Induction Sequence Drugs Flashcards
1
Q
Vasopressors Color
A
purple
2
Q
Muscarinic Antagonist/Anticholinergic Color
A
green
3
Q
paralytic color
A
bright orange/red
4
Q
sedatives/benzos color
A
orange
5
Q
opioids color
A
blue
6
Q
local anesthetics color
A
grey
7
Q
induction agents color
A
yellow
8
Q
AChE inhibitor color
A
candy cane (red and white stripe)
9
Q
phenylephrine original vial/concentration
A
1 mL vial, [10 mg/mL]
10
Q
phenylephrine final concentration
A
[100 mcg/mL]
11
Q
phenylephrine syringe size
A
10 mL syringe
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
13
Q
phenylephrine dose
A
0.5-1.5 mcg/kg
14
Q
phenylephrine onset/DOA
A
onset = <1 min DOA = 15-20 min
15
Q
phenylephrine clinical pearls
A
- alpha 1 agonist
- reflex bradycardia
16
Q
ephedrine original vial/concentration
A
1 mL vial or 1 mL ampule, [50 mg/mL]
17
Q
ephedrine final concentration
A
[5 mg/mL]
18
Q
ephedrine syringe size
A
10 mL syringe
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]
20
Q
ephedrine dose
A
0.1-0.2 mg/kg
21
Q
ephedrine onset/DOA
A
onset = seconds DOA = 10-60 min
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
23
Q
atropine vial/concentration
A
1 mL vial of either [0.4 mg/mL] or [1 mg/mL]
24
Q
atropine syringe size
A
3 mL syringe
25
atropine dose
0.01-0.03 mg/kg
26
atropine onset/DOA
```
onset = 45-60 sec
DOA = 1-2 hours
```
27
atropine clinical pearls
- muscarinic antagonist, antisialagogue
| - caution with closed angle glaucoma
28
succinylcholine vial/concentration
10 mL vial of [20 mg/mL]
29
succinylcholine syringe size
10 mL syringe
30
succinylcholine dose
1 mg/kg
31
succinylcholine onset/DOA
```
onset = 30-60 sec (paralyze larynx in 34 sec)
DOA = 5-15 min
```
32
succinylcholine clinical pearls
- 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
33
Emergency Drugs Acronym
```
PEAS
Phenylephrine
Ephedrine
Atropine
Succinylcholine
```
34
rocuronium vial/concentration
5 mL vial of [10 mg/mL]
35
rocuronium syringe size
5 mL syringe
36
rocuronium dose
0. 6 mg/kg
| 1. 2 mg/kg for RSI
37
rocuronium onset/DOA
```
onset = 2-3 min (1 min for RSI)
DOA = 15-85 min (avg 35 min)
```
38
rocuronium clinical pearls
- 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
vecuronium vial
10 mg vial powder
40
vecuronium reconstitution
reconstitute with 10 mL NS
41
vecuronium final concentration
[1 mg/mL]
42
vecuronium syringe size
10 mL syringe
43
vecuronium dose
0.1 mg/kg
44
vecuronium onset/DOA
```
onset = 2-3 min
DOA = 30-60 min
```
45
vecuronium clinical pearls
- 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
cisatracurium vial/concentration
5 mL vial or 10 mL vial of [2mg/mL]
47
cisatracurium syringe size
5 mL syringe
48
cisatracurium dose
0.1 mg/kg
49
cisatracurium onset/DOA
```
onset = 2 min
DOA = 30-60 min
```
50
cisatracurium clinical pearls
- benzolisoquinolinium NMBD
| - good for patients with hepatorenal disease
51
midazolam vial/concentration
- 2 mL vial of [1 mg/mL]
| - 1 mL vial of [5 mg/mL]
52
midazolam syringe size
3 mL syringe
53
midazolam dose
0.02-0.04 mg/kg
54
midazolam onset/DOA
```
onset = 2 min
DOA = 1-6 hours
```
55
midazolam clinical pearls
- benzodiazepine (GABA)
| - PO (0.4-0.8 mg/kg) - good for peds 30 min before induction
56
fentanyl vial/concentration
2 mL or 5 mL vial of [50 mcg/mL]
57
fentanyl syringe size
5 mL syringe
58
fentanyl dose
1-3 mcg/kg
59
fentanyl onset/DOA
```
onset = 2-5 min
DOA = 0.5-1 hour
```
60
fentanyl clinical pearls
- sole surgical anesthetic 50-150 mcg/kg
- marked synergism with propofol and midazolam
- reverse with naloxone 1-4 mcg/kg
61
lidocaine 2% vial/concentration
5 mL vial of [20 mg/mL]
62
lidocaine syringe size
5 mL syringe
63
lidocaine dose
1-1.5 mg/kg
64
lidocaine onset/DOA
```
onset = 45-90 sec
DOA = 10-20 min
```
65
lidocaine clinical pearls
- max dose 500 mg or 7 mg/kg with epi or 5 mg/kg without epi
- lower dose for hepatic impairment
66
propofol vial/concentration
20 mL vial of [10 mg/mL]
67
propofol syringe size
20 mL syringe
68
propofol dose
1.5-2.5 mg/kg
69
propofol onset/DOA
```
onset = <40 sec
DOA = 5-10 min
```
70
propofol clinical pearls
- 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
etomidate vial/concentration
10 mL vial of [2 mg/mL]
72
etomidate syringe size
10 mL syringe
73
etomidate dose
0.2-0.4 mg/kg
74
etomidate onset/DOA
```
onset = 30-60 sec
DOA = 3-10 min
```
75
etomidate clinical pearls
- Contraindications: porphyria, adrenocortical suppression, critically ill septic shock pts
- Bad for SSEPs
76
ketamine vial/concentration
- 5 mL vial of [100 mg/mL]
| - 10 mL vial of [50 mg/mL]
77
ketamine syringe size
5 or 10 mL syringe
78
ketamine dose
1-2.5 mg/kg
79
ketamine onset/DOA
```
onset = 30 sec
DOA = 5-15 min
```
80
ketamine clinical pearls
- 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
neostigmine syringe/concentration
3 mL syringe of 1mg/mL
82
neostigmine dose
40-80 mcg/kg (max 6 mg)
| 0.04-0.08 mg/kg
83
neostigmine onset/DOA
```
onset = <3 min
DOA = 40-60 min
```
84
neostigmine clinical pearls
- Acetylcholinesterase inhibitor
| - PONV risk >2.5 mg
85
glycopyrrolate syringe/concentration
1 or 2 mL syringe of [0.2 mg/mL]
86
glycopyrrolate dose
0.01 mg/kg
Antisialogogue 0.1-0.2mg
87
glycopyrrolate onset/DOA
```
onset = <1 min
DOA = 2-4 hours
```
88
glycopyrrolate clinical pearls
- muscarinic antagonist, antisialagogue
- caution with closed angle glaucoma
- use with neostigmine for non-depolarizing NMBD reversal
