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N928 - Basics of Anesthesia > Induction Sequence Drugs > Flashcards

Induction Sequence Drugs Flashcards

1
Q

Vasopressors Color

A

purple

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2
Q

Muscarinic Antagonist/Anticholinergic Color

A

green

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3
Q

paralytic color

A

bright orange/red

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4
Q

sedatives/benzos color

A

orange

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5
Q

opioids color

A

blue

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6
Q

local anesthetics color

A

grey

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7
Q

induction agents color

A

yellow

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8
Q

AChE inhibitor color

A

candy cane (red and white stripe)

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9
Q

phenylephrine original vial/concentration

A

1 mL vial, [10 mg/mL]

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10
Q

phenylephrine final concentration

A

[100 mcg/mL]

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11
Q

phenylephrine syringe size

A

10 mL syringe

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12
Q

phenylephrine dilution

A

Draw up 9 mL NS and add 1 ml [10mg/mL]. Take 1 mL of that mixture and dilute again with 9 mL NS for a final concentration of 100 mcg/mL

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13
Q

phenylephrine dose

A

0.5-1.5 mcg/kg

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14
Q

phenylephrine onset/DOA

A 
onset = <1 min 
DOA = 15-20 min
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15
Q

phenylephrine clinical pearls

A
  • alpha 1 agonist

- reflex bradycardia

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16
Q

ephedrine original vial/concentration

A

1 mL vial or 1 mL ampule, [50 mg/mL]

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17
Q

ephedrine final concentration

A

[5 mg/mL]

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18
Q

ephedrine syringe size

A

10 mL syringe

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19
Q

ephedrine dilution

A

draw up 9 mL NS and add 1 mL [50 mg/mL] for a final concentration of [5 mg/mL]

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20
Q

ephedrine dose

A

0.1-0.2 mg/kg

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21
Q

ephedrine onset/DOA

A 
onset = seconds
DOA = 10-60 min
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22
Q

ephedrine clinical pearls

A
  • extended duration bc non-catecholamine (NT release and some alpha/beta AR receptor agonism)
  • 10-25 mg IV for N/V associated with postural hypotension in PACU
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23
Q

atropine vial/concentration

A

1 mL vial of either [0.4 mg/mL] or [1 mg/mL]

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24
Q

atropine syringe size

A

3 mL syringe

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25
Q

atropine dose

A

0.01-0.03 mg/kg

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26
Q

atropine onset/DOA

A 
onset = 45-60 sec
DOA = 1-2 hours
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27
Q

atropine clinical pearls

A
  • muscarinic antagonist, antisialagogue

- caution with closed angle glaucoma

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28
Q

succinylcholine vial/concentration

A

10 mL vial of [20 mg/mL]

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29
Q

succinylcholine syringe size

A

10 mL syringe

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30
Q

succinylcholine dose

A

1 mg/kg

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31
Q

succinylcholine onset/DOA

A 
onset = 30-60 sec (paralyze larynx in 34 sec)
DOA = 5-15 min
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32
Q

succinylcholine clinical pearls

A
  • depolarizing NMBD
  • potentiated by ketamine, Alzheimer’s meds
  • contraindications - peds <5 yo, can increase potassium (increase 0.5 mEq/L/dose so caution in burns, abd infection, acidosis, parapledgia, muscular dystrophy, Guillian-Barre), MH risk, open eye injury, ICP issues
  • liver disease, malnutrition can cause low PChEs
  • Dibucaine # - >70 OK, 40-60 double DOA, <30 produces 4-8 hour block
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33
Q

Emergency Drugs Acronym

A 
PEAS 
Phenylephrine
Ephedrine
Atropine
Succinylcholine
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34
Q

rocuronium vial/concentration

A

5 mL vial of [10 mg/mL]

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35
Q

rocuronium syringe size

A

5 mL syringe

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36
Q

rocuronium dose

A
  1. 6 mg/kg

1. 2 mg/kg for RSI

37
Q

rocuronium onset/DOA

A 
onset = 2-3 min (1 min for RSI)
DOA = 15-85 min (avg 35 min)
38
Q

rocuronium clinical pearls

A
  • steroidal NMBD
  • caution in hepatorenal disease
  • reverse with sugammadex (TOF >2 [2 mg/kg], TOF 1-2 [4 mg/kg], TOF 0 [8-16 mg/kg]) or neo/glyco
39
Q

vecuronium vial

A

10 mg vial powder

40
Q

vecuronium reconstitution

A

reconstitute with 10 mL NS

41
Q

vecuronium final concentration

42
Q

vecuronium syringe size

A

10 mL syringe

43
Q

vecuronium dose

44
Q

vecuronium onset/DOA

A 
onset = 2-3 min
DOA = 30-60 min
45
Q

vecuronium clinical pearls

A
  • steroidal NMBD
  • caution in liver disease
  • reverse with sugammadex (TOF >2 [2 mg/kg], TOF 1-2 [4 mg/kg], TOF 0 [8-16 mg/kg]) or neo/glyco
46
Q

cisatracurium vial/concentration

A

5 mL vial or 10 mL vial of [2mg/mL]

