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Anesthesiology > Drugs - Concentrations & Dosing > Flashcards

Drugs - Concentrations & Dosing Flashcards

1
Q

Midazolam (Versed)
1 - Concentration (IV, IM)
2 - Dosing (IV, IM, PO)

A

Midazolam (Versed)

Midazolam Concentration:
IV: 1 mg/ml
IM: 5 mg/ml

Midazolam Dosing:
IV: 1-2 mg
IM: 1-5 mg
PO: 0.5 mg/kg, up to 20mg

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2
Q

Fentanyl
1 - Concentration
2 - Dosing
3 - Duration

A

Fentanyl

Fentanyl Concentration:
IV: 50 mcg/ml (vile is 50 mcg/ml)

Fentanyl Dosing:
IV: 1 mcg/kg
(For average sized adults, start with 50mcg bolus)

Fentanyl Duration - LASTS 30-60 MINUTES

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3
Q

Dilution Equation

A

C1V1 = C2V2
C1 - concentration of stock solution (on bottle, do it over 1 mL)
V1 - volume of stock solution you’re adding from stock to the final solution
C2 - concentration you WANT in final solution
V2 - volume of final solution

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4
Q

Sufentanil
1 - Concentration (and Dilution)
2 - Dosing
3 - Duration

A

Sufentanil

Sufentanil Concentration:
IV: 5 mcg/ml

Sufentanil Dilution: vial is 100 mcg/2 ml (which is 50 mcg/ml, same as Fentanyl)
In a 20cc syringe, add
2 ml of Sufentanil (which is 100 mcg, the whole vile) and fill the rest with saline up to 20 ml =
5 mcg/ml
Because 100 mcg in 20 ml = 5 mcg/ml

Sufentanil Dosing:
IV: 0.1 mcg/kg (a 75 kg adult gets 7.5 mcg)

Sufentanil Duration - LASTS 30-60 MINUTES

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5
Q

Brand name for Remifentanil:

A

Ultiva

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6
Q

Remifentanil (Ultiva)
1 - Concentration (and Dilution)
2 - Dosing (Induction, Infusion)
3 - Duration

A

Remifentanil (Ultiva)

Remifentanil Concentration:
IV: 25 mcg/ml

Remifentanil Dilution:

  • Comes as 1 mg powder (1,000 mcg)
  • Add 1 mg in 40 cc of saline (in a 60cc syringe) to get 25 mcg/ml concentration because 1,000 mcg divided by 40ml is 25 mcg/ml
  • THEN separate the 40cc into eight 5cc syringes

Remifentanil Dosing:

Induction:
1 mcg/kg (same as Fentanyl) WITH Propofol 2mg/kg
75kg person gets 75 mcg induction which is 3cc (25 mcg per cc)

Infusion:
Start at 0.05 mcg/kg/min
75kg person gets 3.75 mcg per minute (about 0.2cc) - Remi infusion is for Open Airway or IV Sedation at 0.05 mcg/kg/min

Duration - LASTS 3-10 MINUTES

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7
Q

Induction FOR INTUBATION: 2 ways

A

1 - Remifentanil 1 mcg/kg plus Propofol 2 mg/kg, or
— The Remifentanil relieves the pain of intubation, Propofol actually puts them to sleep
2 - Propofol 2 mg/kg with Paralytics
(From Craig’s text on 6/24/2022)

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8
Q

Brand name: Dexmedetomidine

A

Precedex

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9
Q

Dexmedetomidine (Precedex)
1 - Concentration (and Dilution)
2 - Dosing (Loading, Maintenance, MAC)
3 - Duration

A

Dex-mede-tomi-dine (Precedex)

Dexmedetomidine Concentration:
4 mcg/ml

  • Comes as 2 ml vial of 100 mcg/ml (total 200 mcg in vial) – 200 mcg/2 ml
  • Using 60cc syringe, draw entire 2 ml (which is 200 mcg total) plus saline up to 50cc mark. 200 mcg in 50 ml solution = 4 mcg/ml
  • Separate the 50cc solution into ten 5cc syringes

Dexmedetomidine/Precedex Dosing:
Loading: 4-12 mcg bolus (giving 1-3cc from syringe)

Maintenance: 0.5 mcg/kg/hour (80kg person, 40mcg per hour)

MAC (Monitored Anesthesia Care): 4-8 mcg bolus

Dexmedetomidine Duration - 1-2 hours

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10
Q

Brand name: Propofol

A

Diprivan

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11
Q

Propofol (Diprivan)
1 - Concentration
2 - Dosing (Pediatrics, Adult, Infusion)
3 - How long after drawing up Propofol can you use it? Why?

