Drug Quiz 14 - RSI Drugs Flashcards
Vecuronium, Etomidate, Succinylcholine, Ativan, Rocuronium, Lidocaine, Atropine, Versed
1
Q
vecuronium trade name
A
norcuron
2
Q
norcuron generic
A
vecuronium
3
Q
vecuronium drug class
A
non-depolarizing neuromuscular blocker
4
Q
vecuronium MOA
A
cholinergic R-antagonist; competes with Ach at neuromuscular junction to prevent binding so neuromuscular transmission is inhibited
5
Q
vecuronium onset
A
<1 min
6
Q
vecuronium peak
A
3-5 min
7
Q
vecuronium duration
A
25-40 min
8
Q
vecuronium half life
A
30-80 min
9
Q
vecuronium indications
A
temporary paralysis for RSI
10
Q
vecuronium contraindications
A
hypersensitivity
11
Q
vecuronium SE
A
wheezing, respiratory depression, apnea, aspiration, dysrhythmias, bradycardia, sinus arrest, HTN, hypotension, increased intraocular pressure, increased ICP
12
Q
vecuronium adult dose
A
0.08-0.1mg/kg IV
13
Q
vecuronium pedi dose
A
0.1mg/kg IV
14
Q
vecuronium precautions
A
have rescue airway devices and resuscitative equipment standing by
15
Q
vecuronium interactions
A
potentiated by lidocaine, procainamide, B-blockers, mag sulfate, and other neuromuscular blockers
16
Q
succinylcholine trade
A
anectine
17
Q
anectine generic
A
succinylcholine
18
Q
succinylcholine drug class
A
depolarizing neuromuscular blocker
19
Q
succinylcholine MOA
A
cholinergic R-agonist, causes initial wave of widespread depolarization and blocks Ach and secondary muscle stimulation
20
Q
succinylcholine onset
A
30-60 sec IV, 2-3 min IM
21
Q
succinylcholine peak
A
1-3 min
22
Q
succinylcholine duration
A
2-3 min IV, 10-30 min IM
23
Q
succinylcholine half-life
A
5-10 min
24
Q
succinylcholine indications
A
temporary paralysis for RSI
25
succinylcholine contraindications
penetrating eye injuries, narrow angle glaucoma, hyperkalemia, Hx of malignant hyperthermia
26
succinylcholine SE
wheezing, respiratory depression, apnea, aspiration, dysrhythmias, bradycardia, sinus arrest, HTN, hypotension, increased intraocular pressure, increased ICP
27
succinylcholine adult dose
1-2 mg/kg IV
28
succinylcholine pedi dose
1 mg/kg
29
succinylcholine precautions
may cause Fx in children, dysrhythmias, CA; have rescue airways available
30
succinylcholine interactions
potentiated by lidocaine, procainamide, B-blockers, mag sulfate, and other neuromuscular blockers
31
rocuronium trade
zemuron
32
zemuron generic
rocuronium
33
rocuronium drug class
non-depolarizing neuromuscular blocker
34
rocuronium MOA
cholinergic R-antagonist; competes with Ach at neuromuscular junction to prevent binding so neuromuscular transmission is inhibited
35
rocuronium onset
30-60 sec
36
rocuronium peak
1-3 min
37
rocuronium duration
30-60 min
38
rocuronium half-life
14-18 min
39
rocuronium indications
temporary paralysis for RSI
40
rocuronium contraindications
hypersensitivity
41
rocuronium SE
bronchospasms
42
rocuronium adult dose
0.6-1.2 mg/kg IV
43
rocuronium pedi dose
0.6 mg/kg
44
rocuronium precautions
have rescue airway devices available and resuscitative equipment available
45
rocuronium drug interactions
potentiated by lidocaine, procainamide, B-blockers, K-sparing diuretics, mag sulfate, and other neuromuscular blockers
46
lidocaine trade
xylocaine
47
xylocaine generic
lidocaine
48
lidocaine MOA
Na+ channel blocker, slows phases IV and 0 of cardiac cycle; inhibits action potential formation in sensory neurons
49
lidocaine onset
<3 min
50
lidocaine peak
5-7 min
51
lidocaine duration
10-20 min
52
lidocaine half life
1.5-2 hrs
53
lidocaine indications
1) VF, VT (alternative to amiodarone) 2) anesthetic for IO's 3) pre med for RSI with suspected increased ICP
54
lidocaine contraindications
2nd degree type II, 3rd degree blocks; bradycardia; stokes-adams syndrome, WPN, LGL
55
lidocaine SE
flushing, sweating, decreased deep tendon reflex, itching, rash, hypothermia, bradycardia, drowsiness, seizures, confusion, hypotension, N+V, heart block, respiratory/cardiac arrest
56
lidocaine VF, pulseless VT adult dose
1st 1-1.5 mg/kg then 2nd 0.5-0.75 mg/kg then 1-4 mg/min maintenance
57
lidocaine VT w/ pulse PVC's adult dose
0.5-1.5mg/kg then 1-4 mg/min maintenance
58
lidocaine RSI adult dose
1 mg/kg (max 100mg) slow IV 3 min prior to induction
