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Principles 2 A > Pharmacology COPY > Flashcards

Pharmacology COPY Flashcards

TXWES REFERENCE GUIDE

1
Q

BENZOS

Dose (IV, PO), Onset, Duration:
Diazepam

A

0.1mg/kg IV
Onset 1-5mins ⏐Duration 2-6h

0.2mg/kg PO

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2
Q

BENZOS

Dose, Onset, Duration:
Lorazepam

A

0.04mg/kg ⏐ Onset 1-5mins ⏐6-10h

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3
Q

BENZOS

Dose, Onset, Duration:
Midazolam

Versed

A

1-5mg or 0.01-0.05mg/kg ⏐Onset 1-5mins ⏐15-80min

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4
Q

BENZOS

Dose, Onset, Duration:
Flumazenil

Romazicon

A

0.2mg ⏐ Onset 1-5mins ⏐30mins!!!

Repeat 0.1 q 1min –> MAX 3mg

BENZO REVERSAL

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5
Q

OPIOIDS

Dose (intraOp, postop), Onset, Duration:
Morphine

A

1-10mg IntraOp
5-20mg PostOp
Onset 10-20mins ⏐ Duration 4-5h

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6
Q

OPIOIDS

Dose, Onset, Duration:
Fentanyl

A

1.5-3mcg/kg
Onset 30-60sec ⏐ Duration 1-1.5h

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7
Q

OPIOIDS

Dose, Onset, Duration:
Sufentanil

A

0.3-1mcg/kg
Onset 30-60sec ⏐ 1-1.5hr

Infusion: 0.5-1mcg/kg/hr (close to intraop dose)

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8
Q

OPIOIDS

Dose (IVP & gtt) & over how long (IVP)? Onset, Duration:
Remifentanil
“Remi is Rapid”

A

0.5 - 1mcg/kg OVER 1 MIN!!!
Onset 30-60sec ⏐ 6-8min

gtt: 0.125-0.375 mcg/kg/MIN

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9
Q

OPIOIDS

Dose, Onset, Duration:
Meperidine

Demerol

A

12.5mg (Shivering)
Onset 5-15min ⏐ Duration 2-4h

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10
Q

OPIOIDS

Dose (intra, postop), Onset, Duration:
Hydromorphone

Diluadid

A

1 - 4mg IntraOp
1.5 - 4mg PostOp (basically the same)
Onset 5-15min ⏐ Duration 2-4hr

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11
Q

OPIOIDS

Dose, Onset, Duration:
Naloxone

Narcan

A

40-80mcg ⏐ Onset 1-5 min⏐ Duration 30min

Opioid REVERSAL

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12
Q

INDUCTION MEDS

Dose (induction, sedation gtt, TIVA gtt), Onset, Duration:
Propofol

A

1.5-2.5mg/kg Induction
25-100 mcg/kg/min Sedation
100-300 mcg/kg/min TIVA
Onset 30-60sec ⏐ 1-8mins

