LAS DROGAS Flashcards
MOA Morphine Sulphate
CNS depressant acts on μ-Opiate Receptors.
Onset of Morphine Sulphate
<5 minutes IV 15-30 minutes IM
Peak Effects of Morphine Sulphate
20 minutes IV 30-60 minutes IM
Duration and half-life of Morphine Sulphate
2-7 hours; 1-7 hours
Indications of Morphine Sulphate
Severe pain
Contraindications of Morphine Sulphate
Severe hypotension, hypersensitivity, “undiagnosed head injury or abdominal pain”
Side effects of Morphine Sulphate
Nausea, vomiting, abdominal cramps, blurred vision, constricted pupils, AMS, respiratory depression.
Interactions for Morphine Sulphate
Interacts with antihistamines, antiemetics, sedative, hypnotics, barbiturates, and alcohol.
Hydromorphone brand name
Dilaudid
MOA of Hydromorphone
CNS depressant acts on μ-Opiate Receptors.
Onset of Hydromorphone
15-30 minutes IV
Peak effects of Hydromorphone
30-90 minutes
Duration and half life of Hydromorphone
4-5 hours 2.6 hours
Dosage of Morphine Sulphate
2-5mg Adult IV
5-15mg Adult IM
0.1-0.2 mg/kg peds
Dosage of Hydromorphone
1-2mg Adult IV
2-4mg Adult IM
0.015 mg/kg peds
Indications of Hydromorphone
Severe Pain
Contraindications of Hydromorphone
Hypersensitivity or “undiagnosed head injury or abdominal pain”
Side effects of Hydromorphone
nausea, vomitting, abdominal cramps, blurred vision, constricted pupils, AMS, respiratory depression.
Interactions of Hydromorphone
antihistamines, antiemetics, sedative, hypnotics, barbiturates, and alcohol.
Brand name of Fentanyl
Sublimaze
MOA of Fentanyl
CNS depressant acts on μ-Opiate Receptors. Less emetic effect than other narcotic analgesics.
Onset of Fentanyl
Almost immediate
Peak effects of Fentanyl
3-5 minutes IV
Duration and half life of Fentanyl
30-60 minutes 6-8 hours
Indications of Fentanyl
Maintenance analgesia, adjunct for RSI, severe pain.
Contraindications
Severe hemorrhage, shock, hypersensitivity.
Side effects of Fentanyl
Respiratory depression, apnea, muscle rigidity, bradycardia.
Interactions of Fentanyl
CNS depressants, Monoamine oxidase inhibitors.
Dosage of Fentanyl
25-100 mcg adult IV
1-2 mcg/kg peds IV
Ketorolac brand name
Toradol
MOA of Ketorolac
NSAID. Inhibition of prostaglandin synthesis by competitively blocking enzyme cyclooxygenase. Produces anti-inflammatory, antipyretic, and analgesic effects.
Onset of Ketorolac
30 minutes
Peak effects of Ketorolac
45-60 minutes
Duration and half life of Ketorolac
6-8 hours; 4-6 hours
Indications of Ketorolac
Mild to moderate pain. Useful for management of sickle cell and kidney stone related pain.
Contraindications of Ketorolac
Hypersensitivity. Patients also taking aspirin or other NSAIDS.
Side effects of Ketorolac
edema, hypertension, rash, itching, nausea, heartbearn, constipation, diarrhea, GI hemorrhage, drowsiness, and dizziness.
Interactions of Ketorolac
Conjunctional use with other NSAIDS can cause worse side effects. IM Ketorolac reduces diuretic response to LASIX.
Dosage of Ketorolac
15-30 mg adult IV
30-60 mg adult IM
0.5 mg/kg peds IV
Brand name of Midazolam
Versed
MOA of Midazolam
Benzodiazepines bind to specific sites on GABA type A receptors. GABA is a major inhibitory neurotransmitter of the CNS. Benzos have no effect on the receptor but potentiate the effects of GABA. Benzos produce hypnotic, anxiolytic, and anticonvulsant effects.
Onset of Midazolam
1.5 minutes IV; 15 minutes IM
Peak effects of Midazolam
20-60 minutes
Duration and half life of Midazolam
<2 hours IV; 1-6 hours IM
Half Life: 1-4 hours
Indications of Midazolam
Premedication for painful procedures and as a sedative.
Contraindications of Midazolam
Hypersensitivity, narrow-angle glaucoma, shock state, alcoholic coma.
Side effects of Midazolam
Laryngospasm. bronchospasm, dyspnea, respiratory depression and arrest, drowsiness, amnesia, ams, bradycardia, tachycardia, PVCs, retching. Increased respiratory depression compared to other benzos.
Interactions of Midazolam
Other CNS depressants ie narcotics and alcohol.
Dosage of Midazolam
1-2.5 mg adult IV
2-5 mg adult IM
0.03 mg/kg peds
Brand name of Lorazepam
Ativan
MOA of Lorazepam
Benzodiazepines bind to specific sites on GABA type A receptors. GABA is a major inhibitory neurotransmitter of the CNS. Benzos have no effect on the receptor but potentiate the effects of GABA. Benzos produce hypnotic, anxiolytic, and anticonvulsant effects.
