Induction Of The CV Patient Flashcards
3 main Opioids Used:
Which of the 3 is best for Cardio protective properties?
Fentanyl
Sulfentanil
Remifentanil (Cardio Protective)
Fentanyl Dose
3-10 mcg/kg
2 attributes of fentanyl
- 98% redistributed from plasma in first hour.
- Large volume of distribution
Sufentanil Dose
0.1-1 mcg/kg
5 attributes of Sufentanil
- 7-10 x more potent than fentanyl
- > pKa and only 20% ionized
- Half as lipid soluble
- < volume of distribution
- Faster recovery time than fentanyl
Remifentanil Dose:
0.5-1 mcg/kg
Onset and recovery time of Remifentanil:
Onset: 1 min
Recovery: 9-20 mins
2 attributes of Remifentanil:
- Widespread extrahepatic hydrolysis bu nonspecific tissue and blood esterases
- Requires careful provision of post op pain
5 hypnotic medications
Propofol Etomidate Thiopental Ketamine Scopolamine
Propofol dose:
1-2 mg/kg
2 attributes of Propofol:
- < SVR, map, CI, and SV
- > redistribution allowing for quick recovery.
Etomidate Dose:
0.2 mg/kg
4 attributes of Etomidate:
- small < in MAP and SVR, > HR and CO
- may initiate myoclonus
- > epileptiform activity in pts with known seizure disorders
- adrenal suppression (unusual)
Thiopental (not quizzed on)
N/A
Ketamine dose:
2 mg/kg
3 Attributes of Ketamine
- dissociative anesthesia
- > ICP and coronary demand (SNS stimulation)
- > HR, >MAP, > plasma Epi levels
- Good for pt with hypovolemia, hemorrhage, cardiac tamponade.
What are 2 negatives with N2O?
- Air trapping (gastric distention)
- post-op N/V
4 attributes of Desflurane:
- Fast Off
- Bronchial irritant
- poor with smokers
- > HR
Is isoflurane slow off or fast off?
Slow
3 attributes of all inhalation agents:
- myocardial depression
- dose-dependent vasodilation
- dose dependent reflex tachycardia
What is a short acting NMB?
Succinlycholine
What are intermediate acting NMBs?
Cisatracurium (good for renal pts)
Rocuronium
Vecuronium
What are long acting NMBs?
Pancuronium (vagolytic effects)
