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Anesthesia > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What is the concentration and dosage of Hydromorphone?

A

Concentration: 2mg ampule
Dosage: 0.5 - 2 mg

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2
Q

What are the cautions of Hydromorphone?

A

5x as potent as Morphine

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3
Q

What is the trade name, class and use for Hydromorphone?

A

Trade Name: Dilaudid
Class: Semi-synthetic (synthetic heroine)
Use: Analgesia

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4
Q

What is the trade name, class and use of Naloxone?

A

Trade Name: Narcan
Class: Opioid Antagonist
Use: Opioid Reversal, Respiratory Depression, Overdose

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5
Q

What is the concentration and dosage of Naloxone?

A

Concentration: 0.4 mg vial
Dosage: 1-4 mcg/kg

Note: Dilute 0.4 mg vial in 10 cc. Give 1-2 cc over 2-3 mins

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6
Q

What are the cautions of Naloxone?

A

N/V
Pain
Tachycardia
Increased SNS (Fight or Flight)

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7
Q

What is the concentration and dosage of Lidocaine (Induction use)?

A

Concentration: 20 mg/ml (2%)
Dosage: 0.5 - 1 mg/kg

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8
Q

What is the trade name, class, and use of Propofol?

A

Trade Name: Diprivan
Class: Diisopropylphenol
Use: Induction, sedation, MAC

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9
Q

What is the concentration, dosage, onset time and duration of Propofol?

A 
Concentration: 10 mg/ml (1%)
Dosage:  1-2.5 mg/kg (Induction)
                25-200 mcg/kg/hr (Infusion)
Onset Time:  30 - 60 sec.
Duration:  5 min.
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10
Q

What are the contraindications of Propofol?

A 
Bacterial growth after 6 hours
Soy/Egg allergy
Hypotension / vasodilation
Burns on injection
Start with low dose for the elderly
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11
Q

What is the trade name and use of Etomidate?

A

Trade name: Amidate

Use: Induction, hypnosis

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12
Q

What is the concentration, dosage, onset time and duration of Etomidate?

A

Concentration: 2 mg/ml (0.2%)
Dosage: 0.2-0.3 mg/kg
Onset time: 30-60 sec.
Duration: 5 min.

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13
Q

What are the contraindications and advantages of Etomidate?

A

Advantages: Cardiovascular stability (no decrease in BP)
Caution: Burns
Myoclonus (involuntary muscle movmt)
PONV

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14
Q

What is the trade name, class and use of Ketamine?

A

Trade Name: Ketalar
Class: Phencyclidine
Use: Induction, Analgesia, Amnesia

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15
Q

What is the concentration, dosage, onset time and duration of Ketamine?

A 
Concentration:  10, 50, 100 mg/mL
Dose:  1-2 mg/kg (Induction)
           4-8 mg/kg (IM)
Onset Time:  30 sec.
Duration:  5 mins.
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16
Q

What are the advantages and cautions of Ketamine?

A

Advantages:
Does not cross placenta to baby
Does not cause apnea
Used on people addicted to narcotics

Caution:
Emergence Delirium (used in comb. with Versed to relieve)
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17
Q

What is the trade name, class and use for Midazolam?

A

Trade Name: Versed
Class: Benzodiazepine
Use: Anxiolysis, sedation, amnesia (antegrade)

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18
Q

What is the concentration, dosage and onset time of Midazolam?

A

Concentration: 1 mg/mL
Dose: 1-2.5 mg IV
Onset Time: 2 mins.

*Can also be given PO (0.5 mg/kg)

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19
Q

What are the contraindications of Midazolam?

A

Hepatic Disease
Elderly (usually not given to people >75)
Synergy with narcotics

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20
Q

What is the class and use of Fentanyl?

A

Class: Synthetic Opioid
Use: Analgesia

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21
Q

What is the concentration, dosage, onset time and duration of Fentanyl?

A 
Concentration:  50 mcg/ml
Dose:  1-2 mcg/kg (Low dose)
           2-20 mcg/kg (Moderate dose)
           1-2 mcg/kg/hr (Infusion)
Onset Time:  3-5 mins.
Duration:  30-60 mins.
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22
Q

What are the cautions of Fentanyl?

