Pharmacology Flashcards
TXWES REFERENCE GUIDE
BENZOS
Dose (IV, PO), Onset, Duration:
Diazepam
0.1mg/kg IV
Onset 1-5mins ⏐Duration 2-6h
0.2mg/kg PO
BENZOS
Dose, Onset, Duration:
Lorazepam
0.04mg/kg ⏐ Onset 1-5mins ⏐6-10h
BENZOS
Dose, Onset, Duration:
Midazolam
Versed
1-5mg or 0.01-0.05mg/kg ⏐Onset 1-5mins ⏐15-80min
BENZOS
Dose, Onset, Duration:
Flumazenil
Romazicon
0.2mg ⏐ Onset 1-5mins ⏐30mins!!!
Repeat 0.1 q 1min –> MAX 3mg
BENZO REVERSAL
OPIOIDS
Dose (intraOp, postop), Onset, Duration:
Morphine
1-10mg IntraOp
5-20mg PostOp
Onset 10-20mins ⏐ Duration 4-5h
OPIOIDS
Dose, Onset, Duration:
Fentanyl
1.5-3mcg/kg
Onset 30-60sec ⏐ Duration 1-1.5h
OPIOIDS
Dose, Onset, Duration:
Sufentanil
0.3-1mcg/kg
Onset 30-60sec ⏐ 1-1.5hr
Infusion: 0.5-1mcg/kg/hr (close to intraop dose)
OPIOIDS
Dose, Onset, Duration:
Remifentanil
0.5 - 1mcg/kg OVER 1 MIN!!!
Onset 30-60sec ⏐ 6-8min
gtt: 0.125-0.375 mcg/kg/MIN
OPIOIDS
Dose, Onset, Duration:
Meperidine
Demerol
12.5mg (Shivering)
Onset 5-15min ⏐ Duration 2-4h
OPIOIDS
Dose (intra, postop), Onset, Duration:
Hydromorphone
Diluadid
1 - 4mg IntraOp
1.5 - 4mg PostOp (basically the same)
Onset 5-15min ⏐ Duration 2-4hr
OPIOIDS
Dose, Onset, Duration:
Naloxone
Narcan
40-80mcg ⏐ Onset 1-5 min⏐ Duration 30min
Opioid REVERSAL
INDUCTION MEDS
Dose (induction, sedation gtt, TIVA gtt), Onset, Duration:
Propofol
1.5-2.5mg/kg Induction
25-100 mcg/kg/min Sedation
100-300 mcg/kg/min TIVA
Onset 30-60sec ⏐ 1-8mins
Induction
Dose, Onset:
Etomidate
0.3mg/kg ⏐ Onset 1 min
Induction
Dose (induction, IV analgesia), Onset, Duration:
Ketamine
0.5-1.5mg/kg Induction
0.2-0.5 mg/kg IV Analgesia
Onset 1 min⏐ 10-20min
Induction Dose
Dose, Onset, Duration:
Midazolam
Versed
0.1-0.2mg/kg
Onset 30-60sec ⏐ Duration 5-10min
*may precede dose w/ Fentanyl 50-100mcg
Dose and normal Concentration/dilution:
Dexmedetomidine
Precedex
Bolus 0.5-1mcg/kg over 10mins then 0.2-0.7mcg/kg/hr
Usually on-hand 200mcg/2ml > mix with 48cc NS > 4mcg/ml
Inhalation
MAC, VP, Blood:Gas Co.:
Sevoflurane (Ultane)
MAC 1.8
VP 157
Blood:Gas Coefficient 0.69
Inhalation
MAC, VP, Blood:Gas Co.:
Desflurane (Suprane)
MAC 6.6
VP 669
Blood:Gas Coefficient 0.42
Inhalation
MAC, VP, Blood:Gas Co.:
Isoflurane (Forane)
MAC 1.17
VP 238
