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Anesthesia Basics > PNS And NMB > Flashcards

PNS And NMB Flashcards

1
Q

4 monitoring phases

A

Baseline (no NMB)
Intubation- intub dose NMB
Maintenance- redosing
Emergence- reversal

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2
Q

Order of muscles most resistant to most sensitive 8

A

VC, diaphragm, orbicularis oculi, abd rectus, adductor pollicis, masseter, pharyngeal, extraocular

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3
Q

% NMB left with: 4 responses, 3 responses, 2 responses, 1 response

A

<70%, 75%, 80%, 90%

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4
Q

TOF ratio

Use, how to

A

Non depolarizing blocks. Last divided by first

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5
Q

NMB dosing types

A

Intubating dose, relaxant dose (after sch for ett), or defasciculating (before sch)

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6
Q

Succ

__ acting. Dose. Larger dose needed when what

A

Short. 0.5-2 mg/kg. If precurarization w NDMR.

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7
Q

Succ

Onset, DOA, gtt rate

A

30-60 sec. 3-5 min. 1g/500 ml, 2-4 mg/min or 50-100 mcg/kg/min

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8
Q

Mivacurium

__ acting. Dose. When to use.

A

Short. 0.2 mg/kg. To avoid myalgia w succ

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9
Q

Mivacurium

Onset, DOA, useful when

A

2-3 min, 12-20 min. O/P surgery for intubation

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10
Q

Intermediate acting
DOA
Onset- which most rapid
Minimal __ effects

A

20-30 min. Roc. Circulatory.

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11
Q

How much of dose as priming dose

A

1/10 of surgical relaxation dose

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12
Q

Doses
Roc
Vec

A

0.6-1.2 mg/kg

.1-.2 mg/kg

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13
Q

Doses
Atracurium
Cis-atracurium

A

.2-.5 mg/kg

.15-.2 mg/kg

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14
Q

Long acting muscle relaxants
Onset
Maintenance for which procedure length
Duration

A

3-5 min, >2 hr procedure, 60-90 min

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15
Q

Long acting muscle relaxants

Drug, dose

A

Pancuronium

.07-.15 mg/kg

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16
Q

Gtt rate
Atracurium
Vec
Roc

A

4-12 mcg/kg/min
1 mcg/kg/min
3-12 mcg/kg/min

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17
Q

Gtt rate
Cisatracurium
Mivacurium

A

0.4-4 mcg/kg/min

3-15 mcg/kg/min

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18
Q

Intubating dose (mg/kg)
Panc
Doxacurium

A

.1

.05-.08

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19
Q

Intubating dose (mg/kg)
Pipecuronium
Atracurium

A

.14

.4-.5

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20
Q

Intubating dose (mg/kg)
Vec
Roc

A

.08-.1

.6-1.2

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21
Q

Intubating dose (mg/kg)
Cisatracurium
Mivacurium

22
Q

Adequate surgical relaxation for abdominal surgery

A

> 80% twitch depression, 1 or 2 twitches on TOF

23
Q

Succ

Intermittent doses, max, timing

A

0.6 mg/kg over 10-30 sec, 150 mg total

24
Q

Succ maintenance dose, timing

A

.04-.07 mg/kg q 5-10 min

25
Q

Succ gtt dose

A

2.5 mg/min (0.5-10)

Dilute 1-2 mg/ml

26
Q

Mivacurium
Intubation dose
Extended block dose
Recovery when

A

.15mg/kg bolus
6-7 mcg/kg/min
15-30 min

27
Q

Roc
Intubation: rsi
Maintenance

A

.6-1.2 mg/kg, 0.6 initial.

.1-.2 mg/kg

28
Q

Roc

Maintenance dose gtt

A

.01-.012 mg/kg/min

29
Q

Roc
Skeletal muscle relaxation
Initial, maint

A

0.6 mg/kg. 0.1-0.2 mg/kg repeated as needed or just do gtt

30
Q

Vec
Intermittent dose
Higher dose for rapid onset
Maintenance

A

.08-.1 mg/kg IBW. (0.3)

.01-.015 mg/kg q 25-45 min

31
Q

Vec
Bolus then gtt
Reduce dose in who

A

.08-.3 mg/kg bolus, then in 30 min.1 mcg/kg/min (0.8-1.2).

Renal failure q

32
Q

Atracurium
May be given as what
Initial bolus then which dose after

A

Undiluted

0.4-.5 mg/kg then .08-.01 mg/kg q 20-45 min

33
Q

Atracurium

Gtt

A

After bolus (.4 mg), 5-9 mcg/kg/min gtt. (2-15 range)

34
Q

Atracurium
Dont use in what, why
Vial concentration

A

Renal failure- toxic metabolite iadanosine

50 mg/5 ml or 100 mg/10 ml

35
Q

Cisatracurium (nimbex)

Initial dose, following doses

A

.15-.2 MG/KG

.03 mg/kg q 50 min

36
Q

Nimbex
Gtt
Dose reductions

A

Bolus dose then 1-3 mcg/kg/min. Renal or hepatic failure- dont need to reduce dose

37
Q

Nimbex is DOC in which cases

A

HR high or MAP >110 on panc, steroid use >72hrs, renal dysfunc (cr cl <30 ml/min), hx asthma/bronchospasm

38
Q

Pancuronium
Intermittent dose
Bolus/gtt

A

.1-.2 mg/kg q 1-3 hrs

Load: .04-.1 mg/kg, then 1-1.7 mcg/kg/min

39
Q

Doxacurium
Anesthesia adjunct
Initial then what, duration

A

.05-.08 mg/kg, 100-160 min

40
Q

Doxacurium

Maintenance, duration

A

.005-.01 mg/kg, 30-45 min

41
Q

Doxacurium
ETT intubation dose
Concentration

A

.05 mg/kg. If w succ .025.

1 mg/ml

42
Q

__, __, and __ are antag by __ within __ min when single twitch is 10% of control. Or __ min when all 4 twitches are present

A

Atra, vec, panc. 30. 10.

43
Q 
Test - TOF equivalent 
5 sec head/leg lift 
Normal grip 
Masseter 
All uncomfortable at TOF
44
Q

Neostigmine

Dose, onset, duration

A

25-75 mcg/kg
5-15 min
45-90 min

45
Q

Pyridostigmine
Dose
On
DOA

A

100-300 mcg/kg
10-20
60-120

46
Q

Edrophonium
Dose
On
DOA

A

500-1000 mcg/kg
5-10
30-60

47
Q

Atropine
Dose
Onset
Duration

A

15 mcg/kg
1-2 min
1-2 hr

48
Q

Glyco
Dose
Onset
DOA

A

10-20 mcg/kg
2 min
2-4 hr

49
Q

Which drug most reliable in deep block

A

Neostigmine

50
Q

Onset and peak glyco vs neostigmine. Atropine peak.

A

Neo: on 3 min, peak 7-10 min. Glyco peaks 3-5 min. Atropine 1-2 min

Anesthesia Basics (10 decks)

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