Exam 4 - NMBD Reversal, Local Anesthetics, Adjuncts Flashcards

1
Q

Neostigmine dose

A

40 to 70 mcg/kg (0.04-0.07 mg/kg)

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2
Q

Edrophonium dose

A

1 to 1.5 mg/kg
Just know 1 mg… per Castillo

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3
Q

Atropine

A

7 to 10 mcg/kg
Matches profile of Edrophonium

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4
Q

Glycopyrrolate

A

7 to 15 mcg/kg (1 mg max)
Matches profile to both Neostigmine and Pyridostigmine

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5
Q

Sugammadex dose for…
Moderate Block:
Deep Block:
Extreme Block:

A

Moderate - 2 mg/kg
Deep - 4 mg/kg
Extreme - 8-16 mg/kg

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6
Q

Protein Binding percentages for Bupivacaine, Lidocaine, and Prilocaine?

A

Bupivacaine - 95%
Lidocaine - 70%
Prilocaine - 55%

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7
Q

Lidocaine
Metabolism:
Metabolite:
Max Dose:

A

Metabolism: Oxidative dealkylation in liver
Metabolite: Xylidide
Max Dose: 300 mg alone and 500 mg w/ Epi

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8
Q

Prilocaine
Metabolite:
Max Dose:

A

Metabolite: Orthotoluidine
Max Dose: 600 mg
Converts hemoglobin to methemoglobin

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9
Q

Methylene Blue
Indication:
Dose:

A

Indication: Methemoglobinemia
Dose: 1 to 2 mg/kg IV over 5 mins
Total dose not to exceed 7 to 8 mg/kg over 24 hours

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10
Q

Bupivacaine and Ropivacaine bind to which protein?

A

α1-acid glycoprotein

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11
Q

Procaine metabolite

A

PABA

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12
Q

Benzocaine
Onset:
Duration:
Max Dose:

A

Onset: Rapid
Duration: 30 to 60 mins
Max Dose: 200 to 300 mg spray

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13
Q

Cocaine
Peak:
Duration:
Elimination:

A

Peak: 30 to 45 mins
Duration: 60 mins after peak
Elimination - Urine

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14
Q

Max dose for Lidocaine? With Epi?

A

300 mg
With Epi = 500 mg

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15
Q

Bupivacaine max dose? With Epi?

A

175 mg
225 mg with Epi

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16
Q

Atenolol (Tenormin) dose?

A

5 mg q 10 mins IV

17
Q

Metoprolol (Lopressor) dose?

A

1 mg q5mins IV (In blocks of 5 mg)

18
Q

Esmolol (Brevibloc) initial dose? Metabolism?

A

Initial dose = 20-30 mg IV
Metabolized by plasma esterases in the cytosol

19
Q

What is the IVP dose for Phenylephrine?

A

100 mcg bolus

20
Q

Labetalol
Dose?
Max effect?

A

Dose - 2.5-5 mg IV, may increase to 10 mg IV
Max effect - 5-10 mins

21
Q

An epinephrine bolus dose of 2-8 mcg lasts how long?

A

1-5 mins

22
Q

Epinephrine infusions and the receptors…
1-2 mcg/min?
4 mcg/min?
10-20 mcg/min?

A

1-2 mcg/min = beta-2
4 mcg/min = beta-1
10-20 mcg/min = Predominately alpha

23
Q

Single IV dose for Ephedrine? Vasopressin? Epinephrine? Phenylephrine?

A

Ephedrine - 5-10 mg
Vaso - 1-2 units
Epinephrine - 1-2 mcg
Phenylephrine - 50-100 mcg

24
Q

Sodium nitroprusside initial dose?

A

0.3 mcg/kg/min
Titrated to 2 mcg/kg/min

25
Q

Nitroglycerine initial dose?

A

5-10 mcg/min infusion and titrate

26
Q

Hydralazine
Dose?
1/2 life?
Peak plasma concentration?

A

Dose - 2.5 mg IV
1/2 Life - 3-7 hours
Peak - 1 hour

27
Q

Nicardipine (Cardene) dose?

A

Initial dose 5 mg/hr, increase 2.5 mg/hr x 4 to max dose of 15 mg/hr

28
Q

Procaine
Potency?
Maximum Single Dose?
pK?
Protein Binding?

A

Potency - 1
Maximum Single Dose - 500 mg
pK - 8.9
Protein Binding - 6%

29
Q

Chloroprocaine
Potency?
Maximum Single Dose?
pK?
Protein Binding?

A

Potency - 4
Maximum Single Dose - 600 mg
pK - 8.7
Protein Binding… no number was given.

Also has a rapid onset

30
Q

Tetracaine
Potency?
Maximum Single Dose?
pK?
Protein Binding?

A

Potency - 16
Maximum Single Dose - 100 mg (topical)
pK - 8.5
Protein Binding - 76%

31
Q

Lidocaine
Potency?
Maximum Single Dose?
pK?
Protein Binding?

A

Potency - 1
Maximum Single Dose - 300 mg
pK - 7.9
Protein Binding - 70%

32
Q

Prilocaine
Potency?
Maximum Single Dose?
pK?
Protein Binding?

A

Potency - 1
Maximum Single Dose - 400 mg
pK - 7.9
Protein Binding - 55%

33
Q

Mepivacaine
Potency?
Maximum Single Dose?
pK?
Protein Binding?

A

Potency - 1
Maximum Single Dose - 300 mg
pK - 7.6
Protein Binding - 77%

34
Q

Bupivacaine
Potency?
Maximum Single Dose?
pK?
Protein Binding?

A

Potency - 4
Maximum Single Dose - 175 mg
pK - 8.1
Protein Binding - 95%

35
Q

Levobupivacaine
Potency?
Maximum Single Dose?
pK?
Protein Binding?

A

Potency - 4
Maximum Single Dose - 175 mg
pK - 8.1
Protein Binding - > 97%

36
Q

Ropivacaine
Potency?
Maximum Single Dose?
pK?
Protein Binding?

A

Potency - 4
Maximum Single Dose - 200 mg
pK - 8.1
Protein Binding - 94%

37
Q

Eutectic Mixture of LA (EMLA) dose components and dosage?

A

Lidocaine 2.5% and Prilocaine 2.5%
1 to 2 grams/10 cm^2 area

38
Q

For subarachnoid blocks, dosing for a a 5ft person is _________ of 0.75% Bupivacaine… how much do you increase for each inch above 5ft?

A

1 ml
Increase by 0.1 mL/inch over 5 ft.