Exam 2 Numbers Only (doses and whatnot) Flashcards
1
Q
Sevoflurane (Ultane)
MAC
B/G
O/G
A
2%
0.6
50
-5evoflurane
six-sevo (start w/ āsā)
2
Q
Isoflurane (Forane)
MAC
B/G
O/G
A
1.15%
1.4
99
.15oflurane
1.forane
quite literally a tank of an anesthetic, slow and potent
3
Q
N2O
MAC
B/G
O/G
A
105%
0.47
1.4
fast but weak lil guy
4
Q
Desflurane (Suprane)
MAC
B/G
O/G
A
5.8%
0.42
18.7
De5.8
Supr8
-like a sport car without a lot of horsepower, not super strong but the fastest
5
Q
Brain is happy and can autoregulate CBF with a MAP in the range of:
A
60-180mmHg
6
Q
Hypervent pt or perform low normal vent to compensate increased ICP and cerebral vasodilation in pts by trying to shoot for PaCO2 in range of:
A
30-35
7
Q
Epi doses should be no stronger than:
A
1:100,000 or 0.01mg/mL
no more than 10mL or 0.1mg within 10 min
and no more than 30mL or 0.3mg within 60 min
8
Q
-% of pts experience Desflurane tachycardia which we give fentanyl to fix
A
10-20%
9
Q
Sevo has a metabolite level of -%
A
5-8%
10
Q
N2O causes immune suppression in cases >_ hrs
A
6hrs
11
Q
Compound A can form and cause renal injury when Sevo is set at a low flow <_L/min
A
<3L/min
12
Q
N2O is teratogenic and has the highest chance of causing miscarriage within - days postop, if it has to be given, give at low concentration like _ MAC or less.
A
1-7 days
1MAC or less
13
Q
Neurotoxicity from inhaled anesthetics can occur between ages _ _ to _ yo
A
third trimester
3 yo
14
Q
Pediatric Emergence Delirium is short term and typically lasts _-_mins
A
10-15mins
15
Q
Elective procedures should be done in the _ trimester for pregnant pts
A
2nd
16
Q
Ionizing radiation may cause mental retardation to fetus if mom is exposed during week - gestation
A
8-15wk
17
Q
MAC-awake=
A
40-50% MAC
18
Q
MAC-BAR=
A
1.6 x MAC
19
Q
MAC peaks at _ months old and decreases from there
A
6months
20
Q
Sevoflurane
-boiling point
-vapor pressure
A
boils: 59*C
vapor:157
21
Q
Isoflurane
-boiling point
-vapor pressure
A
boils:49*C
vapor:238
22
Q
Desflurane
-boiling point
-vapor pressure
A
boils: 24*C ~room temp!
vapor: 669~atmospheric pressure (760)
23
Q
N2O
-boiling point
-vapor pressure
A
boils:-88*C
vapor: 38,770
24
Q
Drug is considered eliminated after - half lives
A
4-5
25
1st half life, how much drug remains/gone
50% and 50%
26
2nd half life, how much drug remains/gone
25% and 75%
27
3rd half life, how much drug remains/gone
12.5% and 87.5%
28
4th half life, how much drug remains/gone
6.25% and 93.75%
29
5th half life, how much drug remains/gone
3.125% and 96.875%
30
Volume of Distribution for 70kg person:
42L or 0.6L/kg
31
A drug with a small volume of distribution of < _L/kg will stay mainly in plasma and be water soluble
<0.6L/kg
32
A drug with a large volume of distribution of >_L/kg will be widely distributed in the body and is lipid soluble
>0.6L/kg
33
Diazepam (Valium)
-class
-beta half life
-volume of distribution
-protein binding
class: benzo
beta: 20-50 hr **
volumedist: 0.8-1.3L/kg
protein: 98% **
34
Lorazepam (Ativan)
-class
-beta
-protein binding
class: benzo
beta: 10-16hr**
-protein: 90%**
35
Midazolam (Versed)
-class
-beta
-protein binding
class: benzo
beta: 2-4hr
protein: 94%**
36
Etomidate (Amidate)
-class
-beta
-protein
class: Imadazole compound
beta: 2-5hr
protein: 75%
37
Propofol (Diprivan/generic)
-class
-beta
-protein
class: sedative/hypnotic
beta: 1-5hr
protein: 98%**
38
Ketamine (Ketelar)
-class
-beta
-protein
class: DISSOCIATIVE anesthetic ***
beta:2-3hr
protein:12%
39
Dexmedetomidine (Precedex)
-class
-beta
-protein
class: alpha 2 adrenergic AGonist
beta: 2-2.6hr
protein:94%**
40
Propofol
-onset of action
-duration
-beta half life
-total time in body
OOA: 10-15 sec
duration: 8-10min
beta: ~1hr
total time: 4hr
-fast distribution and fast REDISTRIBUTION
41
What % of protein binding is considered significant?
