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Anesthesia Pharm > Exam 2 part VI > Flashcards

Exam 2 part VI Flashcards

1
Q

DOA of atropine IM

A

2-4 hrs

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2
Q

adult dose of scopolamine adult IV/IM

A

0.3-0.6 mg

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3
Q

peds premed dose of scopolamine

A

6 mcg/kg IV/IM

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4
Q

DOA of scopolamine IV

A

30-60 min

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5
Q

DOA of scopolamine IM

A

4-6 hrs

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6
Q

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

A

1.0; 4

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7
Q

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

A

scopolamine

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8
Q

which anticholinergic has pronounced ocular effects

A

scopolamine

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9
Q

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

A

4; 72

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10
Q

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

A

10; 2

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11
Q

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

A

15-30; 4

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12
Q

Glycopyrolate adult dose premed IV/IM

A

0.1-0.2 mg

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13
Q

pediatric premed dose of glycopyrolate ________________ IV /IM

A

4-8 mcg/kg

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14
Q

onset of glycopyrolate

A

2-3 min

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15
Q

DOA of glycopyrolate IV

A

2-4 hours

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16
Q

DOA of glycopyrolate IM

A

6-9 hours

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17
Q

dose of ipratroprium bromide

A

0.5 mg metered dose inhaler

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18
Q

sugammadex aka __________

A

bridion

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19
Q

sugammadex is for the reversal of what NDMR

A

rocuronium or vecuronium

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20
Q

dose of suggamadex if you have 2/4 TOF twitches

A

2 mg/kg

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21
Q

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

A

4 mg/kg

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22
Q

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

A

16 mg/kg

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23
Q

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

A

5 min; 24 hours

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24
Q

metabolism of sugammadex

A

no metabolites; 95% excreted in the urine unchanged

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25
Q

half life of sugammadex

A

2 hours

26
Q

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

A

19 hours

27
Q

sugammadex is _______% protein boudn

A

0

28
Q

contraindications of suggamdex

A
  1. hypersensitivity reactions (skin irritation - anaphylaxis) 2. severe renal impairment with dialysis 3. marked bradycardia
29
Q

MOA of suggamadex

A
  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
30
Q

s/e of suggamadex

A
  1. HA 2. N/V 3. pain 4. marked bradycardia 5. Hotension
31
Q

sugammadex is incompatible with what meds

A
  1. zofran 2. verapamil 3. rantinidine
32
Q

dose adjustment of suggamadex is only necessary for ______________ renal dz

A

SEVERE

33
Q

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

A

use a different form of contraception for at least 7 days

34
Q

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

A

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

35
Q

NDMR + NDMR = __________________ block

A

augmented

36
Q

SUC + NDMR = _____________________

A

antagonism of depolarizing block

37
Q

NDMR + anticholinesterase = ____________________

A

antagonize

38
Q

SUC + anticholinesterase = ______________________

A

augment

39
Q

what is the preferred site for PNS with emergence

A

adductor pollicis

40
Q

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

A

black

41
Q

preferred PNS site for intubation

A

facial

42
Q

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

A

facial

43
Q

which PNS site closely mimics upper airway musculature

A

adductor pollicis

44
Q

which PNS site is the Least reliable site?

A

peroneal placement

45
Q

with peroneal PNS placement, the black electrode goes where

A

below the internal malleolus

46
Q

single twitch sends _____________ stimuli over _______ seconds at __________ Hz

A

1; 0.2; 0.1-1

47
Q

TOF sends ___________ stimuli over ___________ seconds at ____________ Hz

A

4; 2; 2 (0.5 sec apart)

48
Q

Double burst sends _______________ stimuli over _____________ seconds at __________ Hz

A

6; 0.8; 50

49
Q

Tetany sends ______________ stimuli for _____________ seconds at _________ Hz

A

250; 5; 50-100

50
Q

what is the most commonly used PNS mode

A

train of four

51
Q

double burst is used to determine _____________

A

fade

52
Q

which PNS twitch mode needs a baseline prior to drug administration

A

single twitch

53
Q

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

A

single twitch

54
Q

PNS single twitch can be repeated when?

A

> 10 seconds

55
Q

with TOF twitches fade as relaxation _________________

A

increases

56
Q

TOF reflects blockade from _________ to ___________%

A

70; 100

57
Q

TOF is useful during which parts of anesthesia

A

onset, maintenance, & emergence

58
Q

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

A

15-Dec

59
Q

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

A

TRUE

60
Q

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

A

adequate reversal, but not necessarily complete

Anesthesia Pharm (18 decks)

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