Blood:Gas Coefficient 1.46
Inhalation
MAC, VP, Blood:Gas Co.:
Nitrous Oxide
MAC 104
VP 🚀 38,770 gas
Blood:Gas Coefficient 0.46
Muscle Relaxants
Dose, Onset, Duration:
Succinylcholine
Anectine
1-1.5 mg/kg
Onset 30-60sec ⏐Durations 5-10min
Muscle Relaxants
Dose, Onset, Duration:
Cisatricurium
Nimbex
0.1 mg/kg
Onset 2-3min ⏐ Duration 40-75min
Hoffman Elimination
Muscle Relaxants
Dose, Onset, Duration:
Vecuronium
Norcuron
0.1 mg/kg
Onset 2-3min⏐ 45-90min
Muscle Relaxants
Dose (1st & 2nd), Onset, Duration:
Rocuronium
Zemuron
0.6 mg/kg Onset 2-3mins
1.2 mg/kg Onset 1.5 mins
Duration 35-75mins
Muscle Relaxants
Dose, Onset, Duration:
Pancuronium
Pavulon
0.1 mg/kg
Onset 2-3min ⏐Duration 60-120min
Also a vagolytic (increases HR and other SNS things)
Muscle Relaxants Reversals
Dose, Onset, Duration, Anticholinergic buddy:
Neostigmine
0.04-0.07 mg/kg
Onset 5-10min ⏐ Duration 60min
Glyco 0.2mg per mg of Neo to avoid bradycardia and excess secretions
Muscle Relaxants Reversals
Dose, Onset, Duration, Anticholinergic buddy:
Sugammadex
2-16 mg/kg (depends on TOF & PTP)
Onset 1-4min ⏐ Duration 1.5-3hrs
NONE 🙃
REGIONAL MEDS
Amide/Ester?
MAX dose (mg/kg) w/ & w/o EPI?
Lidocaine
Amide
5mg/kg, 7mg/kg
REGIONAL MEDS
Amide/Ester?
MAX dose (mg/kg) w/ & w/o EPI?
Prilocaine
Amide.
6mg/kg, 8.5mg/kg
REGIONAL MEDS
Amide/Ester?
MAX dose (mg/kg) w/ & w/o EPI?
Mepivicaine
Amide.
5mg/kg, 7mg/kg
REGIONAL MEDS
Amide/Ester?
MAX dose (mg/kg) w/ & w/o EPI?
Bupivicaine
Amide.
2.5mg/kg, 2.5mg/kg
EPI DONT MAKE NO DIFFERENCE! 😅
REGIONAL MEDS
Amide/Ester?
MAX dose (mg/kg) w/ & w/o EPI?
Ropivicaine
Amide.
3mg/kg, 4mg/kg
REGIONAL MEDS
Amide/Ester?
MAX dose (mg/kg) w/ & w/o EPI?
Procaine
Ester.
7mg/kg, 8.5mg/kg
REGIONAL MEDS
Amide/Ester?
MAX dose (mg/kg) w/ & w/o EPI?
Chloroprocaine
Ester.
6mg/kg, 14mg/kg!
REGIONAL MEDS
Amide/Ester?
MAX dose (mg/kg) w/ & w/o EPI?
Tetracaine
Ester.
3mg/kg, 3mg/kg
EPI MAKES NO DIFFERENCE 😅
CSE LABOR ANALGESIA
Epidural (%) & Spinal (mg) doses?
Bupivicaine
Epidural: 0.0625-0.125%
Spinal: 1.25 - 2.5 ml
CSE LABOR ANALGESIA
Epidural (%) & Spinal (mL) doses?
Ropivicaine
0.08 - 0.2%
2.5-4.5 mL
CSE LABOR ANALGESIA
Epidural (%) & Spinal (mL) doses?
Lidocaine + Epi
2% in 5cc bolus
N/A
No spinal dose.