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13
Q

Induction

Dose, Onset:
Etomidate

A

0.3mg/kg ⏐ Onset 1 min

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14
Q

Induction

Dose (induction, IV analgesia), Onset, Duration:
Ketamine

A

0.5-1.5mg/kg Induction
0.2-0.5 mg/kg IV Analgesia
Onset 1 min⏐ 10-20min

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15
Q

Induction Dose

Dose, Onset, Duration:
Midazolam

Versed

A

0.1-0.2mg/kg
Onset 30-60sec ⏐ Duration 5-10min

*may precede dose w/ Fentanyl 50-100mcg

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16
Q

Dose:
Dexmedetomidine

Precedex

A

Bolus 0.5-1mcg/kg over 10mins

Usually on-hand 200mcg/2ml > mix with 48cc NS > 4mcg/ml

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17
Q

Inhalation

MAC, VP, Blood:Gas Co.:
Sevoflurane

A

MAC 1.8
VP 157
Blood Coefficient 0.69

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18
Q

Inhalation

MAC, VP, Blood:Gas Co.:
Desflurane

A

MAC 6.6
VP 669
Blood Coefficient 0.42

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19
Q

Inhalation

MAC, VP, Blood:Gas Co.:
Isoflurane

A

MAC 1.17
VP 238
Blood Coefficient 1.46

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20
Q

Inhalation

MAC, VP, Blood:Gas Co.:
Nitrous Oxide

A

MAC 104
VP 🚀 38,770 gas
Blood Coefficient 0.46

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21
Q

Muscle Relaxants

Dose, Onset, Duration:
Succinylcholine

Anectine

A

1-1.5 mg/kg
Onset 30-60sec ⏐Durations 5-10min

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22
Q

Muscle Relaxants

Dose, Onset, Duration:
Cisatricurium

Nimbex

A

0.1 mg/kg
Onset 2-3min ⏐ Duration 40-75min

Hoffman Elimination

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23
Q

Muscle Relaxants

Dose, Onset, Duration:
Vecuronium

Norcuron

A

0.1 mg/kg
Onset 2-3min⏐ 45-90min

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24
Q

Muscle Relaxants

Dose (1st & 2nd), Onset, Duration:
Rocuronium

Zemuron

A

0.6 mg/kg Onset 2-3mins
1.2 mg/kg Onset 1.5 mins
Duration 35-75mins

25
# Muscle Relaxants Dose, Onset, Duration: **Pancuronium** | Pavulon
0.1 mg/kg Onset 2-3min ⏐Duration 60-120min
26
# Muscle Relaxants Reversals Dose, Onset, Duration, Anticholinergic buddy: **Neostigmine**
0.04-0.07 mg/kg Onset 5-10min ⏐ Duration 60min | **Glycopyrrolate 0.2mg/ml of Neo to avoid bradycardia**
27
# 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** 🙃
28
# REGIONAL MEDS Amide/Ester? MAX dose (mg/kg) w/ & w/o EPI? **Lidocaine**
Amide 5, 7
29
# REGIONAL MEDS Amide/Ester? MAX dose (mg/kg) w/ & w/o EPI? **Prilocaine**
Amide. 6, 8.5
30
# REGIONAL MEDS Amide/Ester? MAX dose (mg/kg) w/ & w/o EPI? **Mepivicaine**
Amide. 5, 7
31
# REGIONAL MEDS Amide/Ester? MAX dose (mg/kg) w/ & w/o EPI? **Bupivicaine**
Amide. 2.5, 2.5 | EPI DONT MAKE NO DIFFERENCE! 😅
32
# REGIONAL MEDS Amide/Ester? MAX dose (mg/kg) w/ & w/o EPI? **Ropivicaine**
Amide. 3, 4
33
# REGIONAL MEDS Amide/Ester? MAX dose (mg/kg) w/ & w/o EPI? **Procaine**
Ester. 7, 8.5
34
# REGIONAL MEDS Amide/Ester? MAX dose (mg/kg) w/ & w/o EPI? **Chloroprocaine**
Ester. 6, 14!
35
# REGIONAL MEDS Amide/Ester? MAX dose (mg/kg) w/ & w/o EPI? **Tetracaine**
Ester. 3, 3 | EPI MAKES NO DIFFERENCE 😅
36
# CSE LABOR ANALGESIA Epidural (%) & Spinal (mg) doses? **Bupivicaine**
0.0625-0.125% 1.25 - 2.5 ml
37
# CSE LABOR ANALGESIA Epidural (%) & Spinal (mL) doses? **Ropivicaine**
0.08 - 0.2% 2.5-4.5 mL
38
# CSE LABOR ANALGESIA Epidural (%) & Spinal (mL) doses? **Lidocaine + Epi**
2% in 5cc bolus N/A | No spinal dose.
39
# CSE LABOR ANALGESIA Epidural & Spinal doses? (mcg) **Fentanyl**
50-100 mcg 10-25 mcg
40
# CSE LABOR ANALGESIA Epidural & Spinal doses? (mcg) **Sufentanil**
5-10 mcg 1.5 - 5 mcg
41
# CSE LABOR ANALGESIA Epidural (%) & Spinal (mg) doses? **Morphine**
NO epidural dose. Spinal: 0.1 - 0.2 mg
42
# ANTIEMETICS Dose, Onset, Duration: **Droperidol** | Inapsine
0.625mg, 1-5min, 2-3hrs
43
# ANTIEMETICS Dose, Onset, Duration: **Promethazine** | Phenergran
6.25 -12.5 mg, 1-5mins, 4-6hrs
44
# ANTIEMETICS Dose, Onset, Duration: **Ondansetron** | Zofran
4mg, 10mins, 4-9hrs
45
# ANTIEMETICS Dose, Onset, Duration: **Dexamethasone** | Decadron
4mg, 10-30mins, 2-10hrs
46
# ANTIEMETICS Dose, Onset, Duration: **Metoclopramide** "Regular Reglan" | Reglan
10-20mg, 10mins, 2hrs
47
# ANTIEMETICS Dose, Onset, Duration: **Scopolamine**
Patch, 2-4hrs, 72hrs! | Non-hairy area - dont touch eyes after handling --> can cause mydriasis.
48
# ANTIEMETICS Dose (IVP and gtt): **Propofol** | Diprivan
10-15mg IV followed by 10**mcg**/kg/**min**
49
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
50
If I have 0 PONV risk factors, what is the chance I will have PONV?
10% | This requires NO pre-treament drugs.
51
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??
52
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
53
My chance of PONV is 20%. How many risk factors do I have? What drug(s) will you give me?
I have 1 risk factor and you should give me a 5HT-blocker like zofran :)
54
# NON OPIOID ANALGESICS 1x Dose/Frequency & daily MAX dose. **Acetaminophen** | Ofirmev
1000mg q 4-6hr MAX: 3-4g qd
55
# NON OPIOID ANALGESICS 1x Dose/Frequency & daily MAX dose. **Ketorlac** | Toradol
15-30mg q6h 60-120mg qd
56
# NON OPIOID ANALGESICS 1x Dose & daily MAX dose. **Ibuprofen** | Caldor
200-800mg q6h 3200mg qd
57
List some symptoms of LAST. | Local Anesthetic Systemic Toxicity
Analgesia, lightheadedness, tinnitis, tongue/circumoral numbness, tingling of mouth, funny/metallic taste, SZ, LOC, respiratory arrest, cardiovascular arrest.
58
Explain the lipid rescue for LAST.
In addition to CPR - 1. bolus 20% intralipids 0.25ml/kg/min 2. circulate lipids w/ CPR 3. repeat bolus q3-5 mins UP TO 3ml/kg total dose until ROSC. 4. ⬆ infusion to 0.5ml/kg/min if BP declines - continue infusion until hemodynamically stable. *MAX DOSE: 8ml/kg ## Footnote If you dont have 20% lipids immediately handy - give what you have until you obtain the 20%.

Principles 2 A (21 decks)

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