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Pharmacology > RSI drugs > Flashcards

RSI drugs Flashcards

1
Q

What are the commonly used induction agents for RSI?

A

-etomidate
-propofol
-ketamine
-midazolam

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2
Q

What are the commonly used paralytics for RSI?

A

-succinylcholine
-rocuronium
-vercuronium
-pancuronium

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3
Q

What type of drug is etomidate?

A

-imidazole derivative
-activates GABA receptors

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4
Q

What type of drug is propofol?

A

-alkylphenol derivative
-potentiates GABA receptors

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5
Q

What type of drug is ketamine?

A

-phencyclidine derivative
-non-competitive antagonist of NMDA

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6
Q

What type of drug is midazolam?

A

benzodiazepine

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7
Q

What type of drug is succinylcholine?

A

depolarizing agent

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8
Q

What type of drug is rocuronium?

A

non-depolarizing agent

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9
Q

What type of drug is vecuronium?

A

non-depolarizing agent

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10
Q

What type of drug is pancuronium?

A

non-depolarizing agent

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11
Q

What are the pros of using etomidate?

A

-no hypotension
-no increase in ICP
-short onset of action and half-life
-preferred in trauma

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12
Q

What are the pros of using propofol?

A

-may be neuroprotective
-quick onset and short duration

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13
Q

What are the pros of using propofol?

A

-may be neuroprotective by reducing intracranial pressure
-has anticonvulsive and anti-emetic properties
-quick onset and short duration
-can be used as an infusion

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14
Q

What are the pros of using ketamine?

A

-provides sedation and analgesia
-preserves respiratory drive
-can increase MAP
-has bronchodilator properties that make it good in severe asthma

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15
Q

What are the pros of using midazolam?

A

-good for providing amnesia

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16
Q

What are the pros of using midazolam?

A

-good for providing amnesia
-anticonvulsant

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17
Q

What are the pros of using succinylcholine?

A

-best choice, if one of its many contraindications isn’t a problem

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18
Q

What are the pros of using succinylcholine?

A

-best choice, if one of its many contraindications isn’t a problem

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19
Q

What are the pros of using rocuronium?

A

similar to SCh, but without all the contraindications

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20
Q

What are the pros of using rocuronium?

A

similar to SCh, but without all the contraindications

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21
Q

What are the adverse effects of etomidate?

A

-transient adrenal suppression
-controversial concerns in sepsis and trauma
-transient myoclonus

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22
Q

What are the adverse effects of propofol?

A

-myocardial depression
-peripheral vasodilation –> decreased MAP
-needs to be avoided in hypovolemic pt

23
Q

What are the adverse effects of midazolam?

A

-drops MAP 10-25% in healthy pts
-does not provide analgesia

23
Q

What are the adverse effects of ketamine?

A

-may increase ICP (controversial)

24
Q

What are the adverse effects of succinylcholine?

A

-increases ICP
-in peds causes bradycardia (get the atropine ready)

25
Q

What are the contraindications to using succinylcholine?

A

-hyperkalemia
-h/o malignant hyperthermia
-muscular dystrophy
-rhabdomyolysis
-burns >72hr old

26
Q

What are the adverse effects of rocuronium?

A

-long acting so if a difficult airway be careful because the pt will be paralyzed and unable to breath on their own

27
Q

What is the dosing for rocuronium?

A

1mg/kg

28
Q

What is the dosing for succinylcholine?

A

1.5-2mg/kg

29
Q

What is the dosing for midazolam?

A

0.-0.3mg/kg

30
Q

What is the dosing for midazolam?

A

0.1-0.3mg/kg

31
Q

What is the dosing for ketamine?

A

1-2mg/kg

32
Q

What is the dosing for propofol?

A

1.5-3mg/kg

33
Q

What is the dosing for etomidate?

A

0.3mg/kg

34
Q

What is the onset and duration of etomidate?

A

-15-45s
-3-12min

35
Q

What is the onset and duration of propofol?

A

-15-45s
-5-10min

36
Q

What is the onset and duration of ketamine?

A

-45-60s
-10-20min

37
Q

What is the onset and duration of midazolam?

A

-30-60s
-15-30min

38
Q

What is the onset and duration of succinylcholine?

A

-45-60s
-6-10min

39
Q

What is the onset and duration of rocuronium?

A

-45-60s
-45-80min

40
Q

What is the onset and duration of vecuronium?

A

-1.5-3min
-45-90min

41
Q

What are the pros of using succinylcholine?

A

-best choice, if one of its many contraindications isn’t a problem

41
Q

What are the adverse effects of ketamine?

A

-may increase ICP (controversial)

41
Q

What is the onset and duration of pancuronium?

A

-3-5min
-60-90min

41
Q

What are the adverse effects of propofol?

A

-myocardial depression
-peripheral vasodilation –> decreased MAP
-needs to be avoided in hypovolemic pt

41
Q

What is the onset and duration of vecuronium?

A

-1.5-3min
-45-90min

42
Q

What are the adverse effects of propofol?

A

-myocardial depression
-peripheral vasodilation –> decreased MAP
-needs to be avoided in hypovolemic pt

42
Q

What are the adverse effects of ketamine?

A

-may increase ICP (controversial)

43
Q

What medications can cause a prolonged effect of nondepolarizing agents?

A

-aminoglycosides
-clindamycin

44
Q

What disorders/conditions can cause a prolonged effect of nondepolarizing agents?

A

-hypermagnesemia
-myasthenia gravis
-hypothermia

45
Q

Which nondepolarizing agents have a metabolite that can cross the blood brain barrier and cause seizures?

A

-cistatracurium and atracurium
-metabolized to laudanosine

46
Q

How are cisatracurium and atracurium metablized?

A

-Hofmann elimination
-so can use in liver failure

47
Q

How are rocuronium, vecuronium, pancuronium metabolized?

A

-metabolized in the liver
-eliminated by the kidney

Pharmacology (5 decks)

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