CSE LABOR ANALGESIA
Epidural & Spinal doses? (mcg)
Fentanyl
50-100 mcg
10-25 mcg
CSE LABOR ANALGESIA
Epidural & Spinal doses? (mcg)
Sufentanil
5-10 mcg
1.5 - 5 mcg
CSE LABOR ANALGESIA
Epidural (%) & Spinal (mg) doses?
Morphine
NO epidural dose.
Spinal: 0.1 - 0.2 mg
ANTIEMETICS
Dose, Onset, Duration, Receptors:
Droperidol
Inapsine
0.625mg, 1-5min, 2-3hrs, anti-Dopaminergic
ANTIEMETICS
Dose, Onset, Duration, Receptors:
Promethazine
Phenergran
6.25-25 mg, 1-5mins, 4-6hrs, (Anti-histamine, anti-dopaminergic, anti-muscarinic and anti-cholinergic)
ANTIEMETICS
Dose, Onset, Duration, receptors:
Ondansetron
Zofran
4mg, 10mins, 4-9hrs, 5HT3 blocker
ANTIEMETICS
Dose, Onset, Duration, receptor:
Dexamethasone
Decadron
4mg, 10-30mins, 2-10hrs, anti-inflammatory (steroid)
ANTIEMETICS
Dose, Onset, Duration, receptor:
Metoclopramide
Reglan
10-20mg, 10mins, 2hrs, Gastrokenetic (increases LES tone and GI motility)
ANTIEMETICS
Dose, Onset, Duration, receptors:
Scopolamine
Patch, 2-4hrs, 72hrs!, anti-muscarinic (ACH blocker)
Non-hairy area - dont touch eyes after handling –> can cause mydriasis.
ANTIEMETICS
Dose, Onset, Duration, receptors:
Propofol
Diprivan
10-15mg IV followed by 10mcg/kg/min, blocks 5HT3 release (antiemetic only - there are other receptors for sedation)
List some PONV risk factors.
Female, <40yrs, Hx of PONV or Motion Sickness, vertigo, non-smokers
Surgeries: Laparotomy, Laparoscopy, Major Breast, Strabismus, Intraocular, Middle Ear, Tonsils, Adenoids, Neuro (intracranial), Gynecologic, Testicular, Scrotum, Kidney stones
If I have 0 PONV risk factors, what is the chance I will have PONV?
10%
This requires NO pre-treament drugs.
If I have 3 PONV risk factors, what is the chance I will have PONV?
What drugs will you pre-treat your patient with?
> 60% chance.
Give at least 3 pre-treament drugs: 5HT blocker, steroid, propofol + TIVA??
My patient requires 2 pre-treatment drugs for PONV; I gave zofran and decadron before her surgery.
How many risk factors do you think she has?
What are her chances of developing PONV based on this info?
2 risk factors = 40% chance of developing PONV
My pts chance of PONV is 20%.
How many risk factors do they have?
What drug(s) will you give them?
They have 1 risk factor and you should give a 5HT-blocker like zofran :)
NON OPIOID ANALGESICS
1x Dose & daily MAX dose.
Acetaminophen
Ofirmev
1000mg q 4-6hr
MAX: 3-4g qd
NON OPIOID ANALGESICS
1x Dose & daily MAX dose.
Ketorlac
Toradol
15-30mg q6h
60-120mg qd
NON OPIOID ANALGESICS
1x Dose & daily MAX dose.
Ibuprofen
Caldor
200-800mg q6h
3200mg qd
Dose of Ephedrine for HoTN?
Main receptor(s)?
5mg
⍺ & β
Dose of Neosynephrine for HoTN?
Main receptor(s)?
100mcg
⍺
Labetalol dose for HTN?
Main receptors?
5mg
⍺ & β
Esmolol dose for HTN?
Main receptor?
10mg
β1
Hydralazine dose?
Main receptor?
5mg
Directly vasodilates on the smooth muscle of the arterioles.
What is the dose of Dantrolene for MH?
2.5mg/kg IV (repeat q5-10mins prn)
MAX 10mg/kg