Exam 2 part VI

Question 1

DOA of atropine IM

Answer 1

2-4 hrs

Question 2

adult dose of scopolamine adult IV/IM

Answer 2

0.3-0.6 mg

Question 3

peds premed dose of scopolamine

Answer 3

6 mcg/kg IV/IM

Question 4

DOA of scopolamine IV

Answer 4

30-60 min

Question 5

DOA of scopolamine IM

Answer 5

4-6 hrs

Question 6

transdermal scoplamine patch is a ____________ mg dose and should be applied __________ hrs prior to surgery

Answer 6

1.0; 4

Question 7

which anticholinergic has the most potent: antisialagogue, sedation, amnestic effects?

Answer 7

scopolamine

Question 8

which anticholinergic has pronounced ocular effects

Answer 8

scopolamine

Question 9

scopolamine transdermal antiemetic onset is within __________ hrs and lasts up to _______________

Answer 9

4; 72

Question 10

amnesia with scopolamine IV is achieved within ___________ minutes and lasts up to ____________ hrs

Answer 10

10; 2

Question 11

antiemetic effects of scopolamine if given IM occurs within ___________ min and lasts up to ____________ hours

Answer 11

15-30; 4

Question 12

Glycopyrolate adult dose premed IV/IM

Answer 12

0.1-0.2 mg

Question 13

pediatric premed dose of glycopyrolate ________________ IV /IM

Answer 13

4-8 mcg/kg

Question 14

onset of glycopyrolate

Answer 14

2-3 min

Question 15

DOA of glycopyrolate IV

Answer 15

2-4 hours

Question 16

DOA of glycopyrolate IM

Answer 16

6-9 hours

Question 17

dose of ipratroprium bromide

Answer 17

0.5 mg metered dose inhaler

Question 18

sugammadex aka __________

Answer 18

bridion

Question 19

sugammadex is for the reversal of what NDMR

Answer 19

rocuronium or vecuronium

Question 20

dose of suggamadex if you have 2/4 TOF twitches

Answer 20

2 mg/kg

Question 21

dose of suggamadex if you have 0/4 twitches in TOF with 1-2 post-tetanic twitches

Answer 21

4 mg/kg

Question 22

dose of suggamadex if you have to reverse a 1.2 mg/kg dose of rocuronium within 3 minutes of administration

Answer 22

16 mg/kg

Question 23

if you administer sugammadex (bridion) you must wait to redose NDMR btwn ______ -________ depending on the dose given and pt renal fx

Answer 23

5 min; 24 hours

Question 24

metabolism of sugammadex

Answer 24

no metabolites; 95% excreted in the urine unchanged

Question 25

half life of sugammadex

Answer 25

2 hours

Question 26

if pt has severe renal failure, what is the 1/2 life of sugammadex

Answer 26

19 hours

Question 27

sugammadex is _______% protein boudn

Answer 27

0

Question 28

contraindications of suggamdex

Answer 28

1. hypersensitivity reactions (skin irritation - anaphylaxis) 2. severe renal impairment with dialysis 3. marked bradycardia

Question 29

MOA of suggamadex

Answer 29

1. modified gamma cyclodextrin 2. forms a roc/vec and reduces the amount of NDMR available to bind to the nicotinic receptor in the NMJ

Question 30

s/e of suggamadex

Answer 30

1. HA 2. N/V 3. pain 4. marked bradycardia 5. Hotension

Question 31

sugammadex is incompatible with what meds

Answer 31

1. zofran 2. verapamil 3. rantinidine

Question 32

dose adjustment of suggamadex is only necessary for ______________ renal dz

Answer 32

SEVERE

Question 33

if uses hormonal (oral / non-oral) contraceptive and you use suggamadex to reverse them in surgery, what should you educate them on?

Answer 33

use a different form of contraception for at least 7 days

Question 34

recovery of NDMR even with suggamadex can be prolonged if the patient is on what medication

Answer 34

toremifene (estrogen receptor antagonist used for metastatic breast cancer in post menopausal women)

Question 35

NDMR + NDMR = __________________ block

Answer 35

augmented

Question 36

SUC + NDMR = _____________________

Answer 36

antagonism of depolarizing block

Question 37

NDMR + anticholinesterase = ____________________

Answer 37

antagonize

Question 38

SUC + anticholinesterase = ______________________

Answer 38

augment

Question 39

what is the preferred site for PNS with emergence

Answer 39

adductor pollicis

Question 40

which electrode is closest to the wrist when using adductor pollicis for PNS

Answer 40

black

Question 41

preferred PNS site for intubation

Answer 41

facial

Question 42

which PNS site is the best site for predicting vocal cord paralysis

Answer 42

facial

Question 43

which PNS site closely mimics upper airway musculature

Answer 43

adductor pollicis

Question 44

which PNS site is the Least reliable site?

Answer 44

peroneal placement

Question 45

with peroneal PNS placement, the black electrode goes where

Answer 45

below the internal malleolus

Question 46

single twitch sends _____________ stimuli over _______ seconds at __________ Hz

Answer 46

1; 0.2; 0.1-1

Question 47

TOF sends ___________ stimuli over ___________ seconds at ____________ Hz

Answer 47

4; 2; 2 (0.5 sec apart)

Question 48

Double burst sends _______________ stimuli over _____________ seconds at __________ Hz

Answer 48

6; 0.8; 50

Question 49

Tetany sends ______________ stimuli for _____________ seconds at _________ Hz

Answer 49

250; 5; 50-100

Question 50

what is the most commonly used PNS mode

Answer 50

train of four

Question 51

double burst is used to determine _____________

Answer 51

fade

Question 52

which PNS twitch mode needs a baseline prior to drug administration

Answer 52

single twitch

Question 53

which PNS twitch mode is qualitative rather than quantitative assessment, thus has limited clinical usefulness

Answer 53

single twitch

Question 54

PNS single twitch can be repeated when?

Answer 54

> 10 seconds

Question 55

with TOF twitches fade as relaxation _________________

Answer 55

increases

Question 56

TOF reflects blockade from _________ to ___________%

Answer 56

70; 100

Question 57

TOF is useful during which parts of anesthesia

Answer 57

onset, maintenance, & emergence

Question 58

TOF and double burst twitch patterns can be repeated in _______________ s

Answer 58

15-Dec

Question 59

T/F: double burst is more sensitive than TOF for the clinical evaluation of fade

Answer 59

TRUE

Question 60

w/ PNS tetany if the contraction is sustained for 5 seconds this indicates what

Answer 60

adequate reversal, but not necessarily complete