Emergency Medications 1. 2. 3.

1. Ephedrine 2. Phenylephrine 3. Atropine and Glycopyrrolate

Basic Anesthesia Set Up Flashcards by Iris Jonnah Simbulan

Clindamycin (Cleocin)

dose:

600 - 900 mg IV do not infuse faster than 10 mg/kg/min

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Propofol (Diprovan)

How many mg per ml do you draw?

What is the dose for induction?

10 mg/ ml

Dose: 1.0 - 2.5 mg/kg IV

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Phenylephrine (Neosynephrine)

Mix in ___ mg/ 100 NS = ___ mcg/ ml or double dilute with 10 ml syringe

Mix 10 mg/ 250 ml NS = 40 mcg/ml

dose: _____

Strong acting _____ adrenergic

May see ____ ____ from stimulation of baroreceptors

Hypotension + ______ = ______ + phenylephrine

Mix in 10 mg
NS= 100 mcg/ml

3. 40 - 100 mcg/ ml

Strong acting alpha-adrenergic

May see reflex bradycardia from stimulations of baroreceptors

Hypotension + tachycardia = Fluids + phenylephrine (more alpha adrenergic)

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Vecurnonium (Norcuron) 1mg/ml

needs to be _____

Dose: ___ - ___

RSI dose: _____

diluted
0.08 -0.1 mg/kg

3. RSI DOSE: 0.2 mg/kg

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Fentanyl (50mcg/cc)

How much will you draw and usually give for induction?

Draw up in 3cc or 5cc syringe.

Usually, give 50-100 mcg with induction (but will vary)

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Medications for emergency bradycardia

Atropine
Glycopyrolate

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Glycopyrrolate dose

0.01-0.02mg/kg

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Emergency Medications

Ephedrine
Phenylephrine
Atropine and Glycopyrrolate

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Glycopyrrolate concentration

0.2mg/cc

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Sugammadex is used to reverse

rocuronium or vecuronium
*more predictable with rocuronium

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Awake fiberoptic intubation precedex dose

*loading: 1mcg/kg** over 10 minutes
*Maintenance: 0.7mcg/kg/hr** until ETT secured

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Name the pressors used for emergency

Ephedrine 50mg/ml

dose: 2.5 - 10 mg

Phenylephrine 10mg/ml

IV: 40 - 100 mcg

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What would you always check for in your cart?

Hint: this is an emergency medication

Epinephrine

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Neostigmine concentration and dose

1mg/cc
dose: 0.05-0.07mg/kg

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How many receptors are occupied?

TOF 0/4 - 95% receptor occupied

TOF 1/4 - ____ %

TOF 2/4 - ____ 85%

TOF 3/4- ____ %

TOF 4/4 ____%

TOF 0/4 -95%

TOF 1/4 - 90 %

TOF 2/4 - 85%

TOF 3/4- 75%

TOF 4/4 -70%

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Etomidate (Amidate) comes only comes ______

What is the dose?

Only comes in 20mg/10ml (2mg/ml)

Dose: 0.2 - 0.3 mg/kg IV

may NOT be part of your typical cart set up

Burns on IV injection; can be given with lidocaine

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Metronidazole (Flagyl) dose

500 mg IV

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Basic drug set up ON TOP of cart typical drugs to have ready are

Fentanyl

Lidocaine

Propofol

Zemuron, Vecuronium, Cisatracurium

Succinylcholine

Vancomycin ____ gm IV

1 gm given over an hour

Lidocaine (Xylocaine)

How many ml’s will you draw?

for a 2% , for a 1%?

dose___

Draw up: 5 ml - 10 ml of 2% (20 mg/ml) or 1 % (10 mg/cc)

dose: 1mg/kg

Bridion dose:

If spontaneous recovery of the twitch response has reached 1-2 post-tetanic counts (PTCs), no twitch responses to TOF

4mg /kg

Negative Pressure Pulmonary Edema can be caused by?

How will you try to mitigate it?

