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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
Q

Muscle Relaxants

Dose, Onset, Duration:
Pancuronium

Pavulon

A

0.1 mg/kg
Onset 2-3min ⏐Duration 60-120min

26
Q

Muscle Relaxants Reversals

Dose, Onset, Duration, Anticholinergic buddy:
Neostigmine

A

0.04-0.07 mg/kg
Onset 5-10min ⏐ Duration 60min

Glycopyrrolate 0.2mg/ml of Neo to avoid bradycardia

27
Q

Muscle Relaxants Reversals

Dose, Onset, Duration, Anticholinergic buddy:
Sugammadex

A

2-16 mg/kg (depends on TOF & PTP)
Onset 1-4min ⏐ Duration 1.5-3hrs

NONE 🙃

28
Q

REGIONAL MEDS

Amide/Ester?
MAX dose (mg/kg) w/ & w/o EPI?
Lidocaine

A

Amide
5, 7

29
Q

REGIONAL MEDS

Amide/Ester?
MAX dose (mg/kg) w/ & w/o EPI?
Prilocaine

A

Amide.
6, 8.5

30
Q

REGIONAL MEDS

Amide/Ester?
MAX dose (mg/kg) w/ & w/o EPI?
Mepivicaine

A

Amide.
5, 7

31
Q

REGIONAL MEDS

Amide/Ester?
MAX dose (mg/kg) w/ & w/o EPI?
Bupivicaine

A

Amide.
2.5, 2.5

EPI DONT MAKE NO DIFFERENCE! 😅

32
Q

REGIONAL MEDS

Amide/Ester?
MAX dose (mg/kg) w/ & w/o EPI?
Ropivicaine

A

Amide.
3, 4

33
Q

REGIONAL MEDS

Amide/Ester?
MAX dose (mg/kg) w/ & w/o EPI?
Procaine

A

Ester.
7, 8.5

34
Q

REGIONAL MEDS

Amide/Ester?
MAX dose (mg/kg) w/ & w/o EPI?
Chloroprocaine

A

Ester.
6, 14!

35
Q

REGIONAL MEDS

Amide/Ester?
MAX dose (mg/kg) w/ & w/o EPI?
Tetracaine

A

Ester.
3, 3

EPI MAKES NO DIFFERENCE 😅

36
Q

CSE LABOR ANALGESIA

Epidural (%) & Spinal (mg) doses?
Bupivicaine

A

0.0625-0.125%
1.25 - 2.5 ml

37
Q

CSE LABOR ANALGESIA

Epidural (%) & Spinal (mL) doses?
Ropivicaine

A

0.08 - 0.2%
2.5-4.5 mL

38
Q

CSE LABOR ANALGESIA

Epidural (%) & Spinal (mL) doses?
Lidocaine + Epi

A

2% in 5cc bolus
N/A

No spinal dose.

39
Q

CSE LABOR ANALGESIA

Epidural & Spinal doses? (mcg)
Fentanyl

A

50-100 mcg
10-25 mcg

40
Q

CSE LABOR ANALGESIA

Epidural & Spinal doses? (mcg)
Sufentanil

A

5-10 mcg
1.5 - 5 mcg

41
Q

CSE LABOR ANALGESIA

Epidural (%) & Spinal (mg) doses?
Morphine

A

NO epidural dose.
Spinal: 0.1 - 0.2 mg

42
Q

ANTIEMETICS

Dose, Onset, Duration:
Droperidol

Inapsine

A

0.625mg, 1-5min, 2-3hrs

43
Q

ANTIEMETICS

Dose, Onset, Duration:
Promethazine

Phenergran

A

6.25 -12.5 mg, 1-5mins, 4-6hrs

44
Q

ANTIEMETICS

Dose, Onset, Duration:
Ondansetron

Zofran

A

4mg, 10mins, 4-9hrs

45
Q

ANTIEMETICS

Dose, Onset, Duration:
Dexamethasone

Decadron

A

4mg, 10-30mins, 2-10hrs

46
Q

ANTIEMETICS

Dose, Onset, Duration:
Metoclopramide
“Regular Reglan”

Reglan

A

10-20mg, 10mins, 2hrs

47
Q

ANTIEMETICS

Dose, Onset, Duration:
Scopolamine

A

Patch, 2-4hrs, 72hrs!

Non-hairy area - dont touch eyes after handling –> can cause mydriasis.

48
Q

ANTIEMETICS

Dose (IVP and gtt):
Propofol

Diprivan

A

10-15mg IV followed by 10mcg/kg/min

49
Q

List some PONV risk factors.

A

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
Q

If I have 0 PONV risk factors, what is the chance I will have PONV?

A

10%

This requires NO pre-treament drugs.

51
Q

If I have 3 PONV risk factors, what is the chance I will have PONV?
What drugs will you pre-treat your patient with?

A

> 60% chance.
Give at least 3 pre-treament drugs: 5HT blocker, steroid, propofol + TIVA??

52
Q

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?

A

2 risk factors = 40% chance of developing PONV

53
Q

My chance of PONV is 20%.

How many risk factors do I have?
What drug(s) will you give me?

A

I have 1 risk factor and you should give me a 5HT-blocker like zofran :)

54
Q

NON OPIOID ANALGESICS

1x Dose/Frequency & daily MAX dose.
Acetaminophen

Ofirmev

A

1000mg q 4-6hr
MAX: 3-4g qd

55
Q

NON OPIOID ANALGESICS

1x Dose/Frequency & daily MAX dose.
Ketorlac

Toradol

A

15-30mg q6h
60-120mg qd

56
Q

NON OPIOID ANALGESICS

1x Dose & daily MAX dose.
Ibuprofen

Caldor

A

200-800mg q6h
3200mg qd

57
Q

List some symptoms of LAST.

Local Anesthetic Systemic Toxicity

A

Analgesia, lightheadedness, tinnitis, tongue/circumoral numbness, tingling of mouth, funny/metallic taste, SZ, LOC, respiratory arrest, cardiovascular arrest.

58
Q

Explain the lipid rescue for LAST.

A

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

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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