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Paramedic > Drug Quiz 14 - RSI Drugs > Flashcards

Drug Quiz 14 - RSI Drugs Flashcards

Vecuronium, Etomidate, Succinylcholine, Ativan, Rocuronium, Lidocaine, Atropine, Versed

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1
Q

vecuronium trade name

A

norcuron

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2
Q

norcuron generic

A

vecuronium

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3
Q

vecuronium drug class

A

non-depolarizing neuromuscular blocker

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4
Q

vecuronium MOA

A

cholinergic R-antagonist; competes with Ach at neuromuscular junction to prevent binding so neuromuscular transmission is inhibited

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5
Q

vecuronium onset

A

<1 min

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6
Q

vecuronium peak

A

3-5 min

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7
Q

vecuronium duration

A

25-40 min

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8
Q

vecuronium half life

A

30-80 min

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9
Q

vecuronium indications

A

temporary paralysis for RSI

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10
Q

vecuronium contraindications

A

hypersensitivity

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11
Q

vecuronium SE

A

wheezing, respiratory depression, apnea, aspiration, dysrhythmias, bradycardia, sinus arrest, HTN, hypotension, increased intraocular pressure, increased ICP

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12
Q

vecuronium adult dose

A

0.08-0.1mg/kg IV

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13
Q

vecuronium pedi dose

A

0.1mg/kg IV

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14
Q

vecuronium precautions

A

have rescue airway devices and resuscitative equipment standing by

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15
Q

vecuronium interactions

A

potentiated by lidocaine, procainamide, B-blockers, mag sulfate, and other neuromuscular blockers

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16
Q

succinylcholine trade

A

anectine

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17
Q

anectine generic

A

succinylcholine

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18
Q

succinylcholine drug class

A

depolarizing neuromuscular blocker

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19
Q

succinylcholine MOA

A

cholinergic R-agonist, causes initial wave of widespread depolarization and blocks Ach and secondary muscle stimulation

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20
Q

succinylcholine onset

A

30-60 sec IV, 2-3 min IM

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21
Q

succinylcholine peak

A

1-3 min

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22
Q

succinylcholine duration

A

2-3 min IV, 10-30 min IM

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23
Q

succinylcholine half-life

A

5-10 min

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24
Q

succinylcholine indications

A

temporary paralysis for RSI

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25
Q

succinylcholine contraindications

A

penetrating eye injuries, narrow angle glaucoma, hyperkalemia, Hx of malignant hyperthermia

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26
Q

succinylcholine SE

A

wheezing, respiratory depression, apnea, aspiration, dysrhythmias, bradycardia, sinus arrest, HTN, hypotension, increased intraocular pressure, increased ICP

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27
Q

succinylcholine adult dose

A

1-2 mg/kg IV

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28
Q

succinylcholine pedi dose

A

1 mg/kg

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29
Q

succinylcholine precautions

A

may cause Fx in children, dysrhythmias, CA; have rescue airways available

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30
Q

succinylcholine interactions

A

potentiated by lidocaine, procainamide, B-blockers, mag sulfate, and other neuromuscular blockers

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31
Q

rocuronium trade

A

zemuron

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32
Q

zemuron generic

A

rocuronium

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33
Q

rocuronium drug class

A

non-depolarizing neuromuscular blocker

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34
Q

rocuronium MOA

A

cholinergic R-antagonist; competes with Ach at neuromuscular junction to prevent binding so neuromuscular transmission is inhibited

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35
Q

rocuronium onset

A

30-60 sec

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36
Q

rocuronium peak

A

1-3 min

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37
Q

rocuronium duration

A

30-60 min

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38
Q

rocuronium half-life

A

14-18 min

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39
Q

rocuronium indications

A

temporary paralysis for RSI

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40
Q

rocuronium contraindications

A

hypersensitivity

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41
Q

rocuronium SE

A

bronchospasms

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42
Q

rocuronium adult dose

A

0.6-1.2 mg/kg IV

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43
Q

rocuronium pedi dose

A

0.6 mg/kg

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44
Q

rocuronium precautions

A

have rescue airway devices available and resuscitative equipment available

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45
Q

rocuronium drug interactions

A

potentiated by lidocaine, procainamide, B-blockers, K-sparing diuretics, mag sulfate, and other neuromuscular blockers

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46
Q

lidocaine trade

A

xylocaine

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47
Q

xylocaine generic

A

lidocaine

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48
Q

lidocaine MOA

A

Na+ channel blocker, slows phases IV and 0 of cardiac cycle; inhibits action potential formation in sensory neurons

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49
Q

lidocaine onset

A

<3 min

50
Q

lidocaine peak

A

5-7 min

51
Q

lidocaine duration

A

10-20 min

52
Q

lidocaine half life

A

1.5-2 hrs

53
Q

lidocaine indications

A

1) VF, VT (alternative to amiodarone) 2) anesthetic for IO’s 3) pre med for RSI with suspected increased ICP

54
Q

lidocaine contraindications

A

2nd degree type II, 3rd degree blocks; bradycardia; stokes-adams syndrome, WPN, LGL

55
Q

lidocaine SE

A

flushing, sweating, decreased deep tendon reflex, itching, rash, hypothermia, bradycardia, drowsiness, seizures, confusion, hypotension, N+V, heart block, respiratory/cardiac arrest

