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NMETC > Med Emerg Pharmacology > Flashcards

Med Emerg Pharmacology Flashcards

1
Q

DIAZEPAM Brand Name

A

Valium

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2
Q

DIAZEPAM Class

A

Benzodiazepine

Sedative Hypnotic

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3
Q

DIAZEPAM MOA (3)

A

Inhibits neurotransmitters
Raises seizure threshold
Induces amnesia and sedation

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4
Q

DIAZEPAM Indications (4)

A

Status seizure
Acute anxiety

analgesia for medical procedure (fx reduction/cardioversion)

delirium tremens

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5
Q

DIAZEPAM Contras (6)

A 
Allergy
Glaucoma
Coma
Shock
Substance abuse
head injury
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6
Q

DIAZEPAM Adult Seizure Dose

A

5-10mg IV q 10-15prn

–>5mg over 5mins

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7
Q

DIAZEPAM Adult Seizure Max Dose

A

30mg

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8
Q

DIAZEPAM Cardioversion Sedation Adult Dose

A

5-15mg IV over 5-10mins prior to cardioversion

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9
Q

DIAZEPAM Considerations (3)

A

Pregnancy D
Short duration of anti convulsant effect
Reduce dose by 1/2 in elderly

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10
Q

LORAZEPAM Brand Name

A

Ativan

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11
Q

LORAZEPAM Class

A

Benzodiazepine

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12
Q

LORAZEPAM MOA (3)

A

Anxiolytic

Anticonvulsant/sedative

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13
Q

LORAZEPAM Indications (3)

A

Status epilepticus
Severe anxiety
Sedation

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14
Q

LORAZEPAM Contras (3)

A

Coma
Shock
Suspected drug use

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15
Q

LORAZEPAM Side Effects (3)

A

Hypotension
Resp depression
Bradycardia

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16
Q

LORAZEPAM Adult Dose

A

0.5-2mg IV IN IM q PRN

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17
Q

LORAZEPAM Max Adult Dose

A

8mg (school)

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18
Q

LORAZEPAM Administration note

A

When given IV/IO must dilute with equal volume of NS. Dilution unnecessary with IM administration.

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19
Q

LORAZEPAM Considerations (3)

A

Pregnancy D

Inadvertent arterial admin may cause vasospasm and gangrene

Expires in 6 weeks if not refrigerated

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20
Q

MIDAZOLAM Brand Name

A

Versed

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21
Q

MIDAZOLAM Class

A

Benzodiazepine

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22
Q

MIDAZOLAM MOA (3)

A

Anxiolytic
Sedative
Memory impairment

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23
Q

MIDAZOLAM Indications (4)

A

Status seizure
Sedation
Anxiolytic prior to RSI
Conscious sedation

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24
Q

MIDAZOLAM Contras (7)

A 
Glaucoma
Shock
Coma
EtOH
OD pt
Depressed vitals

Use of other CNS depressants, barbiturates, EtOH, narcotics

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25
Q

MIDAZOLAM Seizure dose

A

2.5-5mg slow IVP IV IM IO IN

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26
Q

MIDAZOLAM Considerations (3)

A

Pregnancy D
Give immediately prior to intubation attempt
Requires constant resp/cardiac fxn monitoring

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27
Q

ACETAMINOPHEN Brand Name

A

Tylenol

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28
Q

ACETAMINOPHEN Class

A

Analgesic

AntiPyretic

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29
Q

ACETAMINOPHEN MOA

A

Reduces prostaglandins

Acts on the brain to decrease body T

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30
Q

ACETAMINOPHEN Indications (2)

A

fever

px

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31
Q

ACETAMINOPHEN Contras (2)

A

Allergy

Severe liver disease

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32
Q

ACETAMINOPHEN Adult Dose

A

20mg/kg PO

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33
Q

ACETAMINOPHEN Toxic dose

A

150mg/kg

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34
Q

ACETAMINOPHEN Consideration

A

Avoid in pt’s with severe liver disease

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35
Q

ETOMIDATE Brand Name

A

Amidate

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36
Q

ETOMIDATE Class

A

Non barbituate hypnotic

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37
Q

ETOMIDATE MOA

A

Short acting hypnotic that acts on reticular activation system

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38
Q

ETOMIDATE Indication

A

Prep for RSI

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39
Q

ETOMIDATE Contras (3)

A

Allergy
Labor/Delivery
Septic shock

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40
Q

ETOMIDATE Adult Dose

A

0.1-0.3mg/kg IV over 15-30sec

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41
Q

ETOMIDATE Considerations

A

Pregnancy C

Caution with risk to pregnant women and babies

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42
Q

KETAMINE Brand Name

A

Ketalar

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43
Q

KETAMINE Class

A

sedative/dissociative analgesic

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44
Q

KETAMINE MOA

A

Blocks px receptors and minimizes spinal cord activity

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45
Q

KETAMINE Indications (3)

