MAI

Question 1

Etomidate (Adult Dose)

Answer 1

0.3 mg/kg IV/IO push
0.2 mg/kg IV/IO (patients hypotensive or > 65 years old

Question 2

Etomidate (Pedi Dose)

Answer 2

0.3 mg/kg IV/IO push > 10 years of age

Question 3

Etomidate (Onset)

Answer 3

30-60 seconds

Question 4

Etomidate (Peak Effect/Duration)

Answer 4

1 minute/5-10 minutes

Question 5

Etomidate (Brand Names)

Answer 5

Amidate

Question 6

Etomidate (Class)

Answer 6

Sedative/Hypnotic Agent

Question 7

Etomidate (Pharmacologic Action)

Answer 7

Binds to the chloride ionophore on GABA a receptors, increasing duration of time the chloride channel is open, leading to prolonged inhibitory effect of GABA

Question 8

Etomidate (Indications)

Answer 8

Induction in Medical Assisted Intubation (MAI)

Question 9

Etomidate (Contraindications)

Answer 9

Hypersensitivity, hypotension associated with sepsis in pediatrics, less than 10 years of age. Use with caution in patients with suspected or confirmed adrenal suppression.

Question 10

Fentanyl (Adult Dose)

Answer 10

1 mcg/kg IV/IO/IM/IN

Question 11

Fentanyl (Pediatric Dose)

Answer 11

1 mcg/kg IV/IO/IM/IN

Question 12

Fentanyl (Onset)

Answer 12

Immediate

Question 13

Fentanyl (Peak Effect/Duration)

Answer 13

3-5 minutes/30-60 minutes

Question 14

Fentanyl (Class)

Answer 14

Synthetic Opiod, Opiod analgesic

Question 15

Fentanyl (Pharmacologic Action)

Answer 15

Narcotic agonist-analgesic of opiate receptors; inhibits ascending pain pathways, thus altering response to pain; increases pain threshold; produces analgesia, respiratory depression, and sedation

Question 16

Fentanyl (Indications)

Answer 16

Management of acute pain

Question 17

Fentanyl (Contraindications)

Answer 17

Hypersensitivity

Question 18

Ketamine (Adult Dose)

Answer 18

1-2 mg/kg IV/IO

Question 19

Ketamine (Pedi Dose)

Answer 19

1-2 mg/kg IV/IO

Question 20

Ketamine (Onset)

Answer 20

30-60 seconds

Question 21

Ketamine (Peak Effect/Duration)

Answer 21

< 5 minutes/10-15 minutes

Question 22

Ketamine (Brand Names)

Answer 22

Ketalar

Question 23

Ketamine (Class)

Answer 23

General anesthetic, analgesic

Question 24

Ketamine (Pharmacologic Action)

Answer 24

Produces dissociative anesthesia. Blocks N-methyl D-aspartate (NMDA) receptor. Causes dose dependent sympathetic nervous system outflow. Also reduces pain impulses by binding to opioid receptors.

Question 25

Ketamine (Indications)

Answer 25

For the management of agitated or violent behavior

Question 26

Ketamine (Contraindications)

Answer 26

Hypersensitivity RELATIVE/CONTROVERSIAL CONTRAINDICATION: Acute coronary syndrome, Aortic dissection/aneurysm, Head trauma, intracranial mass/hemorrhage, hypertension, angina, and stroke, underlying psychiatric disorder. Pediatrics < 28 days of age.

Question 27

Midazolam (Adult Dose) Post Intubation Sedation

Answer 27

0.1 mg/kg IV/IO/IM/IN to a maximum of 6 mg

Question 28

Midazolam (Pedi Dose) Induction for MAI

Answer 28

0.3 mg/kg IV/IO if < 10 years old

Question 29

Midazolam (Onset)

Answer 29

Immediate

Question 30

Midazolam (Peak Effect/Duration)

Answer 30

3-5 minutes/< 2 hours

Question 31

Midazolam (Brand Names)

Answer 31

Versed

Question 32

Midazolam (Class)

Answer 32

Anticonvulsant, anti anxiety agent, anxiolytic, benzodiazepine

Question 33

Midazolam (Pharmacologic Action)

Answer 33

Binds receptors at several sites within the CNS, including the limbic system and reticular formation; effects may be mediated through gamma-aminobutyric acid (GABA) receptor system; increase in neuronal membrane permeability to chloride ions enhances the inhibitory effects of GABA; the shift in chloride ions causes hyper-polarization (less excitability) and stabilization of the neuronal membrane

Question 34

Midazolam (Indications)

Answer 34

For the management of seizures, the management of agitated or violent patients suffering behavioral emergencies, and procedural sedation in intubation and electrical therapy

Question 35

Midazolam (Contraindications)

Answer 35

Documented hypersensitivity, severe respiratory depression, sleep apnea

Question 36

Rocuronium (Adult Dose)

Answer 36

1.5 mg/kg IV/IO/IM

Question 37

Rocuronium (Pedi Dose)

Answer 37

1.5 mg/kg IV/IO/IM

Question 38

Rocuronium (Onset)

Answer 38

45-60 seconds

Question 39

Rocuronium (Peak Effect/Duration)

Answer 39

1-3 minutes/30-60 seconds

Question 40

Rocuronium (Class)

Answer 40

Non depolarizing neuromuscular blocker

Question 41

Rocuronium (Pharmacologic Action)

Answer 41

Competes for nicotinic cholinergic receptors at the motor end plate, resulting in decreased opportunity for acetylcholine to bind, resulting in a prevention of depolarization and a lack of muscle contraction (paralysis)

Question 42

Rocuronium (Indications)

Answer 42

Skeletal muscle relaxation to facilitate endotracheal intubation in Medical assisted intubation (MAI)

Question 43

Rocuronium (Contraindications)

Answer 43

Hypersensitivity

Question 44

Succinylcholine (Adult Dose)

Answer 44

1.5-2 mg/kg IV/IO (if administered IM, Dose should be doubled)

Question 45

Succinylcholine (Pedi Dose)

Answer 45

2 mg/kg IV/IO (if administered IM, Dose should be doubled)

Question 46

Succinylcholine (Onset)

Answer 46

45-60 seconds

Question 47

Succinylcholine (Peak Effect/Duration)

Answer 47

1-3 minutes/4-6 minutes

Question 48

Succinylcholine (Class)

Answer 48

Depolarizing neuromuscular blocker

Question 49

Succinylcholine (Pharmacologic Action)

Answer 49

Competes for nicotinic cholinergic receptors at the motor end plate, resulting in decreased opportunity for acetylcholine to bind, initially causing depolarization (fasciculations) and eventually resulting in a prevention of further depolarization and paralysis

Question 50

Succinylcholine (Indications)

Answer 50

Skeletal muscle relaxation to facilitate endotracheal intubation in medication assisted intubation (MAI)

Question 51

Succinylcholine (Contraindications)

Answer 51

Hypersensitivity, Hyperkalemia, Disorders of Plasma Pseudocholinesteras, Known Neuromuscular Disease