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PHARMACOLOGY > Basic Drugs Condensed > Flashcards

Basic Drugs Condensed Flashcards

1
Q

Lidocaine (Xylocaine)

A

Class: Local Anesthetic (amide)

[20 mg/mL]

Dose: 0.5-1 mg/kg

Use: Local

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2
Q

Meperidine (Demerol)

A

Class: Opioid

[25 mg/mL]

Dose: 12.5-25 mg

Peak effect: 5-7 min Duration: 2-4 hrs

Use: Treat Shivering

90% hepatic metabolism to normeperidine which is renally eliminated

Side effects: Local/Atropine like side effects

  • Block Sodium channels
  • Tachycardia, dry mouth, mydriasis
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3
Q

Midozolam (Versed)

A

Class: Benzodiazepine

[1 mg/mL]

Dose: 1-5 mg (.01-.1 mg/kg) IV, Sedation 0.5-4mg IV load then 1-7mg/hr IV, Induction 0.1-0.2mg/kg, Peds 0.5 mg/kg PO

Onset 30-60 seconds

Peak 3-5 minutes

Duration 15-80 minutes

Elimination half time 1-4hrs

Use: Anti-Anxiety, sedation, induction

Caution: hepatic, pregnant, elderly, > narc effects

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4
Q

Morphine (Morphine)

A

Class: Opioid

[15 mg/mL]

Dose: 0.1-1 mg/kg

Use: Long Pain Relief (3-4hrs)

Onset: 15-30 min

Caution: < resp, PONV, pruritis (caused by histamine release), Morphine 6-glucaronide metabolite

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5
Q

Naloxone (Narcan)

A

Class: Opioid Antagonist

[0.4 mg/mL]

Dose: 1 - 4 µg/kg

Use: Narcotic Reversal

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6
Q

Neostigmine (Prostigmin)

A

Class: Cholinesterase Inhibitor

[1 mg/mL]

Dose: 0.04 -0.07 mg/kg

Use: Relaxant Reversal

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7
Q

Nitroglycerin (Nitroglycerin)

A

Class: Vasodilator (Nitrate)

[50 mg/mL]

Dose: 50–100 µg

Use: ^ HR, decr BP (treat angina, HTN)

Caution: principally venous dilator

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8
Q

Norepinephrine (Levophed)

A

Class: Vasopressor

[1 mg/mL]

Dose: 8–16 µg

Use: decr HR, ^^ BP

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9
Q

Ondansetron (Zofran)

A

Class: Antiemetic

[2 mg/mL]

Dose: 4 mg

Use: Treat N/V

Indication: female, h/o motion sickness, nonsmoker, obesity, >narcotics, gastric distension, surgical procedure

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10
Q

Phenylephrine (Neosynephrine)

A

Class: Vasopressor

[10 mg/mL (dilute –> 100 mcg/ml)]

Dose: 50–100 µg

Use: decr HR, ^ BP

Caution: Reflex Bradycardia

  1. selective a1-adrenergic receptor agonist
  2. Contraindications: hypertension and use of MAO inhibitors
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11
Q

Propofol (Diprivan)

A

Class: Hypnotic

[10 mg/mL]

Dose: Induction: 1–2.5 mg/kg, IV Sedation: 25-200mcg/kg/min, GA TIVA: 100-200mcg/kg/min

Onset–30 seconds
Peak effect 90-100 seconds
Duration–5-10 minutes (dose dependent)
Recovery
–Distribution half life is 2-8 minutes
–Context sensitive half time of prolonged infusions less than 40 minutes

Caution: burns on injection, expires 6-12 hrs, decr BP, egg allergy

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12
Q

Rocuronium (Zemeron)

A

Class: Neuromuscular Blocker (NDMB)

[10 mg/mL]

Dose: Intubation 0.6–1.2 mg/kg,

       Maint 0.1 mg/kg

Onset: 1-2 min Duration: 20-35 min

Use: Paralysis

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13
Q

Succinylcholine (Anectine)