47
Q

cisatracurium syringe size

A

5 mL syringe

48
Q

cisatracurium dose

49
Q

cisatracurium onset/DOA

A 
onset = 2 min
DOA = 30-60 min
50
Q

cisatracurium clinical pearls

A
  • benzolisoquinolinium NMBD

- good for patients with hepatorenal disease

51
Q

midazolam vial/concentration

A
  • 2 mL vial of [1 mg/mL]

- 1 mL vial of [5 mg/mL]

52
Q

midazolam syringe size

A

3 mL syringe

53
Q

midazolam dose

A

0.02-0.04 mg/kg

54
Q

midazolam onset/DOA

A 
onset = 2 min
DOA = 1-6 hours
55
Q

midazolam clinical pearls

A
  • benzodiazepine (GABA)

- PO (0.4-0.8 mg/kg) - good for peds 30 min before induction

56
Q

fentanyl vial/concentration

A

2 mL or 5 mL vial of [50 mcg/mL]

57
Q

fentanyl syringe size

A

5 mL syringe

58
Q

fentanyl dose

A

1-3 mcg/kg

59
Q

fentanyl onset/DOA

A 
onset = 2-5 min
DOA = 0.5-1 hour
60
Q

fentanyl clinical pearls

A
  • sole surgical anesthetic 50-150 mcg/kg
  • marked synergism with propofol and midazolam
  • reverse with naloxone 1-4 mcg/kg
61
Q

lidocaine 2% vial/concentration

A

5 mL vial of [20 mg/mL]

62
Q

lidocaine syringe size

A

5 mL syringe

63
Q

lidocaine dose

A

1-1.5 mg/kg

64
Q

lidocaine onset/DOA

A 
onset = 45-90 sec
DOA = 10-20 min
65
Q

lidocaine clinical pearls

A
  • max dose 500 mg or 7 mg/kg with epi or 5 mg/kg without epi
  • lower dose for hepatic impairment
66
Q

propofol vial/concentration

A

20 mL vial of [10 mg/mL]

67
Q

propofol syringe size

A

20 mL syringe

68
Q

propofol dose

A

1.5-2.5 mg/kg

69
Q

propofol onset/DOA

A 
onset = <40 sec
DOA = 5-10 min
70
Q

propofol clinical pearls

A
  • Contraindications: lipid metabolism disorder, sulfite allergy for generic
  • MAC: [25-100 mcg/kg/min], use in conjunction with anxiolytic and opioid
  • TIVA: [100-300 mcg/kg/min] with remifentanil
  • Careful with pts unable to compensate for low BP
71
Q

etomidate vial/concentration

A

10 mL vial of [2 mg/mL]

72
Q

etomidate syringe size

A

10 mL syringe

73
Q

etomidate dose

A

0.2-0.4 mg/kg

74
Q

etomidate onset/DOA

A 
onset = 30-60 sec
DOA = 3-10 min
75
Q

etomidate clinical pearls

A
  • Contraindications: porphyria, adrenocortical suppression, critically ill septic shock pts
  • Bad for SSEPs
76
Q

ketamine vial/concentration

A
  • 5 mL vial of [100 mg/mL]

- 10 mL vial of [50 mg/mL]

77
Q

ketamine syringe size

A

5 or 10 mL syringe

78
Q

ketamine dose

A

1-2.5 mg/kg

79
Q

ketamine onset/DOA

A 
onset = 30 sec
DOA = 5-15 min
80
Q

ketamine clinical pearls

A
  • NDMA antagonist
  • IM dart: [4-8 mg/kg]. PO: [10 mg/kg]. Multimodal pain: [0.5-1 mg/kg]
  • Contraindications: TBIs/ICP issues, cardiac disease (R-HF), eye injuries/procedures, schizophrenia, PTSD
  • Emergence delirium, lots of spit (laryngospasm!)
  • ↑IOP, ICP, BP/HR/SVR
  • Potentiates succinylcholine (PChE inhibition) and roc
81
Q

neostigmine syringe/concentration

A

3 mL syringe of 1mg/mL

82
Q

neostigmine dose

A

40-80 mcg/kg (max 6 mg)

0.04-0.08 mg/kg

83
Q

neostigmine onset/DOA

A 
onset = <3 min 
DOA = 40-60 min
84
Q

neostigmine clinical pearls

A
  • Acetylcholinesterase inhibitor

- PONV risk >2.5 mg

85
Q

glycopyrrolate syringe/concentration

A

1 or 2 mL syringe of [0.2 mg/mL]

86
Q

glycopyrrolate dose

A

0.01 mg/kg

Antisialogogue 0.1-0.2mg

87
Q

glycopyrrolate onset/DOA

A 
onset = <1 min
DOA = 2-4 hours
88
Q

glycopyrrolate clinical pearls

A
  • muscarinic antagonist, antisialagogue
  • caution with closed angle glaucoma
  • use with neostigmine for non-depolarizing NMBD reversal

N928 - Basics of Anesthesia (17 decks)

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