Onset of Lorazepam
1-5 minutes IV; 15-30 minutes IM
Peak effects of Lorazepam
15-20 minutes IV; 2 hours IM
Duration and half life of Lorazepam
6-8 hours; 10-20 hours
Indications of Lorazepam
Major motor seizures, status epilepticus, premed before procedures, acute anxiety.
Contraindications of Lorazepam
hypersensitivity
Note for usage of Lorazepam
Should be diluted before use.
Side effects of Lorazepam
Hypotension, drowsiness, headache, amnesia, respiratory depression, blurred vision N&V.
Interactions of Lorazepam
other CNS depressants and alcohol.
Dosage of Lorazepam
0.5mg-2mg adult IV
1-4mg adult IM
0.05-0.10 Peds IV
Brand name of Ketamine
Ketalar
MOA of Ketamine
Thought to cause a dissociation of the cortical and limbic systems resulting in an awake patient who is dissociated from the environment.
Onset of Ketamine
<1 minute IV; <5 minutes IM
Peak effects of Ketamine
Variable
Durations and half life of Ketamine
10-15 minutes IV; 20-30 minutes IM
1-2 hours
Indications of Ketamine
Sedative and RSI agent.
Contraindications of Ketamine
Significantly elevated blood pressure. Hypersensitivity.
Side effects of Ketamine
Hallucinations, increased skeletal muscle tone, N&V. Protective airway reflexes may be enhanced. Excessive bronchial secretions.
Interactions of Ketamine
Recovery time may be prolonged when used in conjunction with narcotics and barbiturates.
Dosage of Ketamine
0.1-0.3mg/kg Adult IV Analgesic
0.5-1mg/kg Adult IV Sedation.
2-4mg/kg Adult IM Sedation.
Brand name of Etomidate
Amidate
MOA of Etomidate
Etomidate stimulate GABA receptors to produce general anesthesia.
Onset of Etomidate
10-20 seconds
Peak effects of Etomidate
<1 minute
Duration and half life of Etomidate
3-5 minutes; 30-70 minutes
Indications of Etomidate
RSI
Contraindications of Etomidate
Hypersensitivity
Side effects of Etomidate
Myoclonic skeletal movement, apnea, hypo/hyperventilation, laryngospasm, hypo/hypertension, tachy/bradycardia, N&V.
Dosage of Etomidate
0.3mg/kg
Brand name of Succinylcholine
Anectine
MOA of Succinylcholine
Succinylcholine is a parasimpathimimetic that acts on cholinergic receptors in motor neurons causing depolarization. Additionally, Succinylcholine is not inactivated by acetylcholinesterase and prevents the muscles from being stimulated again.
Onset of Succinylcholine
30-60 seconds IV; 2-3 minutes IM
Peak effects of Succinylcholine
1-3 minutes
Duration and half life of Succinylcholine
2-3 minutes IV; 10-30 minutes IM
5-10 minutes
Indications of Succinylcholine
Paralytic used in RSI
Contraindications of Succinylcholine
Hypersensitivity, penetrating eye injuries, narrow-angle glaucoma.
Precautions of Succinylcholine
Fractures, severe burns, crush injuries
Side effects of Succinylcholine
Wheezing, respiratory depression, apnea, aspiration, arrhythmias, bradycardia, sinus arrest, hypertension, hypotension, hyperkalemia, increased interocular pressure, increased ICP.
Interactions of Succinylcholine
Lidocaine, procainamide, beta-blcokers, magnesium sulfate, and other neuromuscular blockers increase the effects of Succinylcholine.
Dosage of Succinylcholine
1-1.5 mg/kg Adult IV
1mg/kg peds IV
Brand name of Vecuronium
Norcuron
MOA of Vecuronium
Competes with Acetylcholine at cholinergic receptor sites resulting in paralysis.
Onset of Vecuronium
<1 minute
Peak effects of Vecuronium
3-5 minutes
Duration and half life of Vecuronium
25-40; 30-80 minutes
Indications of Vecuronium
RSI
Contraindication of Vecuronium
hypersensitivity
Side effects of Vecuronium
Wheezing, respiratory depression, apnea, aspiration, arrhythmia, bradycardia, sinus arrest, and hypertension.
Interactions of Vecuronium
Lidocaine, procainamide, beta-blcokers, magnesium sulfate, and other neuromuscular blockers increase the effects of Succinylcholine.
Dosage of Vecuronium
0.1 mg/kg
Brand name of Rocuronium
Zemuron
MOA of Rocuronium
Competitively binding on cholinergic receptors at motor neurons to antagonize the actions of Acetylcholine.
Onset of Rocuronium
30-60 seconds
Peak effects of Rocuronium
1-3 minutes
Duration and half life of Rocuronium
30-60 minutes; 14-18 minutes
Indications of Rocuronium
RSI
Contraindications of Rocuronium
Hypersensitivity
Side effects of Rocuronium
Bronchospasm, hypertension, tachycardia.
Interactions of Rocuronium
Intensity and duration of paralysis may be prolonged by pretreatment with Sux, general anesthesia, lidocaine, quinidine, procainamide, beta-adrenergic blocking agents, potassium losing diuretics, magnesium.
Dosage of Rocuronium
0.6 mg/kg