A

Excited delirium
Px
RSI Sedation

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46
Q

KETAMINE Contras (2)

A

Allergy

HTN that could be dangerous to pt cdxn

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47
Q

KETAMINE Interactions

A

increases effect of opiates, barbiturates, and nondepolarizing neuromuscular blockers

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48
Q

KETAMINE Adult Excited Delirium Dose-

A

5-10mg/kg IM

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49
Q

KETAMINE Adult Px Dose- IV

A

0.3-0.5MG/KG repeat 1x in 10mins

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50
Q

KETAMINE Adult Px Dose- IN/IM

A

1mg/kg repeat 1x in 20mins

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51
Q

KETAMINE RSI Adult Dose- IV

A

1-2mg/kg IVP q 30-45mins

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52
Q

KETAMINE RSI Adult Dose- IM

A

4-5mg

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53
Q

KETAMINE Sedation Adult Infusion Dose

A

0.5-2mg/kg/hr

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54
Q

KETAMINE Sedation Infusion Prep

A

1000mg Ketamine in 250mL NS –> 4mg/mL

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55
Q

KETAMINE Considerations (2)

A

Pregnancy C

Caution in elderly

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56
Q

KETOROLAC Brand Name

A

Toradol

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57
Q

KETOROLAC Class

A

NSAID

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58
Q

KETOROLAC MOA

A

Inhibits prostaglandin synthesis

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59
Q

KETOROLAC Indications (2)

A

Moderate to Severe Px

Kidney stone px

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60
Q

KETOROLAC Contras (5)

A 
Allergy 
ASA allergy
Bleeding disorders
Renal failure
Active ulcer
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61
Q

KETOROLAC Adult Dose IM Kidney Stones

A

30mg

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62
Q

KETOROLAC Adult Dose IV Kidney Stones

A

15mg

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63
Q

KETOROLAC Dose considerations

A

give 1/2 dose in elderly

pregnancy C

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64
Q

ROCURONIUM Brand Name

A

Zemuron

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65
Q

ROCURONIUM Class

A

NonDepolarizing Neuromuscular blocker

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66
Q

ROCURONIUM MOA

A

Binds to acetylcholine receptor at neuromuscular junction and doesn’t initiate depolarization at muscle membrane –>complete muscle relaxation

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67
Q

ROCURONIUM Indication

A

RSI

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68
Q

ROCURONIUM Contas (3)

A

Allergy to bromides

caution with Muscular dystrophy diseases

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69
Q

ROCURONIUM Interaction

A

positive chronotropic drugs may potentiate tachycardia

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70
Q

ROCURONIUM Adult Dose

A

0.6-1.2mg/kg IV

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71
Q

ROCURONIUM Considerations (4)

A

Pregnancy C
Doesn’t have effect on px or consciousness
Will not stop seizures
HR and CO will be increased

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72
Q

SUCCINYLCHOLINE Brand Name

A

Anectine

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73
Q

SUCCINYLCHOLINE Class

A

Neuromuscular blocker, depolarizing

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74
Q

SUCCINYLCHOLINE MOA

A

Ultra short acting depolarizing muscle relaxant that binds with cholinergic receptors on the motor end plate

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75
Q

SUCCINYLCHOLINE Indication

A

RSI

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76
Q

SUCCINYLCHOLINE Contras (5)

A 
penetrating eye injury
malignant hyperthermia
hyperK
acute injury after multisystem trauma
major burns
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77
Q

SUCCINYLCHOLINE Interactions (2)

A

Potentiated by oxytocin, beta blockers, organophosphates.

Diazepam may reduce duration of action

78
Q

SUCCINYLCHOLINE Adult dose

A

1.5mg/kg IV

79
Q

SUCCINYLCHOLINE Consideration

A

Pregnancy C

80
Q

AMIODARONE INFUSION MIX

A

150mg in 100mL NS/D5W

81
Q

EPI INFUSION MIX

A

1mg 1:1000 in 250mL (4mcg/mL)

82
Q

KETAMINE INFUSION MIX

A

1000mg in 250mL NS (4mg/mL)

83
Q

LABETALOL INFUSION MIX

A

200mg in 500mL D5W

84
Q

LIDOCAINE INFUSION MIX

A

1g in 250mL D5W (4mg/mL)

