Flash card assignment
Succ trade name
Anectine
Succ class
Depolarizing NMBA
Succ indications
Medicated facilitated intubation after administration of sedation/analgesic
Succ contras
Hypersensitivity, known or suspected hyperK+, family hx of MH or psuedocholinesterase deficiency, myopathies associated with elevated CK
Succ dose
Adults 1.5mg/kg IV/IO
Peds 1.5 - 2.0 mg/kg IV/IO
Succ additional considerations
Don’t be a dick
*Consider withhold in difficult airway
Takes 60-90 secs for full effect
Acute airway burns not a cause for hyperK+
Roc trade name
Zemuron
Roc class
Non depolarizing NMBA
Roc indications
Post intubation to facilitate airway control and maintain muscle relaxation
Roc contras
Hypersensitivity
Roc dosage
Adult 1mg/kg IV/IO repeated 0.5mg/kg IV/IO PRN
Roc ped dose
Exact fucking same as adult
Vecuronium trade name
Norcuron
Vecuronium class
Non depolarizing NMBA
Vecuronium indications
Post intubation for airway control and maintain muscle relaxation
Vecuronium contras
Hypersensitivity
Vecuronium adult dose
0.1mg/kg IV/IO maintain at 0.01-0.05mg/kg IV/IO Q 20-40
Vecuronium peds
Exact fucking same as adults
Roc additional considerations
Don’t be a dick
Antibiotics (micins) or CCB (dipine) can potentiate effects of roc
Can increase BP, heart rate, induce bronchospasm
NO histamine release
Duration of paralysis 20-40 minutes
Time to onset of paralysis 1-3 minutes
Vecuronium additional considerations
Don’t be a dick
Micins and CCBs can potentiate
No histamine release, cardiovascular effects are minimized
Pancuronium Bromide trade name
Pavulon
Pancuronium Bromide class
Non depolarizing NMBA
Pancuronium Bromide indications
Post tube to facilitate airway control and maintain muscle relaxation
Pancuronium Bromide contas
Hypersensitivty
Pancuronium Bromide adult dose
0.1mg/kg IV/IO maintain at 0.01mg/kg q 20-40 IV/IO
Pancuronium Bromide peds dose
Exact fucking same as adults
Pancuronium Bromide additional considerations
Don’t be a dick
Is the prototype non depol NMBA
NO histamine release, minimal cardiovasc effects
30-45% of drug undergoes hepatic metabolism
Atropine Sulfate trade name
Atropine
Atropine Sulfate Class
Anticholinergic, parasympatholytic
Atropine Sulfate indications
Symptomatic bradycardia, organophosphate poisoning
Atropine Sulfate contras
Hypersensitivity
Atropine Sulfate dose adult for bradycardia
0.5mg IV/IO q3-5 max 3mg
Atropine Sulfate adult dose organophosphate poisoning
2mgIV/IO/IM q5 prn until sludgem reversed
Atropine Sulfate peds for brady
0.02mg/kg IV/IO single max of 0.5
May give q3-5 prn ma of 0.04mg/kg or 1mg
Atropine Sulfate peds organo poisoning
0.05mg/kg q5 prn until DJ BMSLUDGE reversed
Atropine Sulfate additional considerations
Drug of choice in acute symptomatic bradycardia (if immediately reversible causes are not found)
Immediate pacing may be considered over atropine in 2nd degree type II or 3rd degree block
Atropine should not be administered to pts with a hx of heart transplant
Ipratropium Bromide trade name
atrovent
Ipratropium Bromide class
Antichol, parasympatholytic
Ipratropium Bromide indications
bronchospasm, anaphylaxis
Ipratropium Bromide contras
Hypersensitivity
Ipratropium Bromide adult dose
Neb 500mcg repeat prn
MDI w/spacer 10 puffs ONLY if pt has no received 3 doses of nebulized atrovent, repeat q 20 max 30
Ipratropium Bromide pediatric dose
Less than 20kg - 250mcg with ventolin
Greater than 20kg - 500mcg with ventolin nebbed
Ipratropium Bromide additional considerations
Each puff 20mcg
Invert canister multiple times prior to each puff
Depress 3x away prior to
As pt begins to inhale, deliver one puff
Direct pt to continue to inhale slowly then hold breath 5-10 seconds
Allow pt to breath into chamber 5 times
MDI requires 30 seconds between puffs
Alternate single puffs with salbutamol during recharge period
Dopamine trade name
Intropin
Dopamine class
Adrenergic agonist, vasopressor, inotropic, sympathomimetic
Dopamine indications
Shock management, sepsis, pulmonary edema, symptomatic bradycardia,
Beta blocker/ calcium channel blocker OD
Dopamine contras
Pheochromocytomo Tachyarrythmias V fib MAOI within 14 days Allergy to sulphites
Dopamine dose
Adult initial 5mcg/kg/minute titrate to max dose of 20
Dopamine peds
2-20mcg/kg/minute - titrate to effect
Dopa renal dose
Increased renal at 2-5mcg/kg/min
Dopa beta 1 dose
5-10mcg/kg/min
Dopa A1 effects
10-20mcg/kg/min
Dopa additional notes
400mg/250ml saline or D5W = 1600mcg/mL use baxter control-a-flow and a 60 drop set
Dobutamine trade name
Dobutrex
Dobutamine class
Adrenergic agonist, beta 1 agnoist, inotropic, sympathomimetic