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Clinical > Drugs: doses, MOA, etc > Flashcards

Drugs: doses, MOA, etc Flashcards

1
Q

fentanyl dosing

A

1-2mcg/kg low dose; awake patients

2-20mcg/kg

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2
Q

fentanyl MOA

A

binds to opioid receptors of the presynaptic and postsynaptic sites in the CNS and peripherally

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3
Q

major advantages of fentanyl

A
  • no direct myocardial depression
  • no histamine release
  • suppresses stress response to surgery
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4
Q

fentanyl side effects

A
  • respiratory depression
  • increased ICP
  • reflex coughing
  • decreases HR
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5
Q

Propofol dosing

A

2-2.5mg/kg

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6
Q

propofol MOA

A

GABA receptor agonist (enhances inhibition), hyperpolarizes cell membranes

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7
Q

propofol common side effects

A
  • decreases HR, BP, RR, CMRO2, CBF, and ICP
  • injection site pain
  • inhibits platelet aggregation
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8
Q

advantages of propofol

A
  • fast on/off with minimal residual effects
  • antiemetic
  • antipruritic
  • anticonvulsant
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9
Q

Ketamine dosing

A

1-2mg/kg

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10
Q

ketamine MOA

A

NMDA receptor antagonist; inhibits glutamate; inhibits catecholamine uptake in postganglionic nerves

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11
Q

ketamine side effects

A

“increases everything”: ICP, BP, HR, O2 demands

-emergence delirium

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12
Q

advantages of using ketamine

A
  • bronchodilating properties

- maintains spontaneous ventilation

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13
Q

what 2 drugs are often administered with ketamine

A

glycopyrrolate and benzo for secretions and emergence delirium

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14
Q

Etomidate dose

A

0.3mg/kg

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15
Q

Etomidate MOA

A

mimics inhibitory effects of GABA by increasing the receptors affinity to GABA; depresses the reticular activating system; opens Cl channels

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16
Q

avoid etomidate with what patients

A

seizure

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17
Q

major disadvantages of etomidate

A
  • emetic

- adrenocortical suppression

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18
Q

advantage of etomidate

A

good hemodynamic profile

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19
Q

Dexmedetomidine dosing

A

loading dose: 0.5-1mcg/kg over 10min

infusion: 0.2-1.4mcg/kg/hr

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20
Q

Dexmedetomidine MOA

A

alpha 2 agonist: hyperpolarizes cell w/ efflux of K, reduced NE release, decreased cAMP by inhibiting adenylyl cyclase

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21
Q

Side effects of precedex bolus

A

bradycardia and HTN

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22
Q

Midazolam dosing

A

1-2mg IV

0.3-0.5mg/kg PO

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23
Q

midazolam MOA

A

causes increased binding of GABA to its receptor-> opening of Cl channel-> hyperpolarization

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24
Q

cardioprotectant feature of versed

A

prolongs adenosine

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25
Q

unique feature of versed

A

imidazole ring makes its lipid-soluble at pH >4

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26
Q

Lidocaine dosing

A

1-1.5mg/kg
max w/o epi: 4.5mg/kg
max w/ epi: 7mg/kg

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27
Q

rocuronium dosing

A

ED95: 0.3mg/kg

Intubating dose: 0.6mg/kg

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28
Q

non-depolarizing MOA

A

competes with Ach at nicotinic receptor alpha subunits, prevents the opening of Na ion channel, which prevents depolarization

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29
Q

depolarizing MOA

A

binds to alpha subunits on nicotinic receptor causing depolarization

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30
Q

roc metabolism

A

hepatic > renal

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31
Q

succinylcholine dosing

A

1-1.5mg/kg

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32
Q

succinylcholine metabolism

A

plasma cholinesterases

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33
Q

Cisatracurium dosing

A

ED95: 0.05mg/kg

Intubating dose: 0.2mg/kg

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34
Q

cisatracurium metabolism

A

Hoffman elimination

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35
Q

cisatracurium benefits over atracurium

A

less histamine release and less laudanosine formation

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36
Q

vec dosing

A

ED95: 0.05mg/kg

intubating dose: 0.1mg/kg

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37
Q

Neostigmine MOA

A

acetylcholinesterase inhibitor

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38
Q

Neostigmine dose

A

0.04-0.07mg/kg

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39
Q

What anticholinergic is used with Neostigmine

A

gylcopyrrolate

40
Q

what drug is neostigmine often used for reversal

A

vec ( and roc i think)