85
Q

MAG SULFATE INFUSION MIX

A

2g in 100mL NS/D5W

86
Q

NITRO INFUSION MIX

A

50mg in 250ml D5W

87
Q

NOREPI INFUSION MIX

A

4mg in 250mL D5W

88
Q

PROCAINAMIDE INFUSION MIX

A

2g in 250mL NS (8mg/mL)

89
Q

TXA INFUSION MIX

A

1g in 100mL NS over 10 mins

90
Q

Activated Charcoal Class

A

Adsorbant

91
Q

Activated Charcoal MOA

A

Adsorbs toxins from GI tract

92
Q

Activated Charcoal Indications

A

Oral poisonings

Medication ODs

93
Q

Activated Charcoal Contras

A

Comatose pt
Corrosive ingestion
Caustic ingestion
Petroleum ingestion

94
Q

Activated Charcoal Adult Dose

A

1-2g/kg PO or NGT

95
Q

Activated Charcoal Consideration

A

Does not adsorb cyanide, lithium, iron, lead, arsenic

96
Q

Dextrose Class

A

Carb/Hypertonic Solution

97
Q

Dextrose MOA

A

Rapidly increases serum glucose

98
Q

Dextrose Indications

A

ALOC secondary to hypoglycemia

99
Q

Dextrose Contraindications

A

Intracranial bleed

DTs

100
Q

Dextrose Drug Interactions

A

Bicarb

Coumadin

101
Q

Dextrose Adult Dose

A

12.5-25g slow IVP repeat as needed

102
Q

Dextrose Considerdation

A

Do not give to CVA pt unless hypoglycemia documented

103
Q

Glucagon Class

A

Pancreatic hormone

104
Q

Glucagon MOA

A

Increases blood glucose by stimulating glycolysis
Stabilizes cardiac rhythm during Beta Blocker OD
Minimal positive inotrope and chronotrope

105
Q

Glucagon Indications

A

ALOC with hypoglycemia

Inotropic agent in beta blocker OD

106
Q

Glucagon Contraindications

A

hyperglycemia

allergy/hypersensitivity

107
Q

Glucagon Adult Dose

A

0.5-1mg IM/SC/slow IVP q 20mins as needed

108
Q

Glucagon Considerations

A

Pregnancy C

Ineffective if glycogen stores depleted

109
Q

Glucose Class

A

Hyperglycemic

110
Q

Glucose MOA

A

Quickly absorbed glucose to increase blood glucose levels

111
Q

Glucose Indications

A

Conscious pt’s with hypoglycemia

112
Q

Glucose Contraindications

A

Decreased LOC

N/V

113
Q

Glucose Adult Dose

A

1 tube, 17-25g

114
Q

Naloxone Brand Name

A

Narcan

115
Q

Naloxone Class

A

Narcotic antagonist

116
Q

Naloxone MOA

A

Competitive inhibition at narcotic receptor sites
Reverses respiratory depression secondary
Inhibits effects of morphine

117
Q

Naloxone Indications

A

Respiratory depression secondary to opiate OD

Complete/partial reversal of CNS depressants induced by opioids
-morphine, heroin, hydromorphone, methadone, demerol, paregoric, fentanyl, oxycodone, codeine, darvon

118
Q

Naloxone Contraindications

A

Caution with narcotic dependent pt’s

Caution with neonates of narcotic addicted moms

119
Q

Naloxone Adult Dose

A

0.4-2mg (4mg protocols) IV/IM/SC/IN q 5mins

120
Q

Naloxone Max Cumulative dose

A

10mg (school) no max dose with protocols

121
Q

Naloxone Infusion

A

2mg in 500mL D5W (4mcg/ml)

infuse at 0.4mg/hr

122
Q

Naloxone Considerations (4)

A

Pregnancy B
Seizures possible
May not reverse hypotension
Watch for combative behavior with addicts

123
Q

Ondansetron Brand Name

A

Zofran

124
Q

Ondansetron Class

A

Antiemetic

125
Q

Ondansetron MOA

A

Selective 5 HT receptor antagonist

blocks serotonin

126
Q

Ondansetron Indication

A

N/V

127
Q

Ondansetron Contraindications

A

Allergy

128
Q

Ondansetron Considerations

A

Prolongs QT

Pregnancy B

129
Q

Ondansetron Adult dose

A

4-8mg IV/SL

130
Q

Oxygen Class

A

Atmospheric gas

131
Q

Oxygen MOA

A

Reverses hypoxemia

132
Q

Oxygen Indications

A 
Hypoxemia
Ischemic chest px
Respiratory insufficiency 
Carbon monoxide poisoning
ALOC
133
Q

Oxygen Contraindication

A

Hyperventilation

Some COPD pts

134
Q

Thiamine Brand name

A

Vitamin B1

135
Q

Thiamine MOA

A

Combines with ATP to form thiamine coenzyme, which is needed for carbohydrate metabolism