A

Class: Neuromuscular Blocker (Depolarizing)

[20 mg/mL]

Dose: 1–2 mg/kg

Onset: 30 sec Duration: 3-5 min

Use: Paralysis, RSI

Caution: Malignant Hyperthermia, Hyperkalemia (^bl. K+)

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14
Q

Atropine (Atropine)

A

Class: Anticholinergic

[0.4 mg/mL]

Dose: 0.4–0.6 mg (up to 3 mg)

Use: ^^HR, NMB reversal

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15
Q

Vecuronium (Norcuron)

A

Class: Neuromuscular Blocker (NDMB)

[10 mg/mL - powder reconst to 1 mg/ml]

Dose: Intubation 0.08–0.12 mg/kg

       Maint 0.01 mg/kg

Use: Paralysis

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16
Q

Diphenylhydramine (Benadryl)

A

Class: Antihistamine

[25 mg/mL]

Dose: 12.5–50 mg

Use: Treat Allergy

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17
Q

Cisatracurium (Nimbex)

A

Class: Neuromuscular Blocker (NDMB)

[2 mg/mL] 20 mg vial

Dose: 0.1–0.15 mg/kg

Use: Paralysis

Indicated for: Renal

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18
Q

Droperidol (Inapsine)

A

Class: Antiemetic

[2.5 mg/mL]

Dose: 0.625 mg

Use: Treat N/V

Caution: Parkinsons, prolonged QT interval, abnormal EKG

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19
Q

Ephedrine (Ephedrine)

A

Class: Vasopressor

[50 mg/mL –> 5mg/ml]

Dose: 5–20 mg

Onset: ~1 min, Duration: 3-5 min

Use: ^ HR / ^BP (indirect action)

Caution: tachyphylaxis

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20
Q

Epinephrine (Adrenaline)

A

Class: Vasopressor

[16 µg/ml syringe]

Dose: 8–16 µg

Use: ^^HR / ^^BP

  1. Activates both a and b receptors; higher affinity for B
  2. Route: IM or IV
  3. Duration: half-life of less than one minute
  4. Tx: cardiac arrest, acute bronchospasm and shock
  5. profound bronchodilation as well as powerful increases in cardiac output, blood glucose levels and blood pressure
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21
Q

Esmolol (Brevibloc)

A

Class: Beta Blocker (cardioselective)

[10 mg/mL]

Dose: 0.2-0.5 mg/kg (initial dose 10 mg)

Use: decr decr HR

Onset: 5 min Duration: 10–30 min

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22
Q

Etomidate (Amidate)

A

Class: Hypnotic

[2 mg/mL] (35% glycol)

Dose: 0.2–0.3 mg/kg

Onset – 30 sec, 1 minute peak, 3-5 minutes duration, Elimination half time 2.6 hours
Use: Induction

Indication: Cardiovascular stability

Caution: PONV, burns on injection

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23
Q

Fentanyl (Sublimaze)

A

Class: Opioid

[50 µg/mL]

Dose: 1–2 µg/kg (low)

       2-20 µg/kg (moderate)

       1-2 µg/kg/hr Infusion

Onset 3-5 min Duration 30-60 min

Use: Pain Relief

Caution: 100x > morphine, versed incr

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24
Q

Glycopyrrolate (Robinul)

A

Class: Anticholinergic

[0.2 mg/mL]

Dose 0.01 mg/kg (0.2 mg/1 mg neostig (1ml/ml))

Use: ^ HR

Indication: Used w/ neostig b/c same onset/duration

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25
Q

Hydromorphone (Dilaudid)

A

Class: Opioid

[2 mg/mL]

Dose 0.5–2 mg

Use: Long Pain Relief

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26
Q

Ketamine (Ketalar)

A

Class: Hypnotic

[50 mg/mL]