56
Q

lidocaine VF, pulseless VT adult dose

A

1st 1-1.5 mg/kg then 2nd 0.5-0.75 mg/kg then 1-4 mg/min maintenance

57
Q

lidocaine VT w/ pulse PVC’s adult dose

A

0.5-1.5mg/kg then 1-4 mg/min maintenance

58
Q

lidocaine RSI adult dose

A

1 mg/kg (max 100mg) slow IV 3 min prior to induction

59
Q

lidocaine pedi dose

A

1 mg/kg IV, q15 min PRN, maintenance 20-50 mcg/kg/min

60
Q

lidocaine precautions

A

Pt 70+ y/o/known hepatic failure - reduce maintenance dose by half

61
Q

lidocaine interactions

A

may cause toxicity with procainamide, phenytoin, quinidine, and B-blockers

62
Q

etomidate trade

A

amidate

63
Q

amidate generic

A

etomidate

64
Q

etomidate drug class

A

sedative/hypnotic

65
Q

etomidate MOA

A

depresses reticular activating system and potentiates GABA causing sedation

66
Q

etomidate onset

A

10-20 seconds

67
Q

etomidate peak

A

<1 min

68
Q

etomidate duration

A

3-5 min

69
Q

etomidate half life

A

30-70 min

70
Q

etomidate indications

A

induction agent for RSI

71
Q

etomidate contraindications

A

hypersensitivity

72
Q

etomidate SE

A

myoclonic skeletic muscle movement, apnea, hyperventilation, hypoventilation, laryngospasm, HTN, hypotension, tachycardia, bradycardia, N+V

73
Q

etomidate adult dose

A

0.1-0.3mg/kg IV over 15-30 seconds

74
Q

etomidate pedi dose

A

0.1-0.3mg/kg IV over 15-30 seconds

75
Q

etomidate precautions

A

caution with hypotension, severe asthma, severe cardiovascular disease

76
Q

etomidate interactions

A

prolongs respiratory depression and apnea with Verapamil

77
Q

atropine sulfate drug class

A

anticholinergic/parasympatholytic

78
Q

atropine MOA

A

acetylcholine R antagonist, causes parasympathetic inhibition, positive chronotropy, no inotropic effect

79
Q

atropine onset

A

immediate

80
Q

atropine peak

A

2-4 min

81
Q

atropine duration

A

4 hrs

82
Q

atropine half life

A

2-3 hrs

83
Q

atropine indications

A

symptomatic bradycardia; premed for RSI with bradycardia (<50 bpm); organophosphate poisoning

84
Q

atropine contraindications

A

no longer recommended for PEA and asystole

85
Q

atropine SE

A

blurred vision, dilated pupils, dry mouth, tachycardia, drowsiness, confusion

86
Q

atropine adult bradycardia dose

A

0.5mg q3-5min IV up to 3mg

87
Q

atropine RSI adult dose

A

0.5-1mg IV

88
Q

atropine organophosphate poisoning dose

A

2-5mg

89
Q

atropine pedi bradycardia dose

A

0.02mg/kg IV; min .1 mg max .5mg

90
Q

atropine pedi RSI dose

A

0.02mg/kg IV

91
Q

atropine organophosphate pdi dose

A

0.02-0.05mg/kg IV q20-30 min until S/S resolve

92
Q

atropine precautions

A

giving less than .5mg adult or .1mg pedi causes paradoxical effect; inneffective for 2nd degree type II/3rd degree; increases myocardial oxygen demand

93
Q

atropine interactions

A

few EMS

94
Q

lorazepam trade

A

ativan

95
Q

ativan drug class

A

anticonvulsant/sedative/hypnotic/benzo

96
Q

ativan MOA

A

positive allosteric modulator for GABA receptors, potentiates binding and effects of GABA, increases intracellular Cl- concentration leading to hyperpolarization

97
Q

ativan onset

A

1-5 min IV, 15-30 min IM

98
Q

ativan peak

A

15-20 min IV, 2 hrs IM

99
Q

ativan duration

A

6-8 hrs

100
Q

ativan half life

A

10-20 hrs

101
Q

ativan indications

A

major motor seizure; premed for cardioversion; anxiety; post intubation sedation

102
Q

ativan contraindications

A

hypersensitivity

103
Q

ativan SE

A

hypotension, drowsiness, HA, amnesia, respiratory depression, blurred vision, N+V

104
Q

ativan adult dose

A

0.5-2mg IV; 1-4mg IM

105
Q

ativan pedi dose

A

0.05mg/kg IV

106
Q

ativan precautions

A

have benzo antagonist available

107
Q

ativan interactions

A

additive effects with CNS depressants and alcohol

108
Q

midazolam trade

A

versed

109
Q

versed generic

A

midazolam

110
Q

versed drug class

A

benzo/anticonvulsant/sedative/hypnotic

111
Q

versed MOA

A

positive allosteric modulator for GABA receptors, potentiates binding and effects of GABA, increases intracellular Cl- concentration leading to hyperpolarization

112
Q

versed onset

A

3-5 min IV, 15 min IM

113
Q

versed peak

A

20-60 min

114
Q

versed duration

A

<2 hrs IV, 1-6 hrs IM

115
Q

versed half life

A

1-4 hrs

116
Q

versed indications

A

pre med for cardioversion/TCP; post intubation sedation; seizure

117
Q

versed contraindications

A

narrow angle glaucoma; shock, depressed vitals, alcoholic coma

118
Q

versed SE

A

laryngospasm, bronchospasm, dyspnea, respiratory depression and arrest, drowsiness, amnesia, AMS, tachycardia, bradycardia, PVC’s, wretching

119
Q

versed adult dose

A

2-5mg (0.5mg/kg) IV

120
Q

versed pedi dose

A

0.2mg/kg IV, max dose 10mg

121
Q

versed precautions

A

have resuscitation equipment ready and monitor vitals; have benzo antagonist available; more potent than other benzos

122
Q

versed interactions

A

additive effects with CNS depressants and alcohol

Paramedic (17 decks)

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