Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Apex > IV Drugs > Flashcards

IV Drugs Flashcards

1
Q

What are some traits about Propofol?

A

Class: alkylphenol
pKa: 11
MOA: direct gaba agonist —> ^ Cl- conductance
Dose: 1.5-2.5 mg/kg; infusion: 25-200 mcg/kg/min
Onset: 30-60 seconds
Duration: 5-10 minutes
Clearance: Liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the cardiovascular effects of propofol?

A

Decreased BP (decreased SNS tone, vasodilation, myocardial depression)
Decreased SVR
Myocardial contractility depression
Decreased venous tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the respiratory effects of propofol?

A

Shifts CO2 curve down and to the right (less sensitive to CO2) —> resp depression and apnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the CNS effects of propofol?

A

Decreases CMRO2
Decreases cerebral blood flow
Decreases ICP
Decreases intraocular pressure
Anticonvulsant properties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Propofol Infusion Syndrome?

A

Propofol contains long-chain fatty acids (LCTs) and an increased LCT load impairs oxidative phosphorylation and fatty metabolism. This starves cells of O2, especially cardiac and skeletal muscle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the risk factors to PRIS?

A

Prop dose > 4mg/kg/min
Duration > 48 hours
Sepsis
Used to be more common in kids
Catecholamine infusions
High-dose steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the clinical presentation of PRIS? What is the tx?

A

Bradycardia —> asystole
Metabolic acidosis
Rhabdomyolysis
Renal failure
Fatty liver
HLD
Lipemia

Tx: discontinue Prop, pace, glucagon, ECMO, CRRT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some traits about fospropofol?

A

Class: isopropylphenol
MOA: prodrug —> metabolized by alkaline phosphatase
Dose: 6.5 mg/kg
Duration: 15-45 min
Clearance: Liver and Lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the side effects of Fospropofol?

A

Genital and anal burning

BUT fospropofol causes less burning on injection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some traits of Ketamine?

A

Class: Arylcyclohexylamine
pKa: 7.5
MOA: NMDA antagonist; secondary receptor opioid, MOA, serotonin, NE and muscarinic channels

Dose:
IV: 1-2 mg/kg
Maintenance: 1-3 mg/min
Low maintenance: 1-3 mcg/kg/min
Analgesia: 0.1-0.5 mg/kg
IM: 4-8 mg/kg
PO: 10 mg/kg

Onset: 30-60 seconds
Duration: 10-20 mins
Clearance: liver
Metabolite: Norketamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the cardiovascular effects of ketamine?

A

^ SNS tone
^ cardiac output
^ HR
^ SVR
^ PVR

Of note, ketamine is a direct myocardial depressant, BUT with an intact SNS it causes increased HR/CO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the resp effects of Ketamine?

A

Bronchodilation
Airway muscle tone and airway reflexes
Maintains resp drive, but can cause period of apnea
Increased oral and pulmonary secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the CNS effects with ketamine?

A

Increased CMRO2
^ cerebral blood flow
^ ICP
^ EEG activity
Emergence delirium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the analgesic effects of ketamine?

A

Relieve somatic pain > visceral pain
Blocks wind up of dorsal horn
Prevents opioid hyperanalgesia
Great for burn pts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some other rando traits about ketamine?

A

Least amount of protein binding
Used to treat depression (s enantiomer)
Avoid in pts with history of acute porphyria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some traits about Etomidate?

A

Class: imadazole
MOA: gaba-agonist
Dose: 0.2-0.4 mg/kg
Onset: 30-60 seconds
Duration: 5-15 mins
Clearance: Liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the cardio effects of etomidate?

A

Hemodynamic stability
SVR is reduced a little

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the resp effects of etomidate?

A

Mild resp depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the CNS effects of etomidate?

A

Decreased CMRO2
Decreased cerebral blood flow
Decreased ICP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is Etomidate a known inhibitor of?

A

11-beta-hydroxylase (main) and 17-alpha-hydroxylase

21
Q

What are some side effects of etomidate?

A

Myoclonus
Adrenicortical suppression
PONV
Acute Intermittant Porphyria

22
Q

What is the difference b/t thiobarbiturates and Oxybarbiturates?

