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Pediatric Anesthesia > Peds Drugs > Flashcards

Peds Drugs Flashcards

1
Q

total body water preterm, full term and 5 months

A

85% preterm

75% full term

60% at 5 months

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2
Q

ECF preterm/full term, 1 year and adults

A

preterm/full term: 45-50%

1 year: 26%

adults: 18%

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3
Q

body fat premature, full term, 1 year and adults

A

preterm 3%

full term 12%

1 year 30%

adult 18%

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4
Q

methohexital rectal dose

A

25-35mg/kg

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5
Q

versed premed intranasal

A

0.2-0.3 mg/kg

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6
Q

versed sedation PR

A

1mg/kg

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7
Q

versed premed IV

A

0.05mg/kg

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8
Q

flumazenil

A

0.01 mg/kg

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9
Q

etomidate induction

A

0.2-0.6 mg/kg

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10
Q

etomidate sedation

A

0.1-0.3mg/kg

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11
Q

propofol >3yrs

A

2.5-3 mg/kg

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12
Q

propfol obese 3-7 yr

A

2mg/kg

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13
Q

propofol sedation infusion

A

125-150 mcg/kg/min

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14
Q

propofol emergence delirium dose

A

1-3mg/kg at end of anesthesia

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15
Q

what is ketofol

A

ratio of ketamine to prop 1:5 for 30 min of anesthesia and 1: 6.7 for 90 min

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16
Q

what do you coadmin with ketamine

A

versed 0.5mg/kg
atropine .02mg/kg

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17
Q

ketamine premed PO

A

6-10 mg/kg

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18
Q

ketamine premed IM

A

3-7mg/kg

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19
Q

ketamine sedation IV

A

0.5-2mg/kg

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20
Q

ketamine induction IV

A

1-2mg/kg

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21
Q

ketamine analgesic IV

A

0.1mg/kg

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22
Q

what does ketamine preserve

A

gag reflex
laryngeal irritability
continued muscle tension

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23
Q

effects of ketamine

A

increases HR, SBP
no resp depression

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24
Q

contraindications of ketamine

A

increased ICP
full stomach

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25
Q

ketamine MOA

A

racemic, nonbarbiturate cyclohexamine derivative that produces dissociation of the cerebral cortex from the limbic system

Antagonizes NMDA

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26
Q

precedex premed IM

A

1-2 mcg/kg

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27
Q

precedex premed intranasal

A

2mcg/kg (max 100mcg/dose)

repeat prn 5-15 min

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28
Q

precedex premed IV

A

0.5mcg/kg

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29
Q

precedex sedation infusion

A

1-2mcg/kg over 10 min
0.5-1mcg/kg/hr

children <1year up to 1.5mcg/kg/hr

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30
Q

precedex shivering dose

31
Q

precedex emergence delirium dose IV

32
Q

precedex MOA

A

selectiveα2-agonist with sedative and analgesic properties

1600 : 1 α2toα1 (7x higher than clonidine)

hyperpolarization of noradrenergic neurons in the locus coeruleus

Mimics normal sleep, no resp depression, CV stable (biphasic response)

33
Q

sevo neonate mac

34
Q

sevo yr old mac

35
Q

N2O dec mac

36
Q

des 2yr old mac

37
Q

morphine IV dose

38
Q

morphine caudal

A

30-50 mcg/kg

39
Q

morphine intrathecal

A

5-7.5 mg/kg

40
Q

meperidine IV

41
Q

meperidine info

A

Agonist at µ-opioid receptor & local anesthetic activity

Active metabolite: Normeperidine
Can accumulate with renal disease ->seizures

Tx: shivering

42
Q

fentanyl IV bolus analgesis

43
Q

fentanyl IV bolus loading dose

A

5-10 mcg/kg

44
Q

fentanyl IV cont infusion

A

1-3mcg/kg/hr

45
Q

fentanyl intranasal dose

A

1-2 mcg/kg

46
Q

oral transmucosal fentanyl

A

5-15mcg/kg

47
Q

naloxone dose

A

0.01 mg/kg
repeat every 2-3 min

48
Q

naloxone info

A

competitive opioid antagonists at theµ-,κ-, andΔ-receptors

high affinity but total lack of efficacy

49
Q

ketorolac

A

0.5-1 mg/kg IM or IV until 16 yrs old

MAX 30mg
<2yr old 3 days
>2 yrs 5 days

50
Q

ketorolac info

A

Potent analgesia

postoperative analgesia comparable to opioids, but without the side effects of respiratory depression, sedation, nausea, and pruritus

Inhibits COX1 & COX2

51
Q

tylenol (APAP) PO

A

10-15mg/kg

52
Q

tylenol (APAP) rectal

53
Q

tylenol (APAP) IV

A

7.5-15mg/kg

54
Q

tylenol MAX

A

< 2yo = 60mg/kg/day

> 50 kg 4gm per day & 1gm per dose

55
Q

atropine

56
Q

scopolamine

A

0.01mg/kg

most effective antisialogues

57
Q

robinul

58
Q

ondansetron

A

0.05 to 0.1 mg/kg up to 4 mg

59
Q

dexamethasone info

A

significant glucocorticoid and minimal mineralocorticoid effects

inhibits multiple inflammatory cytokines

60
Q

succinylcholine info

A

-depolarizing muscle relaxant

-Butyrylcholinesterase

-Neonates and infants require about twice as much succinylcholine

-Faster clearance, larger volume of distribution, and shorter onset time than children older than 2 years of age

-marked variability in block produced by small doses of succinylcholine
—recommended to select doses at the upper end of the range for children undergoing rapid-sequence induction.

61
Q

succinylcholine infant

A

Infants: 3 to 4 mg/kg is necessary

62
Q

succinylcholine children

A

2 mg/kg is required to achieve the same duration

63
Q

succs laryngospasm dose

A

0.1 to 0.2 mg/kg

64
Q

succs side effects

A

dysrhythmias,
increased intraocular pressure,
prolonged apnea,
injured muscle membranes with associated hyperkalemia,
association with masseter spasm
malignant hyperthermia,
death

Arrythmias – profound sustained sinus brady

Intragastric pressure – increased w/ fasciculations -> aspiration

Increased ICP – attenuated with NDMB, propofol, hyperventilation

65
Q

succs with Duchenne muscular dystrophy

A

Intractable, unexpected cardiac arrest with 50& mortality

BLACK BOX WARNING IN PEDIATRICS

66
Q

Rocuronium

A

1.2 mg/kg (four times ED95 ) is alternative

67
Q

non NMB RSI

A

Remifentanil 3 mcg/kg and propofol 3 mg/kg produce RSI conditions

68
Q

Nimbex

69
Q

vecuronium <12 months

70
Q

vecuronium metabolite

A

3-OH metabolite accumulates in renal failure (80% active)

Liver metabolism
Kidney/Liver elimination

71
Q

rocuronium

A

0.6mg/kg
1.2mg/kg RSI

longer DOA in infants

72
Q

neostigmine

73
Q

atropine reversal

A

7-10mcg/kg

74
Q

robinul reversal

Pediatric Anesthesia (5 decks)

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