Dose: 1–2 mg/kg IV, Onset: 30-60 sec, Duration: 5-10 min

       4-8 mg/kg IM, Onset: 2-4 min, Duration: 12-25 min

Use: induction, ANALGESIA, No Vent Depression

Caution: Emergence delirium, ICP, BP, HR &CMRO2 increase

Metabolites: Norketamine

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27
Q

Ketorolac (Toradol)

A

Class: NSAID

COX-2 selective

[30 mg/mL]

Dose: 15–60 mg

Use: Pain Relief

Avoid in: ketoROLAC (Renal, Old, Liver, Asthma, Coagulopathic)

Also not in spinal or for no oozing

Creatinine level required: <1?

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28
Q

Labetalol (Normodyne)

A

Class: Beta Blocker (mixed a1, b1, b2)

[5 mg/mL]

Dose: 5–10 mg (0.1-.25 mg/kg)

Use: decr HR / decr BP

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29
Q

Metoprolol (Lopressor)

A

Class: Beta1- blocker

[5 mg (1 mg/mL)]

Dose: 1–2 mg

Onset: 10 minutes Duration: hours

Use: decr decr HR

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30
Q

Lorazepam

A

Onset: 1–2 minutes

Peak: 20–30 minutes

duration: 6–10 hours

elimination halftime 21–37 hours

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31
Q

Flumazenil

A

Brand-name: romazicon

Class: benzodiazepine antagonist

Function: reversal of benzodiazepines

Dose: .1–.2 mg IV repeated up to 3 mg

Duration: one hour

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32
Q

Hydralazine

A

Class: Vasodilator (Nitrate)

[20 mg/mL]

Dose: 5–20 mg

Onset: 20 minutes Duration: 6–8 hours

Use: HTN, Arterial Dilator

33
Q

Pharmacology reverse

Class: Local Anesthetic (amide)

[20 mg/mL]

Dose: 0.5-1 mg/kg

Use: Local

A

Lidocaine (Xylocaine)

34
Q

Pharmacology reverse

Class: Opioid

[25 mg/mL]

Dose: 12.5-25 mg

Use: Treat Shivering

A

Meperidine (Demerol)

35
Q

Pharmacology reverse

Class: Benzodiazepine

[1 mg/mL]

Dose: 1-5 mg

Use: Anti-Anxiety

Caution: hepatic, pregnant, elderly, > narc effects

A

Midozolam (Versed)

36
Q

Pharmacology reverse

Class: Opioid

[15 mg/mL]

Dose: 0.1-1 mg/kg

Use: Long Pain Relief (3-6hrs)

Onset: 15-30 min

Caution: < resp, PONV, pruritis

A

Morphine (Morphine)

37
Q

Pharmacology reverse

Class: Opioid Antagonist

[0.4 mg/mL]

Dose: 1 - 4 µg/kg

Use: Narcotic Reversal

A

Naloxone (Narcan)

38
Q

Pharmacology reverse

Class: Cholinesterase Inhibitor

[1 mg/mL]

Dose: 0.04 -0.07 mg/kg

Use: Relaxant Reversal

A

Neostigmine (Prostigmin)

39
Q

Pharmacology reverse

Class: Vasodilator (Nitrate)

[50 mg/mL]

Dose: 50–100 µg

Use: ^ HR, decr BP (treat angina, HTN)

Caution: principally venous dilator

A

Nitroglycerin (Nitroglycerin)

40
Q

Pharmacology reverse

Class: Vasopressor

[1 mg/mL]

Dose: 8–16 µg

Use: decr HR, ^^ BP

A

Norepinephrine (Levophed)

41
Q

Pharmacology reverse

Class: Antiemetic

[2 mg/mL]

Dose: 4 mg

Use: Treat N/V

Indication: female, h/o motion sickness, nonsmoker, obesity, >narcotics, gastric distension, surgical procedure

A

Ondansetron (Zofran)