Patient biting on the ET tube; mitigated by using a bite block

For peds bradycardia you would give

atropine
*for its longer action and to match the DOA of succinylcholine

Vecuronium brand name

**Norcuron**

Brand name for Sugammadex

**Bridion**

**ALWAYS** have this drug unless contraindicated. this is considered **de-fasiculating** non-depolarizing drug at (\_\_\_\_mg or 1/2 ml Zemuron It can cause _______ or even arrest (usually with repeat doses) this drug is a trigger for **MH** **GOLD STANDARD** in RSI

**SUCCINYLCHOLINE** 5mg or 1/2 ml brady-arrythmias

Most common ATB drugs in Anesthesia Cefazolin (Kefzol, Ancef) 2 gm IV; ___ gm over 120 kg

Cefazolin (Kefzol, Ancef) 2 gm IV; **3 gm** over 120 kg

Methohexital **(Brevital)** ECT dose \_\_ **what is the SEDATION DOSE?**

ECT: 1 -2 mg/kg IV **sedation dose 0.2- 0.4 MG/KG**

Ephedrine **50 mg/ ml** Draw up 1 ml and dilute in **9 ml of NS** for a **concentration** of _____ mg/ml Hypotension dose: __ -\_\_ mg Iv

1. constitution wanted: **5mg/ ml** 2. **Hypotension: 5 - 10 mg/ml**

RSI dose of rocuronium

**1.2mg/kg** \*gives intubating conditions in 60-90 seconds

Rocuronium **(Zemuron)** comes in **10mg/cc** What is the dose? \_\_\_\_ What is the **de-fasiculating** dose?\_\_\_ Mostly \_\_\_\_\_, slightly ____ elimination so maybe prolonged in ______ failure

Rocuronium **(Zemuron)** dose: **0.6 - 1.2 mg/kg** De-fasiculating dose: **5mg/0.5** ml mostly **liver,** slightly **kidneys (elimination)** so maybe prolonged in **liver** failure

Vecuronium concentration

**1mg/cc \*10mg vial needs to be reconstituted w/ 10cc**

Levofloxacin **(Levaquin)** dose

**500 mg IV** slow on pump 30 60 mins

Glycopyrrolate dose to increase HR and decrease secretions

0.2-0.3mg

Succinylcholine **(Anectine) comes in \_\_\_\_\_** **DOSE??\_\_**

comes in: **20 mg/ml** Dose: **1.0 - 1.5 mg/kg**

Cisatricurium is the same dosing as

vecuronium (0.08-0.2mg/kg or 0.2mg/kg RSI)

NDMR: Reversal Combine Neostigmine/ \_\_\_\_\_\_\_ Neostigmine (1mg/ml) dose \_\_\_\_\_ Always give together with \_:\_ ratio give slowly to prevent **rapid increase in** ____ \_\_\_\_

1. Glycopyrolate (**Robinul)** 0.2mg/ml 2. Neostigmine dose 0.05 - 0.07 mg/kg 3. 1:1 4. heart rate

Neostigmine effects

- decreases HR - causes miosis - causes salivation

**Loading** dose of **precedex**

**1mcg/kg** over 10 minutes

Atropine - **1 mg (0.1 mg/ml)** **\_\_\_\_\_\_** typical **start** point for absolute bradycardia Anti\_\_\_\_ Tertiary amine and crosses BBB

**1. 0.4 mg** **2. Anticholinergic**

Suggamadex If spontaneous recovery has reached the r**eappearance of the second twitch (T2)i**n response to TOF stimulation what will be the dose of Bridion

Bridion **dose for reappearance** of second twitch 2mg/kg

Glycopyrrolate (0.2mg/ ml) Dose: ___ - ___ mg/kg IV draw up 1 -2 ml.

**Dose: 0.01 - 0.02mg/kg** **0.2-0.3 MG( 1- 5 ml)** is usually enought to increase HR and is also a good dose to decrease salivation. Anticholinergic **Increases HR**, causes **mydriasis**, and decrease salivation

**Ketamine dose**

IV: 1-2mg/kg IM: 3-5mg/kg

Dexmetomidine (Precedex) comes in \_\_\_\_\_\_

200 mcg/ 2ml and 100 mcg/ml sigle dose vial