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NUAN 604- Intro to Sim > Induction Meds Quiz 1 > Flashcards

Induction Meds Quiz 1 Flashcards

1
Q

What is the trade name for Cisatracurium?

A

Nimbex

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2
Q

What is the indication for use of Cisatracurium?

A

Skeletal muscle relaxant

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3
Q

What are the contraindications for Cisatracurium?

A

No adverse cardiovascular effects

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4
Q

What is the mechanism of action of Cisatracurium?

A

Competitive Ach receptor antagonist (Ach nicotinic antagonist)

No histamine release

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5
Q

What is the dose range for Cisatracurium?

A

0.1mg/kg/IV

(Maintenance: 0.03mg/kg/IV)

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6
Q

What is the standard concentration for Cisatracurium?

A

2mg/mL, OR 10mg/mL

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7
Q

How is Cisatracurium metabolized?

A

Hoffman Elimination (77%) & renal (16%)

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8
Q

What is the trade name for Dexmedetomidine?

A

Precedex

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9
Q

What is the indication for use of Dexmedetomidine?

A

Decrease the need for narcotics and maintains respiratory stability

sedation

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10
Q

What are the contraindications for Dexmedetomidine?

A

Bradycardic / hypotensive patients

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11
Q

What is the mechanism of action of Dexmedetomidine?

A

Selective alpha2 receptor agonist causing decreased catecholamine release

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12
Q

What is the loading dose for Dexmedetomidine?

A

0.5-1mcg/kg/IV over 10mins.

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13
Q

What is the maintenance dose for Dexmedetomidine?

A

0.4-0.7 mcg/kg/hr IV

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14
Q

What is the standard concentration for Dexmedetomidine?

A

100mcg/ml

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15
Q

How is Dexmedetomidine metabolized?

A

Biotransformation in liver / CYP450

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16
Q

What is the trade name for Etomidate?

A

Amidate

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17
Q

What is the indication for use of Etomidate?

A

No analgesic effect; good for unstable cardiac patient or hypovolemic due to minimal cardiac and respiratory depression

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18
Q

What are the contraindications for Etomidate?

A

Adrenal dysfunction

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19
Q

What is the mechanism of action of Etomidate?

A

Works on GABAA receptor to produce unconsciousness

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20
Q

What is the dose range for Etomidate?

A

0.2-0.3 mg/kg

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21
Q

What is the standard concentration for Etomidate?

A

2mg/ml

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22
Q

How is Etomidate metabolized?

A

Liver

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23
Q

What is the trade name for Fentanyl?

A

Sublimaze

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24
Q

What is the indication for use of Fentanyl?