A

Thiabarbiturates: Sulfer molecule in the second position

Oxybarbiturates: oxygen molecule in the 2nd position

23
Q

What are some key traits about thiopental?

A

Class: barbiturate
MOA: haha agonist
Dose: 2.5-5 mg/kg
Onset: 30-60 seconds
Duration: 5-10 minutes
Clearance: liver

24
Q

What are the cardio effects of thiopental?

A

Hypotension (preload and venodilation)
Histamine release
Baroreceptor reflex intact (reflex tachycardia)

25
Q

What are the resp effects of thiopental?

A

Resp depression
Histamine release

26
Q

What are the CNS effects of thiopental?

A

Decreased CMRO2
Decreased blood flow
Decreased ICP
Decreased EEG

27
Q

Describe thiopentals Neuro protection properties?

A

Focal ischemia: yes
Global ischemia: no

28
Q

What are the S&S of acute intermittant porphyria?

A

Abd pain, N&V
Anxiety confusion, seizures, coma
Skeletal muscle weakness, bulbar muscle weakness

29
Q

What are drugs to avoid in acute intermittent Porphyria?

A

Barbiturates
Etomidate
Ketamine
Amiodarone
CCB
Birth control

30
Q

What is the tx for acute intermittent porphyria?

A

Hydration
Glucose supplementation
Heme arginate
No hypothermia

31
Q

What happens if you inject thiopental in the artery?

A

Injection —> intense vasoconstriction —> crystal formation —> inflammation —> tissue ischemia

32
Q

what is the tx for intra-arterial injection of thiopental?

A

Injection of vasodilator ~ alpha 1 blocker
Sympathectomy

33
Q

What is the gold standard for electroconvulsive therapy?

A

Methohexital

(Dose: 1-1.5 mg/kg)

34
Q

What are some traits about dexmedetomidine?

A

Class: Imidazole
pKa: 7.1
MOA: alpha 2 agonist —> decreases cAMP
Dose: 1 mcg/kg over 10 mins
Infusion: 0.4 - 0.7 mcg/kg/hr
Onset: 10-20 mins
Duration: 10-30 mins
Clearance: Liver

35
Q

What are the cardiovascular effects of precedex?

A

Bradycardia and hypotension

(Rapid administration can cause HTN)

36
Q

What are the resp effects of precedex?

A

None

37
Q

What are the CNS effects of Precedex?

A

Decreased CBF (but no change in CMRO2 —> this causes uncoupling)

38
Q

What is the dose of precedex sedation for children via nasal/buccal routes?

A

3-4 mcg/kg

39
Q

What are the elimination half-lives of the benzos? From longest to shortest

A

Diazepam > lorazepam > midazolam

40
Q

What are some traits about Midazolam?

A

Class: benzodiazepine (has an imidazole ring)
MOA: gaba agonist (increases the frequency of how often the GABA channel opens)
Dose: IV sedation: .02-.04 mg/kg
IV induction: .1-.4 mg/kg
PO: 0.5-1.0 mg/kg

Onset: 30-60 seconds
Duration: 20-60 mins
Clearance: Liver
Metabolite: hydroxymidazolam

41
Q

Cardiovascular effect of versed?

A

sedation dose: none
Induction dose: decreased BP and SVR

42
Q

Respirator effects of midazolam?

A

Sedation: none
Induction: resp depression

Opioids potentiate resp depressant effects

43
Q

CNS effects of Versed?

A

Minimal effects on cerebral blood flow and CMRO2

Anterograde amnesia
Anticonvulsant
Anxiolysis
Skeletal relaxation

44
Q

What are some traits about Diazepam?

A

Undergoes enterohepatic recirculation (this extends its half life ~ 43 hours)

Anticonvulsant
Antispasmodic
Reduces skeletal tone

45
Q

What are some traits about Lorazepam?

A

Amnestic action lasts up to 6 hours!
Slow onset

46
Q

What is the relative potency of the benzos? Greatest to least.

A

Lorazepam > midazolam > diazepam

47
Q

Which benzo has both hydrophilic and lipophilic properties?

A

Midazolam ~ d/t the imidazole ring

48
Q

What is the initial dose of flumazenil?

A

0.2 mg IV ~ it’s then titrated in 0.1 increments until desired response

Apex (47 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions