miscellaneous drugs

Question 1

protamine category

Answer 1

heparin antidote

Question 2

dose of protamine

Answer 2

Immediate – 1-1.5mg per 100u of Heparin

30-60min -0.5-0.75mg

> 2h - 0.25-0.375mg

Question 3

onset of protamine

Answer 3

5 minutes

Question 4

use of protamine

Answer 4

Neutralize acidic heparin to form a stable complex (salt) neutralizing the anticoagulant activity of drugs

Question 5

major adverse side effects of protamine

Answer 5

Drop in blood pressure
Hemorrhage
Hypersensitivity reactions (Hypotension, Non-cardiogenic pulmonary edema, pulmonary vasoconstriction and hypertension)

Question 6

contraindications of protamine

Answer 6

Fish allergy,
Vasectomy,
severe LV dysfunction,
abnormal preoperative pulmonary hemodynamics

Question 7

how much protamine does it take to neutralize 100 units of heparin?

Answer 7

1 mg of protamine neutralizes – 100 units of heparin,

Question 8

what is the MAX dose of heparin?

Answer 8

maximum dose 50mg. 1-1.5mg per 100 units subQ heparin.

Question 9

MOA heparin

Answer 9

Anticoagulant,
Potentiates the action of antithrombin III and

inactivates thrombin (as well a activated coagulation factors IX, X, XI, XII and plasmin)

and prevents the conversion of fibrinogen to fibrin.

Question 10

dose of heparin ACS

Answer 10

ACS- Bolus- 60 units/kg, then 12 units/kg/ hr

Question 11

PCI dose of heparin

Answer 11

PCI- 70-100 units/kg,

Question 12

onset of heparin

Answer 12

immediate

Question 13

use of heparin

Answer 13

anticoagulation of thrombogenic disorders

Question 14

metabolism of heparin

Answer 14

hepatic

Question 15

major adverse effects with heparin

Answer 15

Heparin-induced thrombocytopenia (HIT)
allergic vasospastic reaction,
Anaphylactoid reactions
Heparin resistance, 
hyperkalemia,

Question 16

contraindications

Answer 16

severe thrombocytopenia

Question 17

Dantrolene MOA

Answer 17

Skeletal muscle relaxant,

interfering with release of calcium from SR

Question 18

Dantrolene doses crisis

Answer 18

Crisis- 2.5 mg/kg, MAX 10mg/kg,

continue infusion of 0.25 mg/kg/hr for 24 hrs

Question 19

onset of dantrolene

Answer 19

Varies, peak- 1 min

Question 20

uses of dantrolene

Answer 20

Treatment of MH

Question 21

metabolism of dantrolene

Answer 21

hepatic

Question 22

major adverse effects dantrolene

Answer 22

Flushing, 
AV block, 
tachycardia, 
drowsiness, 
voice disorder, 
headache, 
dysphagia, 
N/V, 
muscle weakness