90% or more
42
Most benzos have long half lives (except versed) so this makes seamlessly reversing these medications difficult without giving multiple doses due to Flumazenil's short half life of:
0.7-1.3hrs
43
Etomidate:
-induction dose
-onset
-duration
-beta
0.2 to 0.3mg/kg
<30sec
5-10min
3hr
What I Eat On My Date
2 to 3 appetizers in 30 seconds
5-10 minutes to eat a 3 course meal
44
Propofol:
-induction dose
-onset
-duration
-beta
1-3mg/kg
<30sec
3-8min
1-2hr
45
Ketamine:
-induction dose
-onset
-duration
-beta
1-2mg/kg
45-60sec**
10-20min
2hr
kid of mine is misbehaving,
1...2...
ok go stand in the corner for 45sec-1minute
ok go to your room for 10-20minutes
ok fine, bed time is 2hr earlier now
46
Dexmedetomidine:
-induction/loading dose/infusion range
-onset
-duration
-beta
load:1mcg/kg over 20 min
infusion: 0.2-0.7mcg/kg/hr
2-5min
10-30min
2hr
Dexter tries to mediate 1 time a day for 20minutes
Every 2-7 minutes he loses focus
So 2-5 minute mediations are easy for him
He's working on staying focused for 10-30 minutes
His ultimate goal is to meditate for 2 hours
47
Midazolam:
-induction
-onset
-duration
0.2-0.4mg/kg
30-60sec
15-30min
48
Lorazepam:
-induction
-onset
-duration
0.03-0.06mg/kg
60-120sec
60-120min
49
Diazepam:
-induction
-onset
-duration
0.3-0.6mg/kg
45-60sec
15-30min
50
Brain receives about _% of CO
15%
51
Propofol infusion syndrome can occur ~_hrs of infusion
48hrs
52
Ketamine induction doses:
-IV
-IM
-PO
IV: 0.5-2mg/kg
IM:4-6mg/kg
PO:6-8mg/kg
53
Ketamine maintenance doses
-w/ N2O
-w/o N2O
W/ N2O: 0.5-1mg/kg IV
W/O N2O: 0.9mcg/kg/min IV
If this kid of mine wants to go out at night,
with friends, Nate and Miller, can hang out from 5-1
just with friend, Mike, must be home by 9, by the minute
54
Ketamine doses:
-sedation
-analgesia
Sedation: 0.2-0.8mg/kg IV over 2-3 min
Pain: 2-4mg/kg IM
55
Ketamine dose for preventing pain:
0.15-0.25mg/kg IV
I need just 15 to 25 minutes to myself a day to deal with this kid of mine
56
Propofol induction apnea:
40sec
57
Etomidate induction apnea:
20 sec
58
Ketamine induction apnea:
VERY RARE (when given fast)
59
Droperidol (tranquilizer) blocks dopamine receptors was used for PONV and came with a lot of bad stuff and has a dose range of:
0.625mg-1.25mg
60
Flumazenil dosing:
0.2mg Q 2-3min up to 1mg over 15-20 min or continuous infusion if needing more
61
Haldol can be used as an antiemetic at which dose?
