Induction Agents

Question 1

Midazolam dosage

Answer 1

0.3 - 15mg/kg - typically give 2mg in preop

Question 2

What is the onset, peak, and duration of Midazolam?

Answer 2

Onset - 1-5 min IV
Peak - 30 min
Duration - 2hrs

Question 3

What receptors does Midazolam activate?

Answer 3

GABA-A and enhancement of the GABA mediated Chloride channels.

Question 4

CNS effects of Midazolam

Answer 4

Potent anticonvulsant
NOT NEUROPROTECTIVE
Decrease CBF and CMRO2
ANTEROGRADE AMNESIA

Question 5

CV effects of Midazolam

Answer 5

Hypotension due to decrease SVR - more drastic in hypovolemic
- Does not prevent sympathetic response to intubation

Question 6

Propofol dosage

Answer 6

1.5 - 2.5mg/kg IV (2mg IV)

10mg/cc, 20cc/vial

Question 7

Propofol - onset, and duration

Answer 7

Onset - 30 sec

Duration - 3-10 min

Question 8

What receptor does Propofol work on?

Answer 8

GABA-A

Question 9

CNS effects of Propofol

Answer 9

NEUROPROTECTIVE
decrease CBF, CMRO2, ICP, IOP
Possesses anti-epileptic properties

Question 10

CV effects of Propofol

Answer 10

Profound decrease in BP - Peripheral Vasodilation

Can cause bradycardia

Question 11

Resp effects of Propofol

Answer 11

respiratory depressant, apnea

Question 12

Other effects of Propofol

Answer 12

Anti-emetic
Pain on injection - give opioid then Lidocaine before Propofol
Antipyretic
Potential for Pulmonary Embolism
Propofol Infusion Syndrome (75mcg/kg/min over 24 hrs)

Question 13

Ketamine dosage

Answer 13

1mg/kg IV, 4-8 mg IM for children

Question 14

Ketamine - onset

Answer 14

30 seconds

Question 15

What receptor does Ketamine work on?

Answer 15

NMDA

Question 16

Ketamine - CV effects

Answer 16

increased BP, HR, CO

Question 17

Ketamine - Resp effects

Answer 17

No significant resp depression

Question 18

Ketamine - not good for…

Answer 18

head injuries, intra cranial pathology

Will increase CBF, CMRO2

Question 19

Lidocaine - dosage

Answer 19

0.5mg/kg (be sure to use Lido for injection), given before Propofol or mixed with Propofol

Question 20

Rocuronium - dosage

Answer 20

0.5 - 1mg/kg

Question 21

Rocuronium - Onset and duration

Answer 21

Onset - 1-2 min

Duration - 30min

Question 22

Rocuronium - Mg/cc and cc/vial

Answer 22

10mg/cc, 5cc per vial

Question 23

What is Rocuronium?

Answer 23

Non-depolarizing muscle relaxant

Question 24

What is Succinylcholine?

Answer 24

Depolarizing muscle relaxant

Question 25

Succs dosage

Answer 25

0.5-2mg/kg (1mg/kg)

20mg/cc, 10cc/vial

Question 26

Succs onset, duration

Answer 26

Onset - 30 sec

Duration - 5 min

Question 27

Succs - warnings

Answer 27

don’t use in abnormal pseudo-cholinesterase, hyperkalemia, eye injury, increase IOP, burns, trauma

Question 28

Fentanyl - dosage

Answer 28

1-2 mcg/kg for sedation
5-15+mcg/kg for general
50-150mcg/kg for cardiac surgery
(50mcg/cc)