A

Adjunct for induction or maintenance analgesia

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25
What is a contraindication for Fentanyl?
Can influence cancer reoccurrence
26
What is the mechanism of action of Fentanyl?
Agonizes Mu receptors to produce analgesia
27
What is the dose range for Fentanyl?
2-50mcg/kg Low: 1-3mcg/kg Moderate: 5-10mcg/kg High: 20-50mcg/kg
28
What is the standard concentration for Fentanyl?
50mcg/ml
29
How is Fentanyl metabolized?
CYP450 Liver
30
What is the trade name for Ketamine?
Ketalar
31
What is the indication for use of Ketamine?
Induction or adjunct to MAC, bronchodilator analgesic- somatic > visceral pain
32
What is a contraindication for Ketamine?***
Head Injury / Inc. ICP
33
What is the mechanism of action of Ketamine?
Interferes with communications between limbic system and thalamus (dissociative state); also a N-methyl-D-aspartate (NMDA) receptor antagonist
34
What is the dose range for Ketamine?
1-2mg/kg/IV
35
What is the standard concentration for Ketamine?
50mg/ml
36
How is Ketamine metabolized?
Liver (Hepatic microsomal enzymes)
37
What is the trade name for Lidocaine?
Xylocaine
38
What is the indication for use of Lidocaine?
Prior to Propofol; part of induction to blunt sympathetic response to laryngoscopy
39
What are the contraindications for Lidocaine?
AV Block
40
What is the mechanism of action of Lidocaine?
Binds to voltage-gated Na channels & prevents Na flow through the channel
41
What is the dose range for Lidocaine?
0.5mg/kg/IV 1-1.5mg/kg/IV
42
What is the standard concentration for Lidocaine?
1% 10mg/ml OR 2% 20mg/ml
43
How is Lidocaine metabolized?
Hepatic CYP450
44
What is the trade name for Midazolam?
Versed
45
What is the indication for use of Midazolam?
Anterograde amnesia & anxiolysis
46
What is a contraindication for Midazolam?
Elderly > 65 y.o.
47
What is the mechanism of action of Midazolam?
Attaches to the alpha subunit on the GABA receptor to produce anesthesia**
48
What is the dose range for Midazolam?
1-3mg/IV
49
What is the standard concentration for Midazolam?
1mg/ml or 5mg/ml
50
How is Midazolam metabolized?
CYP3A4, CYP3A5 (Liver)
51
What is the trade name for Propofol?
Diprivan
52
What is the indication for use of Propofol?
Induction or adjunct to MAC
53
What are the contraindications for Propofol?
Reduce dose in patients over 60 or in the presence of pathophysiologic disease; Propofol Infusion Syndrome avoid in peds with egg allergy
54
What is the mechanism of action of Propofol?
Promotes GABAA mediated inhibitory neurotransmission to produce sedation or loss of consciousness mediates chloride channels
55
What is the induction dose for Propofol?
2-2.5mg/kg/IV
56
What is the maintenance dose for Propofol?
20-200mcg/kg/min
57
What is the standard concentration for Propofol?
10mg/ml
58
How is Propofol metabolized?
Conjugation in the liver
59
What is the trade name for Rocuronium?
Zemuron
60
What is the indication for use of Rocuronium?
NDMR
61
What are the contraindications for Rocuronium?
Anaphylaxis reaction
62
What is the mechanism of action of Rocuronium?
Ach nicotinic antagonist; Competitive Ach receptor antagonist
63
What is the dose range for Rocuronium?
0.45-0.6mg/kg IV (RSI: 0.9-1.2mg/kg/IV)
64
What is the standard concentration for Rocuronium?
10mg/ml
65
How is Rocuronium metabolized?
>70% eliminated by biliary excretion & 10-25% by kidney
66
What is the trade name for Succinylcholine?
Anectine, Succ, Succamethonium diacetylcholine, Quelicin
67
What is the indication for use of Succinylcholine?
Skeletal muscle relaxant; rapid onset, short duration
68
What are the contraindications for Succinylcholine?
Genetically abnormal enzymes; burn patients, history of MH, hyperkalemia, neuro patients, massive trauma, prolonged immobility & severe sepsis.*
69
What is the mechanism of action of Succinylcholine?
Binds to Ach receptors – generates an action potential, prolonging depolarization (fasiculations), continuous depolarization causes muscle relaxation
70
What is the dose range for Succinylcholine?
1-1.5mg/kg/IV Laryngospasm: 0.2-0.5mg/kg/IV Kids: 2-3mg/kg/IV; IM: 4-6mg/kg
71
What is the standard concentration for Succinylcholine?
20mg/ml
72
How is Succinylcholine metabolized?
Butyrylcholinesterase (plasma cholinesterase or psuedocholinesterase)**
73
What is the trade name for Vecuronium?
Norcuron
74
What is the indication for use of Vecuronium?
NDMR
75
What are the contraindications for Vecuronium?
No adverse circulatory effects; don’t use in renal or liver disease
76
What is the mechanism of action of Vecuronium?
Competitive Ach receptor antagonist
77
What is the dose range for Vecuronium?
0.08-0.1mg/kg/IV
78
What is the standard concentration for Vecuronium?
10mg powder (1mg/mL) OR 20mg powder (2mg/mL)
79
How is Vecuronium metabolized?
40-50% hepatic & 50-60% renal
80
What is the first step of a routine induction process?
Confirm patient assessment: pre-op H&P, consents, NPO status, allergies, explanation of process to patient
81
In which position should the patient be placed on the OR table for induction?
Sniffing position
82
How do you preoxygenate during induction?
provide 8-10 liters of oxygen via facemask
83
What should be available at the head of the bed during induction?
Suction
84
What indicates that the patient is unconscious and apneic?
No response to name, unable to open eyes, no lash reflex
85
What should be done after confirming the patient is unconscious?
Manually ventilate the patient
86
What is monitored to assure adequacy of ventilation?
BP, EKG, SpO2, ETCO2
87
What type of muscle relaxant is used in conjunction with an inhalational agent if the patient is hemodynamically stable?
Non-depolarizing muscle relaxant
88
What confirms proper placement of the ETT?
Positive ETCO2, positive and equal breath sounds, negative sounds over abdomen
89
What is a key difference in the injection sequence of medications for RSI compared to routine induction?
No positive pressure ventilation
90
What must be assured before laryngoscopy and intubation in RSI?
Loss of consciousness
91
What should be done after confirming proper placement of ETT during RSI?
Ventilate the patient
92
What is inserted alongside securing the ETT?
OGT/esophageal temp probe

NUAN 604- Intro to Sim (3 decks)

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