1-2mg
62
You should avoid propofol us in pts with an EF less than _-_%
30-40%
63
A pt experiencing MH could have an EtCO2 in the range of _-_
50-80
64
Your pt is experiencing MH with peaked T waves and your buddy is helping mix up a K+ cocktail. While you're slamming dantrolene and cold fluids, they will be preparing _units/kg of insulin and _mL of D50. If the pt is an adult your buddy can just prep _units of insulin without mathing.
0.1unit/kg
50mL D50
10 units
65
When cooling a pt experiencing MH, give _ mL boluses of NS and don't start cooling until the pt is _*C and don't stop cooling efforts until pt is under _*C
20mL
39*C
38*C
66
Risky to use less than _L/min of Sevo
2
-says 3 somewhere else?
67
Never run sevo for more than _ MAC hrs at FGF 1L
2
68
Never run sevo low if case is less than _min
15
69
Morphine Sulfate doses
-pain
-anesthesia
-potency ratio
pain: 10mg
anesthesia: 1-5mg/kg
potency: 1
70
Meperidine (Demerol) doses:
-pain
-anesthesia
-potency ratio
pain: 100mg
anesthesia: N/A
potency: 0.1
71
Fentanyl doses:
-pain
-anesthesia
-potency ratio
pain:100mcg
anesthesia: 50-150mcg/kg
potency: 100
72
Sufentanyl doses:
-pain
-anesthesia
-potency
pain: 10-20mcg
anesthesia: 5-20mcg/kg
potency: 500-1000 *** (damn, son)
73
Alfentanyl doses:
-pain
-anesthesia
-potency
-i can't read this word without seeing ALF in my head
pain: 500-1000mcg
anesthesia: 100-200mcg/kg
potency: 10-20
74
Remifentanyl doses:
-pain
-anesthesia
-potency
pain: infusion
anesthesia: infusion
potency: 100
75
Hydromorphone doses:
-pain
-anesthesia
-potency
pain: 2mg
anesthesia: N/A
potency: 5
76
Butorphanol (Stadol) doses:
-pain
-anesthesia
-potency
pain:2mg
anesthesia:N/A
potency:5
77
Nalbuphine (Nubaine) doses:
-pain
-anesthesia
-potency
pain: 10mg
anesthesia: N/A
potency: 1
-partial agonist
78
Buprenorphine (Buprenex) doses:
-pain
-anesthesia
-potency
pain:0.3mg
anesthesia: N/A
potency: 30
79
Heroin:
-potency
-why are we learning this???
potency: 2 -used for euphoric feeling
80
Codeine doses:
-pain
-anesthesia
-potency
pain:30mg
anesthesia: N/A
potency: 0.04 (weak lil guy who needs tylenol to do the heavy lifting)
81
Remifentanyl is metabolized by non-specific esterase enzymes via hydrolysis and needs something else to be given to pts for pain when they wake up bc its duration of action is:
5min
82
Morphine:
-protein binding
-duration
-beta
protein: 35%
duration: 3-5hr
beta: 1.7-3hr
83
Meperidine:
-protein binding
-volume distribution
-beta
-duration
protein: 70%
volumedist: 3-5L/kg
beta: 3-5hr
duration: 2-4hr
84
Methadone:
-protein binding
-beta
-duration
protein: 90%**
beta: 15-20hr**
duration: 4-8hr
85
Codeine:
-protein binding
-beta
-duration
protein: 20%
beta: 2-4hr
duration:N/A
86
Oxycodone:
-protein binding
-volume distribution
-beta
-duration
protein: 45%
volumedist:2-3L/kg
beta:3-4hr
duration:2-4hr
87
Fentanyl:
-protein binding
-duration
-beta
protein:86%
duration:1-1.5hr (very dose dependent)
beta:2-4hr
88
Alfentanyl:
-protein binding
-beta
-duration
protein:92%*
beta:1-2hr
duration:0.25-0.4hr*
89
Sufentanyl:
-protein binding
-volume dist
-beta
-duration
protein: 93%**
volume dist: 2.5-3L/kg
beta: 2-3.5hr
duration: 0.8-1.3hr
90
Remifentanyl:
-protein binding
-volume dist
-beta
-duration
protein: 66-93%?
volume dist: 0.3-0.4L/kg (very water soluble and barely leaves plasma)***
beta:0.1-0.2hr***
duration: 2-5min***
91
You gave an opioid during your case but it ended way earlier than you expected and your pt's EtCO2 sucks and is >_mmHg so you have to either ask PACU for a vent or give some narcan. Bummer.