42
Q

Pharmacology reverse

Class: Vasopressor

[10 mg/mL (dilute –> 100 mcg/ml)]

Dose: 50–100 µg

Use: decr HR, ^ BP

Caution: Reflex Bradycardia

A

Phenylephrine (Neosynephrine)

43
Q

Pharmacology reverse

Class: Hypnotic

[10 mg/mL]

Dose: Induction: 1–2.5 mg/kg

       Infusion: 25-200mcg/kg/min

Use: Induction

Caution: burns on injection, expires 6-12 hrs, decr BP, egg allergy

A

Propofol (Diprivan)

44
Q

Pharmacology reverse

Class: Neuromuscular Blocker (NDMB)

[10 mg/mL]

Dose: Intubation 0.6–1.2 mg/kg,

       Maint 0.1 mg/kg

Onset: 1-2 min Duration: 20-35 min

Use: Paralysis

A

Rocuronium (Zemeron)

45
Q

Pharmacology reverse

Class: Neuromuscular Blocker (Depolarizing)

[20 mg/mL]

Dose: 1–2 mg/kg

Onset: 30 sec Duration: 3-5 min

Use: Paralysis, RSI

Caution: Malignant Hyperthermia, Hyperkalemia (^bl. K+)

A

Succinylcholine (Anectine)

46
Q

Pharmacology reverse

Class: Anticholinergic

[0.4 mg/mL]

Dose: 0.4–0.6 mg (up to 3 mg)

Use: ^^HR, NMB reversal

A

Atropine (Atropine)

47
Q

Pharmacology reverse

Class: Neuromuscular Blocker (NDMB)

[10 mg/mL - powder reconst to 1 mg/ml]

Dose: Intubation 0.08–0.12 mg/kg

       Maint 0.01 mg/kg

Use: Paralysis

A

Vecuronium (Norcuron)

48
Q

Pharmacology reverse

Class: Antihistamine

[25 mg/mL]

Dose: 12.5–50 mg

Use: Treat Allergy

A

Diphenylhydramine (Benadryl)

49
Q

Pharmacology reverse

Class: Neuromuscular Blocker (NDMB)

[2 mg/mL] 20 mg vial

Dose: 0.1–0.15 mg/kg

Use: Paralysis

Indicated for: Renal

A

Cisatracurium (Nimbex)

50
Q

Pharmacology reverse

Class: Antiemetic

[2.5 mg/mL]

Dose: 0.625 mg

Use: Treat N/V

Caution: Parkinsons, prolonged QT interval, abnormal EKG

A

Droperidol (Inapsine)

51
Q

Pharmacology reverse

Class: Vasopressor

[50 mg/mL –> 5mg/ml]

Dose: 5–20 mg

Onset: ~1 min, Duration: 3-5 min

Use: ^ HR / ^BP (indirect action)

Caution: tachyphylaxis

A

Ephedrine (Ephedrine)

52
Q

Pharmacology reverse

Class: Vasopressor

[16 µg/ml syringe]

Dose: 8–16 µg

Use: ^^HR / ^^BP

A

Epinephrine (Adrenaline)

53
Q

Pharmacology reverse

Class: Beta Blocker (cardioselective)

[10 mg/mL]

Dose: 0.2-0.5 mg/kg (initial dose 10 mg)

Use: decr decr HR

Onset: 5 min Duration: 10–30 min

A

Esmolol (Brevibloc)

54
Q

Pharmacology reverse

Class: Hypnotic

[2 mg/mL] (35% glycol)

Dose: 0.2–0.3 mg/kg

Use: Induction

Indication: Cardiovascular stability

Caution: PONV, burns on injection

A

Etomidate (Amidate)

55
Q

Pharmacology reverse

Class: Opioid

[50 µg/mL]

Dose: 1–2 µg/kg (low)

       2-20 µg/kg (moderate)