A

100x more potent than Morphine

Synergism w/ Midazolam (more respiratory depression)

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23
Q

What is the trade name, class and use of Succinylcholine?

A

Trade Name: Anectine
Class: Depolarizing NMBD
Use: Intubation, paralysis, laryngospasm

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24
Q

What is the concentration, dosage, onset time and duration of Succinylcholine?

A 
Concentration:  20 mg/ml
Dose:  1-2 mg/kg (Intubation)
           0.1 mg/kg IV (laryngospasm)
Onset Time:  30 sec.
Duration: 3-5 mins.
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25
Q

What are the advantages and cautions of Succinylcholine?

A

Advantages:
Metabolized through plasma cholinesterase - not dependent on liver or kidneys

Caution:
Causes fasiculations (sm. dose of Roc will prevent - 5-10 mg)
Hyperkalemia
Myalgia

*Reference list for additional contraindications

26
Q

What is the trade name, class and use of Rocuronium?

A

Trade Name: Zemuron
Class: Aminosteroid, non-depolarizing
Use: Paralysis, RSI

27
Q

What is the concentration, dosage, onset time and duration of Rocuronium?

A 
Concentration:  10 mg/ml
Dose:  0.6 - 1.2 mg/kg (Intubation)
           0.1 mg/kg (Maint.) (1 cc at a time)
Onset Time: 1-2 mins.
Duration:  20-35 mins.

*Dose affects onset time and duration, not dependent on weight/age

28
Q

What are the cautions of Rocuronium?

A

Metabolized through the liver and kidneys

29
Q

What is the trade name, class and use of Vecuronium?

A

Trade Name: Norcuron
Class: Aminosteroid, non-depolarizing
Use: Paralysis

30
Q

What is the concentration, dosage, onset time and duration of Vecuronium?

A 
Concentration: 10 mg powder vial reconstituted to 1 mg/ml
Dose:  0.01 mg/kg (Maintenance)
          1-2 mcg/kg/min (Infusion)
          0.08-0.12 mg/kg (Intubation)
Onset Time:  3-5 mins.
Duration:  20-35 mins.
  • Not often used for intubation b/c onset time is too long. Used mainly for maint.
  • *Cheaper than Roc!
31
Q

What is the trade name, class and use of Cisatracurium?

A

Trade Name: Nimbex
Class: Benzyl Isoquinolinium, non-depol.
Use: Paralysis

32
Q

What is the concentration, dosage, onset time and duration of Cisatracurium?

A 
Concentration:  20 mg vial (2 mg/ml)
Dose:  0.1-0.15 mg/kg (Intubation)
          1-2 mcg/kg/min. (Infusion)
Onset Time:  3-5 mins.
Duration:  20-35 mins.
33
Q

What are the advantages of Cisatracurium?

A

Good for renal/hepatic dysfunction (not metabolized through liver and kidneys)

34
Q

What is the class and use of Phenylephrine?

A

Class: Synthetic non-catecholamine direct-acting (works on alpha receptors)
Use: Increase BP
Nasal Decongestant

35
Q

What is the concentration and dosage of Phenylephrine?

A

Concentration: 10 mg vial (1%)
Diluted to 100 mcg/ml
Dose: 50-100 mcg (Bolus) (1 cc at a time)
0.25-1 mcg/kg/min (Infusion)

36
Q

What are the cautions of Phenylephrine?

A 
Increases afterload
Reflex bradycardia (increase in BP causes a reflex decrease in HR)
Vasoconstrictor
37
Q

What is the class and use of Ephedrine?

A

Class: Synthetic non-catecholamine direct and indirect action
Use: Increase HR, Increase BP

38
Q

What is the concentration and dosage of Ephedrine?

A

Concentration: 5 mg/ml (25 or 50mg in 1 ml)
Normally made into 1:100 dilution - 5 mg/ml
Dose: 5-20 mg

39
Q

What are the cautions of Ephedrine?

A 
Tachyphylaxis (you have to keep increasing dose to get same effect)
Depletion of norepinephrine
Indirect acting (causes release of something else)
40
Q

What is the class and use of Epinephrine?

A

Class: Catecholamine
Use: Increase HR/BP
Anaphylaxis
Bronchospasm

41
Q

What is the concentration and dosage of Epinephrine?

