Brainscape's Knowledge GenomeTM

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


See full index

Principles of Anesthesia I - Summer 24 > Neuraxial Pharmacology > Flashcards

Neuraxial Pharmacology Flashcards

1
Q

Bupivacaine 0.75% in 8.25% Dextrose

A

Hyperbaric

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

Lidocaine 5% in 7.5% dextrose

A

Hyperbaric

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

Tetracaine 0.5% in 5% dextrose

A

Hyperbaric

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

Procaine 10% in water

A
  • still hyperbaric even in water b/c of the high concentration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Bupivicaine 0.5% in saline

A

Isobaric

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

Bupivicaine 0.75% in saline

A

Isobaric

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

Lidocaine 2% in saline

A

isobaric

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

Tetracaine 0.5% in saline

A

Isobaric

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

Bupivicaine 0.3% in water

A

Hypobaric

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

Lidocaine 0.5% in water

A

hypobaric

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

Tetracaine 0.2% in water

A

Hypobaric

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

Spinal Drug

Bupivicaine 0.5-0.75%
T10 Dose:
T4 Dose:
Onset:
Duration:
Duration w/ Epi:

A
  1. T10: 10-15 mg
  2. T4: 12-20 mg
  3. Onset: 4-8 min
  4. Duration: 130-220 min
  5. Duration w/ Epi: + 20-50%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Spinal Drug

Levobupivicaine 0.5%
T10 Dose:
T4 Dose:
Onset:
Duration:

A
  1. T10 Dose: 10-15 mg
  2. T4 Dose: 12-20 mg
  3. Onset: 4-8 min
  4. Duration: 140-230 min
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Spinal Drug

Ropivacaine 0.5-1%
T10 Dose:
T4 Dose:
Onset:
Duration:

A
  1. T10 Dose: 12-18 mg
  2. T4 Dose: 18-25 mg
  3. Onset: 3-8 min
  4. Duration: 80-210 min
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Spinal Drug

2-Chloroprocaine 3%
T10 Dose:
T4 Dose:
Onset:
Duration:

A

T10 Dose: 30-40 mg
T4 Dose: 40-60 mg
Onset: 2-4 min
Duration: 40-90 min

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

Spinal Drug

Tetracaine 0.5-1%
T10 Dose:
T4 Dose:
Onset:
Duration:
Duration w/ Epi:

A

T10 Dose: 6-10 mg
T4 Dose: 12-16 mg
Onset: 3-5 min
Duration: 90-120 min
Duration w/ Epi: + 20-50%

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

What is alkalinization?

A

Adding 1mEq of NaHCO3 to 10mL LA
* increases the pH of LA
* increases concentration of non-ionized free base
* increases rate of diffusion of the drug
* increases the speed of onset of the drug

18
Q

What are the ways of speeding the onset of LA?

A
  1. pKa
  2. concentration (3%)
  3. alkalinization
19
Q

Initial Epidural Dosing

A

1-2 mL/segment of
* L3/L4 – T4 = 10 segments (10-20mL)
* 0.75% = 7.5 mg/mL (15mg = 2mL)

20
Q

Top-up Epidural Dosing

A

50-75% of the initial dose

21
Q

Timing of top-up epidural dose:

A
  • before the block decreases > 2 dermatomes
  • ex: T4 block - sensory check lowered to T6 = give another dose
22
Q

How many mL should we use for thoracic epidural and why?

A

1 mL/segment – it is a smaller area and has greater spread

23
Q

What characteristic of the drug determines how dense or strong the epidural block is?

Example?