       1-2 µg/kg/hr Infusion

Onset 3-5 min Duration 30-60 min

Use: Pain Relief

Caution: 100x > morphine, versed incr

A

Fentanyl (Sublimaze)

56
Q

Pharmacology reverse

Class: Anticholinergic

[0.2 mg/mL]

Dose 0.01 mg/kg (0.2 mg/1 mg neostig (1ml/ml))

Use: ^ HR

Indication: Used w/ neostig b/c same onset/duration

A

Glycopyrrolate (Robinul)

57
Q

Pharmacology reverse

Class: Opioid

[2 mg/mL]

Dose 0.5–2 mg

Use: Long Pain Relief

A

Hydromorphone (Dilaudid)

58
Q

Pharmacology reverse

Class: Hypnotic

[50 mg/mL]

Dose: 1–2 mg/kg

       4-8 mg/kg IM

Use: induction, ANALGESIA

Caution: Emergence delirium

A

Ketamine (Ketalar)

59
Q

Pharmacology reverse

Class: NSAID

[30 mg/mL]

Dose: 15–60 mg

Use: Pain Relief

A

Ketorolac (Toradol)

60
Q

Pharmacology reverse

Class: Beta Blocker (mixed a1, b1, b2)

[5 mg/mL]

Dose: 5–10 mg (0.1-.25 mg/kg)

Use: decr HR / decr BP

A

Labetalol (Normodyne)

61
Q

Pharmacology reverse

Class: Beta1- blocker

[5 mg (1 mg/mL)]

Dose: 1–2 mg

Onset: 10 minutes Duration: hours

Use: decr decr HR

A

Metoprolol (Lopressor)

62
Q

Pharmacology reverse

Onset: 1–2 minutes Peak: 20–30 minutes duration: 6–10 hours elimination halftime 21–37 hours

63
Q

Pharmacology reverse

Brand-name: romazicon Class: benzodiazepine antagonist Function: reversal of benzodiazepines Dose: .1–.2 mg IV repeated up to 3 mg Duration: one hour

A

Flumazenil

64
Q

Pharmacology reverse

Class: Vasodilator (Nitrate)

[20 mg/mL]

Dose: 5–20 mg

Onset: 20 minutes Duration: 6–8 hours

Use: HTN, Arterial Dilator

A

Hydralazine

65
Q

Dobutamine

A
  1. Selective B1 receptor agonist
  2. Commonly used in treatment of shock and cardiac arrest
  3. Duration: roughly 2 minutes
  4. Acts fairly specifically on the heart (due to limited tissue distribution of b1 receptors); inotropic effects are much more prominent than chronotropic effects (relative to epinephrine)
  5. Used in stress tests to reveal cardiac abnormalities
66
Q

Albuterol

A
  1. selective b2-adrenergic receptor agonist
  2. treatment of asthma
  3. Route: orally or by inhalation
  4. Duration: half-life of several hours (relatively poor substrate for MAO
  5. Side Effects: tachycardia, elevated blood glucose levels, and skeletal muscle tremor
  6. Contraindications: cardiac disease & diabetes
67
Q

Clonidine

A
  1. a2-adrenergic receptor agonist
  2. treatment of hypertension, eyedrop solutions to reduce eye irritation (constrict inflamed blood vessels) or treat glaucoma (reduce intraocular pressure)
  3. Route: oral
  4. Duration: several hours
  5. MOA: anti-hypertensive effects via activation of presynaptic a2 receptors in CNS, which suppresses sympathetic activation
  6. Side Effects: dry mouth and sedation
68
Q

Phenelzine

A
  1. Inhibits monoamine oxidase activity
  2. MOA: indirectly-acting sympathomimetic drugs
  3. Route: Oral
  4. Tx: depression, due to effects on CNS receptors
  5. Duration: half-life 24 hr
  6. Side Effects: potentially fatal hypertensive crisis if combined improperly with other sympathomimetics or with foods rich in amines (wine, cheese, beer, chocolate, etc.)
69
Q