50mmHg, you've upset Father Nagelhout.
92
You want to avoid giving glucocorticoids for antiemetics in diabetics bc it will spike their BG for _-_hrs postop and that's mean.
6-12
93
Palonosetron (Aloxi) is a 2nd gen 5-HT3 receptor ANTAgonist and is great for treating PDNV because its half life is _ hrs
44
94
Droperidol is a Butyrophenone drug that was used all the time for PONV until the FDA ruined its life with a black box warning for prolonging QT intervals, but it was given at a dose of _-_mg if that even matters
0.625-1.25mg
95
Metoclopramide (Reglan) antiemetic doses are around _mg but can be bad because they cause EPS and have a sucky half life at _-_minutes
20mg
30-40min
96
Transdermal Scopolamine patches are useful if they're put on the evening before surgery because they have an onset of about _-_ hrs and a minimum duration of _hrs, making them great for ppl with motion sickness on cruises.
2-4hr onset
min duration 24hr
97
Ondansetron(Zofran) PONV dose:
-drug class
-adult +kid
-everything in this drug class sound like names of Transformer characters tbh
5-HT3 Receptor ANTAgonist
Adult: 4-8mg IV
Kid:50-100mcg/kg up to 4mg max IV
98
Palonosetron (Aloxi) PDNV dose:
-drug class
5-HT3 Receptor ANTAgonist
0.075mg IV
99
Droperidol (Inapsine) PONV dose:
-drug class (for PONV)
Dopamine ANTAgonist
0.625-1.25mg IV
100
Haloperidol (Haldol) PONV dose:
-drug class (for PONV)
Dopamine ANTAgonist
1-2mg IV
101
Metoclopramide (Reglan) PONV dose:
-drug class
Dopamine ANTAgonist
10-20mg IV
102
Prochlorperazine (Compazine) PONV dose:
-drug class (for PONV)
Dopamine ANTAgonist
10mg IV
103
Hydroxazine (Atarax) PONV dose:
-drug class
Antihistamine
12.5-25mg IV
104
Promethazine (Phenergan) PONV dose:
-drug class
Antihistamine
12.5-25mg IV
105
Diphenhydramine (Benadryl) PONV dose:
-drug class
Antihistamine
25mg IV or IM
106
Dexamethasone ( Decadron) PONV dose:
-drug class (adult +kid)
Glucocorticoid
adult: 4-8mg IV
kid: 150mcg/kg up to 8mg IV
107
Scopolamine patch PONV dose:
-drug class
Anticholinergic
2.5cm ^2 patch has 1.5mg scopolamine
108
Aprepitant (Emend) PONV dose:
-drug class
Neurokinin-1 ANTAgonist
40mg PO
109
Rolapitant (Varubi) PONV dose:
-drug class
Neurokinin-1 ANTAgonist
90mg PO
110
To stop itching from opioids, especially spinal and epidurals, can give droperidol at _mg, propofol at _mg, or alizapride at _, check hosp policy tho
droperidol 1.25mg
propofol 20mg
alizapride 100mg
111
Merperidine (Demerol) works for antishivering by acting on the KAPPA receptor and can be given at _ mg IV
10mg
112
Mixing Narcan from 0.4mg/mL vials for titration:
-use 5mL syringe and draw up the 1mL of Narcan
-draw up _mL of sterile water for a total of _ mL in the syringe
-you now have _mg/mL and can "titrate" narcan
3mL
4mL
0.1mg/mL
