Transderm Scop)
156
Q

What are the 2 options for Paralytic reversal?

A
  1. Bridion (Sugammadex)
  2. Neostigmine (Prostigmine) + Glycopyrrolate (Robinul) to prevent muscarinic effects of neo such as bradycardia

Basics of Anesthesia (3 decks)

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