Methylphenidate (Ritalin)

A
  1. bind to re-uptake transporters (NET) and vesicular transporters (VMAT) to cause reverse catecholamine transport (Indirect acting)
  2. Route: oral
  3. Duration: half-life of several hrs
  4. Tx: attention deficit disorder (ADHD) and narcolepsy
  5. Side Effects: mild hypertension, tachycardia, insomnia and gastrointestinal problems
70
Q

Pseudoephedrine

A
  1. amphetamine-like drugs that bind to transporters and cause catecholamine release (indirectly-acting)
  2. Route: oral
  3. Duration: half-life of several hrs
  4. Tx: Nasal decongestant
  5. does not efficiently cross the blood brain barrier and has few effects on the CNS, which is its major difference from methylphenidate and amphetamine
71
Q

Propranolol (Inderal)

A
  1. non-selective b-adrenergic receptor antagonist
  2. Decreases cardiac output by reducing both heart rate, the strength of cardiac ventricular contraction,
  3. Route: oral
  4. Duration: half-life of several hours
  5. Tx: hypertension, heart disease, angina, cardiac arrhythmias and muscle tremor plus the inhibition of B1 receptors in the juxtaglomerular region of the kidney, which inhibits the release of renin
  6. Contraindications: asthma, since inhibition of b2 receptors in the lung may cause bronchoconstriction
72
Q

Metroprolol (Lopressor)

A
  1. selective b1-adrenergic receptor antagonists
  2. Route: oral
  3. Duration: half-life of several hours
  4. Tx: hypertension, heart disease, angina and certain cardiac arrhythmias
73
Q

Phentolamine

A
  1. non-selective a-adrenergic receptor antagonist
  2. Route: oral
  3. Duration: half-life of several hours
  4. Tx: pheochromocytoma, a tumor of the adrenal medulla that causes massive release of epinephrine and profound sympathetic over-activation (leading to severe hypertension, cardiac problems, etc.)
  5. induces severe hypotension
  6. reverses hypertensive crisis (patient on MAO inhibitors who consumes too much wine and cheese)
74
Q

Prazosin

A
  1. selective a1-adrenergic receptor antagonists
  2. Route: oral
  3. Duration: half-life of several hours
  4. Tx: hypertension and BPH (the prostate is rich in a1 receptors, which when over-activated in the long-term accelerate cell growth)
75
Q

Yohimbine

A
  1. selective a2-adrenergic receptor antagonist
  2. Route: oral
  3. Duration: half-life of several hours
  4. Tx: sexual dysfunction…mechanism of action is inhibition of a2 receptors in the CNS, so it’s the opposite of clonidine
  5. Side Effects: hypertension, sleep disturbances and various CNS effects…it can be dangerous to combine with sympathomimetics (esp. MAO inhibitors)
76
Q

Reserpine

A
  1. binds to the vesicular monoamine transporter (VMAT) and blocks it, thereby blocking vesicular packaging and release of catecholamines (indirect acting)
  2. Route: oral
  3. Duration: long half-life (36 hours)
  4. Tx: Raynaud’s Syndrome (pathological, painful vasoconstriction of blood vessels in the distal limbs)
77
Q

THIOPENTAL

A

pH - 10.5
MOA: GABA

–Decrease dissociation
–Direct action on Chloride channeL

Sympathetic nervous system
–Decrease transmission

IV induction dose – 3-5mg/kg
Onset 30-40 seconds peak at 1 minute
Duration 5-8 minutes
Protein binding–80%

METABOLIZED BY LIVER

HANGOVER FEELING, Acute Intermittent Porphyria

78
Q

Methohexital

A

More lipid soluble than Pentothal
IV induction 1-1.5mg/kg
Rectal 20-30mg/kg
Hiccups
Previously used for short outpatient cases, ECT, etc.
Currently in use due to propofol recalls and shortage of thiopental

PHARMACOLOGY (5 decks)

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