A
  • drug concentration determines block density
  • ex: walking epidural w/ low concentration of drug
24
Q

Epidural Drug

2-Chloroprocaine 3%
Onset:
Duration:
Epidural surgical analgesia:

A

Onset: 5-15 min
Duration: 30-90 min
Epidural Surgical Analgesia: 3%

24
Q

Epidural Drug

Ropivacaine 0.1-0.75%
Onset:
Duration:
Epidural Surgical Analgesia:

A

Onset: 15-20 min
Duration: 140-220 min
Epidural Surgical Analgesia: 0.75%

25
Q

Epidural Drug

Bupivicaine 0.0625-0.5%
Onset:
Duration:
Epidural Surgical Analgesia:

A

Onset: 15-20 min
Duration: 160-220 min
Epidural Surgical Analgesia: 0.5%

25
Q

Epidural Drug

Lidocaine 2%
Onset:
Duration:
Epidural Surgical Analgesia:

A

Onset: 10-20 min
Duration: 60-120 min
Epidural Surgical Analgesia: 2%

26
Q

Epidural Drug

Levobupivicaine 0.0625-0.5%
Onset:
Duration:
Epidural Surgical Analgesia:

A

Onset: 15-20 min
Duration: 150-225 min
Epidural Surgical Analgesia: 0.5%

27
Q

What is the purpose of neuraxial adjuncts?

A
  • provide post op analgesia
  • extend the duration of the block
  • improves density of the block
28
Q

What are the 3 main classes of drugs that are neuraxial adjuncts?

A
  1. Opioids
  2. Alpha-2 Agonists
  3. Vasopressors
29
Q

Opioids

Sufentanil
Intrathecal Dose:
Epidural Dose:
Epidural gtt Dose:

A
  • lipophilic
    1. Intrathecal: 5-10mcg
    2. Epidural Dose: 25-50mcg
    3. Epidural infusion: 10-20mcg/hr
30
Q

Opioids

Fentanyl
Intrathecal Dose:
Epidural Dose:
Epidural gtt Dose:

A
  • Lipophilic
    1. Intrathecal: 10-20mcg
    2. Epidural Dose: 50-100mcg
    3. Epidural infusion: 25-100mcg/hr
31
Q

Opioids

Hydromorphone
Intrathecal yes or no?
Epidural Dose:
Epidural gtt Dose:

A
  • Hydrophilic
    1. NO INTRATHECAL
    2. Epidural Dose: 0.5-1mg
    3. Epidural infusion: 0.1-0.2 mg/hr
32
Q

Opioids

Meperidine
Intrathecal Dose:
Epidural Dose:
Epidural gtt Dose:

A
  • hydrophilic
    1. intrathecal dose: 10 mg
    2. Epidural dose: 25-50 mg
    3. Epidural infusion: 10-60 mg/hr
33
Q

Opioids

Morphine
Intrathecal Dose:
Epidural Dose:
Epidural gtt dose:

A
  • hydrophilic
    1. Intrathecal dose: 0.25-0.30 mg
    2. Epidural Dose: 2-5 mg
    3. Epidural infusion: 0.1-1 mg/hr
34
Q

Treatment of Opioid induced Pruritis

A
  1. Benadryl 25-50 mg
  2. Naloxone 0.1 mg IV
  3. Buprenex/Buprenorphine (mixed agonist/antagonist)
35
Q

Opioid induced pruritis prophylaxis

A
  1. morphine <300mcg
  2. Ondansetron 4mg
  3. Nubain (Nalbuphine) 2.5-5 mg IV
36
Q

Opioid SE

What dose of morphine is associated w/ less n/v?

A

50-100 mcg

37
Q

Opioid SE

Tx of Opioid induced n/v

A
  1. Ondansetron (5HT-3 antagonist)
  2. Narcan 0.1mg
  3. Phenergan 12.5-25 mg
38
Q

Opioid SE

What causes urinary retention?

A
  • relaxation of detrusor muscle (30-40%)
39
Q

What A-2 agonists can be used as neuraxial adjuncts?

MOA?

A
  • Clonidine 15-45 mcg
  • Dexmedetomidine 3 mcg
  • MOA: intensifies and prolong sensory/motor blockade by ~1hr
40
Q

Neuraxial Adjuncts

What vasoconstrictors can be given as an adjunct?

MOA?

A
  1. Epi Wash (0.2-0.3 mg)
  2. Phenyelphrine 2-5 mg
  • works better w/ Tetracaine
  • MOA: prolongs action of LA (reduced blood flow)

Principles of Anesthesia I - Summer 24 (15 decks)

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