59
lidocaine pedi dose
1 mg/kg IV, q15 min PRN, maintenance 20-50 mcg/kg/min
60
lidocaine precautions
Pt 70+ y/o/known hepatic failure - reduce maintenance dose by half
61
lidocaine interactions
may cause toxicity with procainamide, phenytoin, quinidine, and B-blockers
62
etomidate trade
amidate
63
amidate generic
etomidate
64
etomidate drug class
sedative/hypnotic
65
etomidate MOA
depresses reticular activating system and potentiates GABA causing sedation
66
etomidate onset
10-20 seconds
67
etomidate peak
<1 min
68
etomidate duration
3-5 min
69
etomidate half life
30-70 min
70
etomidate indications
induction agent for RSI
71
etomidate contraindications
hypersensitivity
72
etomidate SE
myoclonic skeletic muscle movement, apnea, hyperventilation, hypoventilation, laryngospasm, HTN, hypotension, tachycardia, bradycardia, N+V
73
etomidate adult dose
0.1-0.3mg/kg IV over 15-30 seconds
74
etomidate pedi dose
0.1-0.3mg/kg IV over 15-30 seconds
75
etomidate precautions
caution with hypotension, severe asthma, severe cardiovascular disease
76
etomidate interactions
prolongs respiratory depression and apnea with Verapamil
77
atropine sulfate drug class
anticholinergic/parasympatholytic
78
atropine MOA
acetylcholine R antagonist, causes parasympathetic inhibition, positive chronotropy, no inotropic effect
79
atropine onset
immediate
80
atropine peak
2-4 min
81
atropine duration
4 hrs
82
atropine half life
2-3 hrs
83
atropine indications
symptomatic bradycardia; premed for RSI with bradycardia (<50 bpm); organophosphate poisoning
84
atropine contraindications
no longer recommended for PEA and asystole
85
atropine SE
blurred vision, dilated pupils, dry mouth, tachycardia, drowsiness, confusion
86
atropine adult bradycardia dose
0.5mg q3-5min IV up to 3mg
87
atropine RSI adult dose
0.5-1mg IV
88
atropine organophosphate poisoning dose
2-5mg
89
atropine pedi bradycardia dose
0.02mg/kg IV; min .1 mg max .5mg
90
atropine pedi RSI dose
0.02mg/kg IV
91
atropine organophosphate pdi dose
0.02-0.05mg/kg IV q20-30 min until S/S resolve
92
atropine precautions
giving less than .5mg adult or .1mg pedi causes paradoxical effect; inneffective for 2nd degree type II/3rd degree; increases myocardial oxygen demand
93
atropine interactions
few EMS
94
lorazepam trade
ativan
95
ativan drug class
anticonvulsant/sedative/hypnotic/benzo
96
ativan MOA
positive allosteric modulator for GABA receptors, potentiates binding and effects of GABA, increases intracellular Cl- concentration leading to hyperpolarization
97
ativan onset
1-5 min IV, 15-30 min IM
98
ativan peak
15-20 min IV, 2 hrs IM
99
ativan duration
6-8 hrs
100
ativan half life
10-20 hrs
101
ativan indications
major motor seizure; premed for cardioversion; anxiety; post intubation sedation
102
ativan contraindications
hypersensitivity
103
ativan SE
hypotension, drowsiness, HA, amnesia, respiratory depression, blurred vision, N+V
104
ativan adult dose
0.5-2mg IV; 1-4mg IM
105
ativan pedi dose
0.05mg/kg IV
106
ativan precautions
have benzo antagonist available
107
ativan interactions
additive effects with CNS depressants and alcohol
108
midazolam trade
versed
109
versed generic
midazolam
110
versed drug class
benzo/anticonvulsant/sedative/hypnotic
111
versed MOA
positive allosteric modulator for GABA receptors, potentiates binding and effects of GABA, increases intracellular Cl- concentration leading to hyperpolarization
112
versed onset
3-5 min IV, 15 min IM
113
versed peak
20-60 min
114
versed duration
<2 hrs IV, 1-6 hrs IM
115
versed half life
1-4 hrs
116
versed indications
pre med for cardioversion/TCP; post intubation sedation; seizure
117
versed contraindications
narrow angle glaucoma; shock, depressed vitals, alcoholic coma
118
versed SE
laryngospasm, bronchospasm, dyspnea, respiratory depression and arrest, drowsiness, amnesia, AMS, tachycardia, bradycardia, PVC's, wretching
119
versed adult dose
2-5mg (0.5mg/kg) IV
120
versed pedi dose
0.2mg/kg IV, max dose 10mg
121
versed precautions
have resuscitation equipment ready and monitor vitals; have benzo antagonist available; more potent than other benzos
122
versed interactions
additive effects with CNS depressants and alcohol
