emergency drugs

Question 1

phenylephrine

Answer 1

synthetic non-catecholamine
primarily a1 adrenergic receptor stimulant
most direct acting
venoconstriction>arterio
less potent than NE
longer lasting

Question 2

phenylephrine dosage

Answer 2

50-200ug IV or cont infusion 20-50ug/min
increase MAP, SBP, DBP, SVR
decrease HR, CO
10mg/ml
double dilution or in 100ml

Question 3

ephedrine

Answer 3

sunthetic non-catecholamine
indirect acting - stim B and a adrenergic receptors
50mg/ml
dilute once

Question 4

ephedrine dosage

Answer 4

5-25mg IV/IM
CV effects similar to epinephrine, 10X longer lasting
SVR effected minimally
increased contractility, MAP, SBP, DBP, HR, coronary BF
decreased renal and splanchnic BF
tachyphylaxis

Question 5

atropine

Answer 5

anticholinergic-antagonizes effect of ach at cholinergic post gang musc receptors
heart salivary glands, smooth muscles GU, GI tracts
tertiary amine-naturally occurring, alkaloid of belladonna
resembles cocaïne, mild analgesic

Question 6

atropine receptors

Answer 6

M1 - CNS, stomach
M2 - lungs and heart
M3 - CNS, airway smooth muscles, glandular tissue
M4/5 - CNS

Question 7

atropine dose

Answer 7

15-75ug/kg IV
drug of choice for intra op bradycardia
antisialalagogue, bronchodilation, mydriasis, decrease GI motility, acid production, bronchodilation, sedation

Question 8

Glycopyrrolate (Robinul)

Answer 8

similar to atropine
quaterary amine - doesnt easily cross BBB so not sedative
.2-.4mg IV
combine with anticholinesterases for reversal .005-.007mg/kg (or 1cc robinul for each cc reversal drawn)

Question 9

succinylcholine

Answer 9

depolarizing muscle relax
attaches to alpha subunits of nic chol receptor
mimics aciton ach

Question 10

succinylcholine dose

Answer 10

.5-1mg/kg
duration of action 3-5 min
used for emergency situation, rapid sequence induction
causes - dysrhythmias, hyperkalemia, myalgias, increased GI pressure, ICP and IOP

Question 11

labetalol

Answer 11

non-selective B blocker as well as alpha blockade
B:a ration 7:1
IV dose .25mg/kg
can repeat 10mins 
bolus 5-10mg
duration of action - 2-18hrs

Question 12

esmolol

Answer 12

beta 1 selective agent 
onset of 2 min
half life of 9 min 
bolus dose of 500ug/kg
use 10-15mg in OR

Question 13

metoprolol

Answer 13

selective B 1 blocker
moderately lipophihlic 
1mg titrate to effect
supplied in 1mb.ml vial
half life 3-7 hours