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Mar: Txwes Pharm Review > Exam 2 Drugs - Induction, Opioid Agonists/Antagonists, Multimodal > Flashcards

Exam 2 Drugs - Induction, Opioid Agonists/Antagonists, Multimodal Flashcards

1
Q

Induction dose for Methohexital (Brevital)?

A

1.5 mg/kg IV

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2
Q

S isomers of barbiturates are more ___________ than R isomers

A

Potent

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3
Q

List the Oxybarbiturates

A

Methohexital
Phenobarbital
Pentobarbital

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4
Q

List the thiobarbiturates

A

Thiopental
Thiamylal

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5
Q

What is the dose for Thiopental?

A

4 mg/kg IV

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6
Q

If a continuous infusion of Brevital is given there can be post-op _______________ in 1 out of 3 patients

A

Seizure activity

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7
Q

If given per rectum, what is the dose for Methohexital (Brevital)?

A

20-30 mg/kg

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8
Q

What is the induction dose for propofol?
Conscious sedation?
Maintenance?

A

Induction: 1.5-2.5 mg/kg IV
Conscious Sedation: 25 to 100 mcg/kg/min
Maintenance: 100-300 mcg/kg/min

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9
Q

Propofol produces unconsciousness within how long?

A

30 seconds

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10
Q

What is the E 1/2 Time for Propofol?

A

0.5-1.5 hours

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11
Q

What is the sub-hypnotic dose or propofol?

A

10-15 mg IV followed by 10 mcg/kg/min

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12
Q

If using propofol as an anti-pruritic, what dose would you give? What about an anti-convulsant?

A

Anti-pruritic - 10 mg IV
Anti-convulsant - 1 mg/kg IV

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13
Q

Etomidate…
Dose:
Onset:
E 1/2 Time :

A

Dose: 0.3 mg/kg IV
Onset: Within 1 minute
E 1/2 Time: 2-5 Hours

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14
Q

Ketamine induction dose…

A

0.5-1.5 mg/kg IV
4-8 mg/kg IM

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15
Q

Ketamine maintenance dose…

A

0.2-0.5 mg/kg IV
4-8 mg/kg IM

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16
Q

Ketamine subanesthetic (analgesic) dose

A

0.2-0.5 mg/kg IV

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17
Q

Ketamine post-op sedation and analgesia dose

A

1-2 mg/kg/hour

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18
Q

Ketamine neuraxial analgesia dose…

A

30 mg - Epidural
5-50 mg in 1mL of NS - Spinal/Intrathecal/Subarachnoid

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19
Q

Ketamine:
Onset
Return of consciousness
Full consciousness
How long does amnesia persist?

A

Onset: 30 seconds - 1 min (IV), 2 to 5 mins (IM)
ROC: 10 to 20 mins
Full Consciousness: 60 to 90 mins
Amnesia persists for 60 to 90 mins

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20
Q

CAD ‘cocktail’?

A

Diazepam 0.5 mg/kg IV
Ketamine 0.5 mg/kg IV
Continuous Ketamine Infusion - 15 to 30 mcg/kg/min IV

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21
Q

Morphine:
Dose
Onset
Peak
Duration

A

Dose: 1-10 mg IV
Onset: 10 to 20 mins (IV and IM)
Peak: 45 to 90 mins IM; 15 to 30 mins IV
Duration: 4-5 hours

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22
Q

How is Morphine metabolized?

A

Glucorinic acid conjugation

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23
Q

What are the two metabolites of morphine? Which is active? Inactive?

A

Morphine-3-glucoronide (Inactive)
Morphine-6-glucoride (Active)

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24
Q

Which active metabolite of Morphine contributes to late respiratory depression?