136
Q

Thiamine Indications

A

DTs

Wernicke encephalopathy

137
Q

Thiamine Contraindication

A

None

138
Q

Thiamine Adult Dose

A

100mg slow IVP/IM

139
Q

Thiamine Considerations

A

Pregnancy A
Large doses may cause respiratory difficulties
Anaphylaxis sometimes reported

140
Q

Glucagon dose Beta Blocker

A

3-5mg slow IVP/IN/IM

—> works because it is a positive chronotrope/inotrope

141
Q

Midazolam RSI dose

A

2.5-10mg IV IO over 2 mins

142
Q

Midazolam Chem Restraint

A

2.5-5mg over 2 mins q PRN IM IV IN

143
Q

Famotidine Classification

A

H2 blocker, antihistamine

144
Q

Famotidine MOA

A

blocks H2 receptors and histamine

145
Q

Famotidine Indication

A

allergic rxn and anaphylaxis

146
Q

Famotidine Contraindication

A

allergy

147
Q

Famotidine Adult dose

A

20mg IV IO

148
Q

Acetaminophen Onset/Duration

A

20-30mins

4-6h

149
Q

ASA Onset/Duration

A

30-60m

4-6h

150
Q

Activated Charcoal Onset/Duration

A

Immediate

24h

151
Q

Adenosine Onset/Duration

A

Immediate

10sec

152
Q

Albuterol Onset/Duration

A

5m

3-4h

153
Q

Amiodarone Onset/Duration

A

15m

40 day half life

154
Q

Atropine Onset/Duration

A

2-5min

20m

155
Q

Calcium Onset/Duration

A

5-15m

up to 4h

156
Q

Dexamethasone Onset/Duration

A

4-8h

24-72h

157
Q

Dextrose/D50/D25 Onset/Duration

A

30-60s

variable

158
Q

Diazepam IV Onset/Duration

A

1-5m

15-60m

159
Q

Diazepam IM Onset/Duration

A

15-30m

15-60m

160
Q

Diltiazem Onset/Duration

A

2-10m

1-3h

161
Q

Epi IV Onset/Duration

A

Immediate

3-5m

162
Q

Epi IM/SQ Onset/Duration

A

5-10m

20m

163
Q

Etomidate Onset/Duration

A

15-20s

5-10m

164
Q

Famotidine Onset/Duration

A

20m

4h

165
Q

Fentanyl Onset/Duration

A

1-2m

7-15m IM

166
Q

Furosemide Onset/Duration

A

5 for preload reduction, 30 for diuresis

2h

167
Q

Glucagon Onset/Duration

A

rapid

168
Q

Heparin Onset/Duration

A

Immediate

1.5h

169
Q

Ipatropium Onset/Duration

A

15-30m

5-7h

170
Q

Ketamine IV Onset/Duration

A

30s

5-10m

171
Q

Ketamine IM Onset/Duration

A

3-4m

12-25m

172
Q

Ketorolac IM Onset/Duration

A

45-60m

4-6h

173
Q

Labetalol Onset/Duration

A

5m

duration dose dependent

174
Q

Lidocaine Onset/Duration

A

45-90s

10-20m

175
Q

Lorazepam Onset/Duration IV and IM

A

1-5m IV/15-30m IM

12-24h

176
Q

Magnesium Onset/Duration

A

1-5m

30m

177
Q

Methylprednisolone Onset/Duration

A

20m-2h

18-36h

178
Q

Metoprolol Onset/Duration

A

Immediate

5-8h

179
Q

Midazolam Onset/Duration

A

1-3m IV/IO 10-20m IM

duration dose dependent

180
Q

Morphine Onset/Duration

A

IV immediate
IM 5-10m

duration 2-7h

181
Q

Naloxone Onset/Duration

A

IV IO immediate
IM 5-10m
IN 2-3m

duration 20-30m

182
Q

Nitro Onset/Duration

A

Immediate

30m

183
Q

Ondansetron Onset/Duration

A

Immediate

30m-4h

184
Q

Oxytocin IV Onset/Duration

A

1m

30m

185
Q

Oxytocin IM Onset/Duration

A

3-7m

60m

186
Q

Procainamide Onset/Duration

A

10-30m

3-6h

187
Q

Rocuronium Onset/Duration

A

60-70s

20m

188
Q

Sodium Bicarb Onset/Duration

A

Immediate

1-2h

189
Q

Succinylcholine Onset/Duration

A

1m

4-6m

190
Q

Thiamine Onset/Duration

A

2h

8h half life

191
Q

TXA Onset/Duration

A

4h

48h

NMETC (11 decks)

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