A

Propofol (Diprivan)

Propofol Concentration:
10 mg/ml

Propofol Dosing:
Pediatrics: 2-3 mg/kg
Adults: 1-2 mg/kg
Infusion: 125 mcg/kg/min, then titrate

In a 75kg adult, that’s 9,375 mcg –> 9.4 mg, so about 1cc per minute

** Use Propofol within 6 hours of drawing up ** it’s in a lipid emulsion with no preservatives so it allows for bacterial growth

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12
Q

Brand name: Ketamine

A

Ketalar

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13
Q

Ketamine (Ketalar)
1 - Concentration (IV, IM, and Dilution)
2 - Dosing (IV, IM)

A

Ketamine (Ketalar)

Ketamine Concentration:
IV: 10 mg/ml (must dilute for IV to get to 10 mg/ml b/c it doesn’t come packaged in that concentration)
IM: 100 mg/ml (do not dilute for IM)

Ketamine Dilution for IV Use:

  • Comes as 100 mg/ml - in a 3cc syringe, draw up 0.3 ml Ketamine (which is 30 mg) and fill the rest with saline to 3 mL mark for desired 10 mg/ml IV
  • Comes as 50 mg/ml - in a 3cc syringe, draw up 0.6 ml Ketamine (which is 30 mg) and fill the rest with saline to 3 mL mark for desired 10 mg/ml IV

Ketamine Dosing:
IV: 10 mg bolus (1 ml mark on a 3cc syringe)
IM: 2-3 mg/kg (75kg adult, give 150-225 mg)

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14
Q

Rocuronium (non-depolarizing NMJ blocker)
1 - Concentration
2 - Dosing (Defasciculation Dose)

A

Rocuronium

Rocuronium Concentration:
10 mg/ml

Rocuronium Dosing:
Defasciculating Dose: 5-10 mg
Defasciculation = the prevention of muscle twitches

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15
Q

Succinylcholine (depolarizing NMJ blocker)
1 - Concentration
2 - Dosing

A

Succinylcholine

Succinylcholine Concentration:
20 mg/ml
(a 10 ml syringe would have 200 mg)

Succinylcholine Dosing:
IV: 1.0-1.5 mg/kg
(a 75kg person would get 75-112 mg)

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16
Q

Brand name: Ondansetron

A

Zofran

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17
Q

Ondansetron (Zofran)
1 - Concentration
2 - Dosing (pediatrics, adult)

A

Ondansetron (Zofran)

Ondansetron Concentration:
2 mg/ml
(in a 2 ml vial, total 4 mg)

Ondansetron Dosing:
Pediatrics: 0.1 mg/kg (a 30 kg child gets 3 mg)
Pediatric Max Dose: 4 mg
Adults: 4 mg

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18
Q

Dexamethasone (Decadron)
1 - Concentration
2 - Dosing (pediatrics, adult)

A

Dexamethasone (Decadron)

Dexamethasone Concentration:
4 mg/ml

Dexamethasone Dosing:
Pediatrics: 0.15 mg/kg (30kg child gets 4.5 mg)
Adults: 4-8 mg (typically 8 mg)

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19
Q

Brand name: Glycopyrrolate

A

Robinul

20
Q

Glycopyrrolate (Robinul)
1 - Concentration
2 - Dosing

A

Glycopyrrolate (Robinul)
(anticholinergic - treats Bradycardia and SLUDGE ** “Juicy” patients)

Glycopyrrolate Concentration:
0.2 mg/ml

Glycopyrrolate Dosing:
IV: 0.1-0.2 mg

21
Q

Atropine
1 - Concentration (2 options)
2 - Dosing

A

Atropine (treats Bradycardia to increase HR)

Atropine Concentration:
0.4 mg/ml, or
1 mg/ml

Atropine Dosing:
0.4-0.5 mg (so administer 1 cc)

22
Q

Ephedrine
1 - Concentration (and Dilution)
2 - Dosing

A

Ephedrine

Ephedrine Concentration:
5 mg/ml

Ephedrine Dilution:

  • Comes as 50 mg/ml vile
  • In a 10cc syringe, draw up 1 ml Ephedrine (which is 50 mg, the entire vile), fill the rest with saline up to 10 ml mark, making 50 mg/10 ml - which is 5 mg/ml in the entire 10cc syringe for a total of 50 mg)

Ephedrine Dosing:
IV: 5-10 mg bolus (1-2 cc)

23
Q

Brand name: Phenylephrine

A

Neo-Synephrine aka Neo

24
Q

Phenylephrine (Neo-Synephrine)
1 - Concentration (and Dilution)
2 - Dosing

A

Phenylephrine (Neo-Synephrine)

Phenylephrine Concentration:
100 mcg/ml
- Comes as 10 mg/ml in 1 ml vile
- Add entire vile to a 100 ml saline bag to get 0.1 ml/mg or 100 mcg/ml

Phenylephrine Dosing:
IV: 50-200 mcg

(0.5-2 cc)

25
Q

Brand name: Ketorolac

A

Toradol

26
Q

Ketorolac (Toradol)
1 - Concentration (2 options)
2 - Dosing (pediatrics, adult)

A

Ketorolac (Toradol)

Concentration:
15 mg/ml, or
30 mg/ml

Dosing:
Pediatrics: 0.5 mg/kg (a 30 kg child gets 15 mg)
Adults: 15 mg bolus

27
Q

Acetaminophen (Tylenol)
1 - Concentration
2 - Dosing (and max dose)

A

Acetaminophen (Tylenol)

Concentration:
1,000 mg/100 ml (10 mg/ml)

Dosing:
IV: 15 mg/kg up to 1,000 mg 
(75kg person --> 1,125 mg, BUT max dose is 1,000 mg)
     Max Dose: 1,000 mg 
     (Daily Max: 4,000 mg)
28
Q

Brand name: Cefazolin

A

Ancef

29
Q

Cefazolin (Ancef)
1 - Concentration
2 - Dosing (based on body weight)

A

Cefazolin (Ancef) - antibiotic

Concentration:
1 g per vial – 1,000 mg/vial (Powder)

Dosing:
Under 80 kg – 1 g (1 vial)
80-120 kg – 2 g (2 vials)
Over 120 kg – 3 g (3 vials)

30
Q

Midazolam - Mechanism of Action

A

GABA-A Agonist

31
Q

Fentanyl - Mechanism of Action

A

Mu opioid receptor Agonist

32
Q

Sufentanil - Mechanism of Action

A

Mu opioid receptor Agonist

33
Q

Remifentanil - Mechanism of Action

A

Mu opioid receptor Agonist

34
Q

Dexmedetomidine (Precedex) - Mechanism of Action

A

Alpha-2 Agonist

35
Q

Propofol (Diprivan) - Mechanism of Action

A
  1. GABA-A Agonist

2. NMDA Antagonist

36
Q

Ketamine (Ketalar) - Mechanism of Action

A

NMDA Antagonist

37
Q

Rocuronium - Mechanism of Action

A

Non-Depolarizing NMJ Blocker

38
Q

Succinylcholine - Mechanism of Action

A

Depolarizing NMJ Blocker

39
Q

Ondansetron (Zofran) - Mechanism of Action

A

5HT3 (Serotonin) Antagonist

40
Q

Dexamethasone (Decadron) - Mechanism of Action

A

Long-acting Corticosteroid

41
Q

Glycopyrrolate (Robinul) - Mechanism of Action

A

Anti-cholinergic (peripherally-acting)

42
Q

Atropine - Mechanism of Action

A

Anti-cholinergic (centrally-acting)

43
Q

Ephedrine - Mechanism of Action

A

Alpha/Beta Agonist

  • INDIRECT acting
  • Releases endogenous catecholamines (and therefore does nothing if the patient’s catecholamines are already depleted)
44
Q

Phenylephrine (Neosynephrine, “Neo”) - Mechanism of Action

A

Alpha-1 Agonist (DIRECT acting)

45
Q

Toradol (Ketorolac) - Mechanism of Action

A

NSAID

46
Q

Acetaminophen (Tylenol) - Mechanism of Action

A

Analgesic, Anti-pyretic

47
Q

Cefazolin (Ancef) - Mechanism of Action

A

Cephalosporin ABX

Anesthesiology (5 decks)

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