A

Morphine-6-Glucoronide

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25
Which receptors does Meperidine/Pethidine agonize?
Mu and Kappa
26
What are the four analogues of Meperidine?
Fentanyl Sufentanil Alfentanil Remifentanil
27
Meperidine Dose: Duration: E 1/2 Time: Metabolism:
Dose: 12.5 mg (Post-op shivering) Duration: 2-4 hours E 1/2 Time: 3-5 hours (35 hours with renal failure) Metabolism: 90% Hepatic (Normeperidine)
28
Fentanyl dose for... Analgesia? Induction? Adjunct with inhaled anesthetics?
Analgesia - 1 to 2 mcg/kg IV Induction - 1.5 to 3 mcg/kg IV Adjunct with inhaled anesthetics - 2 to 20 mcg/kg IV
29
Fentanyl dose for... Surgical Anesthesia (Solo) Intrathecal Transmucosal (Oral) Transdermal
Surgical Anesthesia (Solo): 50-150 mcg/kg IV Intrathecal - 25 mcg Transmucosal (Oral) - 5 to 20 mcg/kg Transdermal - 75 to 100 mcg (18 hours steady delivery)
30
Sufentanil doses
Analgesia - 0.1 to 0.4 mcg/kg IV Induction - 18.9 mcg/kg IV
31
Alfentanil dose for... Induction laryngoscopy Induction alone Maintenance
Induction laryngoscopy - 15 to 30 mcg/kg IV Induction alone - 150 to 300 mcg/kg IV Maintenance - 25 to 150 mcg/kg/hours IV
32
Remifentanil induction dose? Maintenance?
Induction - 0.5 to 1.0 µg/kg IV over 30-60 secs Maintenance - 0.25 to 1 µg/kg IV or 0.005 to 2 µg/kg/min IV
33
Hydromorphone dose?
0.5 mg IV (1 to 4 mg)
34
Codeine E 1/2 Time Metabolism Cough suppressant dose Analgesia dose
E 1/2 Time - 3 to 3.5 hours Metabolism - Liver Cough suppressant dose - 15 mg Analgesia dose - 60 mg
35
120 mg of Codeine is equal to...
10 mg of Morphine
36
Fentanyl is _________ times more potent than morphine?
75 to 125
37
Pentazocine elimination 1/2 time?
2-3 hours
38
Pentazocine moderate chronic pain dose? What dose can cause analgesia, sedation, and depression of ventilation?
Moderate Pain Dose - 10 to 30 mg IV or 50 mg PO (Equivalent to Codeine 60 mg) 20 to 30 mg IM can cause analgesia, sedation, and depression of ventilation (SImilar to 10 mg of Morphine)
39
Butorphanol dose? Half-time? Metabolism?
2 to 3 mg IM (Equal to 10 mg of Morphine) 2.5 to 3.5 hours Hepatic
40
Which opioid agonist-antagonist is equally potent to Morphine?
Nalbuphine (10 mg = 10 mg)
41
Which dose of Buprenorphine is equal to 10 mg of Morphine?
0.3 mg IM
42
Buprenorphine dose? Onset? Duration?
0.3 mg IM Onset - 30 mins Duration - 8 hours
43
Dezocine dose?
0.15 mg/kg IM
44
100 mg of what drug is equal to 8 mg of Morphine?
Meptazinol (Duration < 2 hrs)
45
Naloxone dose? Continuous infusion? Shock? Epidural?
1 to 4 µg/kg IV Continuous - 5 µg/kg IV Shock - > 1 mg/kg IV Epidural - 0.25 µg/kg/hour IV
46
Naloxone duration? Metabolism? E 1/2 time?
30 to 45 mins Liver (Glucoronic Acid) 60-90 min half-time
47
Naltrexone duration? Use?
24 hours Alcoholism
48
Nalmefene dose? E 1/2 time?
15 to 25 mcg IV q 2 to 5 mins 10.8 hours
49
Which drugs are given pre-op and post-op?
Acetaminophen Gabapentin
50
Gabapentin dose for preemptive analgesia?
300 to 1200 mg PO 1-2 hours before OR
51
Celebrex dose? Peak?
200-400 mg PO QD 3 hours
52
Ofirmev Dose? Peak? Duration?
Dose: 1000 mg IV q4-6H (Max 3000-4000 mg QD) Peak: PO (1-3 hours), IV (30 mins to 1 hour) Duration: 6-8 hours
53
Ketorolac dose? Max dose? Peak?
15-30 mg IM q6H Max 60-120 mg QD
54
Ibuprofen dose? Peak?
200 to 800 IV over 30 mins q6 hours (3200 mg/day max) Peak - 1 to 2 hours
55
Lidocaine initial bolus dose? Continuous drip?
Initial = 1 to 2 mg/kg IV Drip = 1 to 2 mg/kg/hour (Terminated in 12 to 72 hours)
56
Magnesium dose?
50 mg/kg IV preop 8 mg/kg/hr intraoperatively
57
Zofran dose?
4 mg IV (Up to 8) 0.1 mg/kg IV (Pediatric)
58
Dexamethasone (Decadron) dose?
8 to 10 mg
59
What two meds should you give before administering Ketamine?
Glycopyrrolate (Antisialagogue) Versed (To prevent emergence delirium)
60
What is the active metabolite of Ketamine?
Norketamine
61
Which opioid agonist has the largest Vd?
Fentanyl
62
What is Fentanyl's E 1/2 time? Why is that significant?
3.1-6.6 hrs It's the longest among the opioid agonists.
63
Which opioid agonist has the lowest lipid solubility and the lowest clearance (300 mL/min)?
Alfentanil
64
Alvimopan is metabolized in the...
Gut flora
65
Which opioid receptor has the following effects? -Analgesia (Supraspinal, spinal) -Euphoria -Low abuse potential -Miosis -Bradycardia -Hypothermia -Urinary retention
Mu-1
66
Which opioid receptor has the following effects? -Analgesia (Spinal) -Depression of ventilation -Physical Dependence -Constipation (marked)
Mu-2
67
Which opioid receptor has the following effects? -Analgesia (Supraspinal, spinal) -Dysphoria, sedation - Low abuse potential -Miosis -Diuresis
Kappa Agonist - Dynorphins
68
Which opioid receptor has the following effects? -Analgesia (Supraspinal, spinal) -Depression of ventilation -Physical Dependence -Constipation (minimal) -Urinary Retention
Delta (Agonist - Enkephalins)

Mar: Txwes Pharm Review (4 decks)

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