41
Q

Edrophonium MOA

A

acetylcholinesterase inhibitor

42
Q

edrophonium dose

A

0.5-1mg/kg

43
Q

anticholinergic given with edrophonium

44
Q

edrophonium used to reverse what relaxant

A

atracurium

45
Q

Sugammadex MOA

A

encapsulates steroidal NMB

46
Q

Sugammadex dose

47
Q

dose of sugammadex to use if you have 0/4 twitches to immediately reverse in an emergency

48
Q

sugammadex is incompatible with what drugs

A
  • verapamil
  • ondansetron
  • ranitidine
49
Q

sugammadex metabolism

A

excreted unchanged by the kidneys

50
Q

gylcopyrrolate MOA

A

anticholinergic; competes with Ach for muscarinic receptors

51
Q

glycopyrrolate dose

A

0.015mg/kg

52
Q

Atropine MOA

A

anticholinergic; competes with Ach for muscarinic receptors

53
Q

atropine dose

54
Q

Phenylephrine drug class/ MOA

A

synthetic noncatecholamine

mostly alpha 1 by direct effect

55
Q

phenylephrine effect on HR

A

decreases it

56
Q

Epinephrine MOA

A

endogenous catecholamine.
alpha and beta effects (dose-dependent)
most potent alpha stimulant

57
Q

Epi dosing

A

low: 1-2mcg/min (beta 2)
moderate: 4mcg/min (beta 1)
large: 10-20mcg/min (beta and alpha 1)

58
Q

concentration of code dose epi

A

1:10,000 = 0.1mg/mL

1 vial= 1mg

59
Q

phenylephrine dosing

A

40-200mcg IV bolus

60
Q

hydralazine MOA

A

vasodilator: interferes with Ca2+ ion transport. Hyperpolarizes smooth muscle; activates guanylate cyclase

61
Q

hydralazine vasodilates arterial, venous, or both? How does this effect the HR?

A

arterial, increases it

62
Q

hydralazine dose

63
Q

hydralazine onset

A

10-20min ** dont immediately redose if you arent seeing effects

64
Q

esmolol MOA

A

selective beta 1 antagonist, slows sinus rate, rate of conduction, and inotropy

65
Q

esmolol dosing

A

0.5mg/kg IV over 60 seconds

66
Q

esmolol metabolism

A

plasma esterase

67
Q

beta-blocker overdose treatment

A

atropine 7mcg/kg

glucagon 1-10mg

68
Q

metoprolol MOA

A

selective beta 1 antagonist

69
Q

metoprolol dosing

A

HR > 80: 5mg
HR 60-80: 2-5mg
HR <60 or SBP < 100: hold

70
Q

benefit of metoprolol

A

less likely to cause AE in pts with obstructive airway disease, PVD, diabetes

71
Q

which is longer acting esmolol or metoprolol

A

metoprolol

72
Q

Phenergan MOA

A

H1 blocker; anticholinergic effect- inhibition of dopamine and muscarinic receptors

73
Q

Phenergan dosing

A

6.25mg- 12.5 mg IV

74
Q

Phenergan side effects

A

sedation, lowers seizure threshold, hypotension

75
Q

dont give phenergan to ___

A

seizure patients

76
Q

metoclopramide (reglan) MOA

A

dopamine blockade in CTZ, cholinergic stimulus in GI

77
Q

metoclopramide (reglan) dosing

A

10-20mg IV

78
Q

metoclopramide primary effect

A

increases gut motility

79
Q

metoclopramide contraindications

A

parkinsons and intestinal obstruction

80
Q

Zofran MOA

A

5HT3 receptor antagonist, blocks peripheral receptors on intestinal vagal afferents and central receptors in the CTZ

81
Q

Zofran dose

82
Q

Dexamethasone MOA

A

inhibits prostaglandin synthesis centrally and controls endorphin release

83
Q

Decadron dosing

84
Q

Vancomycin antibiotic class

A

glycopeptide

85
Q

vancomycin MOA

A

inhibits cell wall synthesis

86
Q

vanc covers

87
Q

cefazolin class

A

beta lactam- cephalosporin

88
Q

cefazolin dose

89
Q

cefazolin covers

A

gram +; strep/staph

90
Q

Metronidazole (Flagyl) interacts with

91
Q

Flagyl covers

92
Q

Heparin MOA

A

potentiates action of antithrombin III

93
Q

Heparin dose

A

300units/kg (for CV)

94
Q

Albuterol MOA

A

beta 2 agonist that relaxes bronchial smooth muscle

95
Q

Ephedrine MOA

A

direct effect on alpha and beta. Indirect effect causes release of NE

96
Q

Ephedrine dose

A

5-10mg repeat up to 50mg

97
Q

Ephedrine effect on HR

A

increases it

Clinical (2 decks)

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