A

Concentration: 16 mcg/ml Syringe
4 mcg/ml (1ml in 250ml)
Dose: 8-16 mcg (Bolus) (1cc at a time)

42
Q

What is the color code and MAC of Isofluorane?

A

Color Code: Purple
MAC: 1.1%

  • Min. metabolism - 0.2%
  • Cardiovascular changes minimal at 1 MAC
43
Q

What are the advantages and cautions of Isofluorane?

A

Advantages:
Very stable
Cheap!
Protective for the brain

Caution:
     Highly potent
     A/W irritant (makes you cough)
     Fat Soluble - takes longer to go to sleep 
           and wake up
44
Q

What is the color code and MAC of Desfluorane?

A

Color Code: Blue

MAC: 6.0%

45
Q

What are the advantages and cautions of Desfluorane?

A

Advantages:
Prompt Recovery
Easily titratable

Caution:
     Pungent - A/W irritant
     AVOID W/ REACTIVE AIRWAYS!!
           (i.e. Asthmatics)
     Decreased potency - relative
     Carbon Monoxide formation
     Not very stable
46
Q

What is the color code and MAC of Sevofluorane?

A

Color Code: Yellow

MAC: 2.0%

47
Q

What are the advantages and cautions of Sevofluorane?

A

Advantages:
Least A/W irritant
Inhalation Induction (Used for people w/
no IV - ex: kids)

Caution:
Metabolized: 2-5%
-Compound A
-Renal Tubular Injury

48
Q

What is the MAC of N2O?

A

MAC: 105%

**Has to be added to other things

49
Q

What are the advantages and cautions of N2O?

A 
Advantages:
     Cheap
     Comes through pipeline
     Sweet smelling
     Fastest - comes on and leaves fast
     Highly insoluble

Caution:
Increased PONV (??)
Can’t be used alone!

50
Q

What is the class and use of Morphine?

A

Class: Opioid
Use: IV, Epidural, Spinal Analgesia

51
Q

What is the concentration, dosage, onset time and duration of Morphine?

A

Concentration: 10 mg/ml (1%)
Dose: 0.1-1 mg/kg (Intraoperative IV)
Onset: 15-30 mins.
Duration: 3-6 hours

52
Q

What are the cautions of Morphine?

A

Depression of ventilation
PONV
Itching (pruritis)

53
Q

What is the trade name, class and use of Meperidine?

A

Trade Name: Demerol
Class: Synthetic Opioid
Use: Analgesia, Post-op shivering

54
Q

What is the concentration and dosage of Meperidine?

A

Concentration: Varies - 2.5%, 5%, 7.5%, 10%
Dose: 12.5-25 mg IV (Post-op shivering)

55
Q

What are the cautions of Meperidine?

A

Neurotoxic

Renal disease

56
Q

What is the trade name, class and use of Ondansetron?

A

Trade Name: Zofran
Class: Serotonin receptor antagonist
Use: Antiemetic

57
Q

What is the concentration and dosage of Ondansetron?

A

Concentration: 4 mg / 2 ml (2 mg/ml)
Dose: 4 mg

  • *Given to everybody
  • *Given 30 mins before end of surgery
58
Q

What is the class and use of Neostigmine?

A

Class: Anticholinesterase
Use: NMB Reversal

59
Q

What is the concentration and dosage of Neostigmine?

A

Concentration: 1 mg/ml (sometimes 0.5 mg/ml)
Dose: 0.04-0.07 mg/kg

60
Q

What are the cautions of Neostigmine?

A 
BLUDS:
   Bradycardia
   Lacrimation
   Urination
   Defecation
   Salivation

Need at least 1 twitch in Train of Four to use
Use in combination with Glycopyrrolate to treat BLUDS symptoms

61
Q

What is the trade name, class and use of Glycopyrrolate?

A

Trade Name: Robinul
Class: Anticholinergic
Use: Antisaligogue, NMB Reversal - treats side effects of Neostigmine

62
Q

What is the concentration and dosage of Glycopyrrolate?

A

Concentration: 0.2 mg/ml
Dose:
0.2 mg per mg of Neostigmine (Reversal)
(1cc per 1cc Neostigmine)

*Similar onset and duration times as Neostigmine

Anesthesia (3 decks)

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