RSI Meds

Question 1

Classification of Etomidate

Answer 1

Anesthetic, Non-Barbiturate, Sedative/ hypnotic

Question 2

Etomidate Mechanism of Action

Answer 2

• Non-Barbiturate that prolongs the effect of GABA

- Depresses the activity and reactivity of the brain stem reticular system

Question 3

Etomidate Indications

Answer 3

• General Anesthesia
• Premedication for RSI
• Adjuncts for low potency anesthetics (Nitronox)

Question 4

Rocuronium Classification

Answer 4

Non-Depolarizing Neuromuscular Blockade

Question 5

Rocuronium MOA

Answer 5

Prevents acetylcholine from binding to receptors on the motor end plate, thus blocking action potential transmission and muscle contraction

Question 6

Rocuronium Indications

Answer 6

RSI or Pharmacologically assisted intubation

Question 7

Succinylcholine Classification

Answer 7

Paralytic, depolarizing neuromuscular blocking agent

Question 8

Succinylcholine MOA

Answer 8

Prevents Neuromuscular transmission by blocking the effect of acetylcholine at the myoneural junction

Question 9

Succinylcholine Indications

Answer 9

RSI

Question 10

Vecuronium Classification

Answer 10

Non Depolarizing skeletal muscle relaxant

Question 11

VECURONIUM TRADE NAME

Answer 11

Norcuron

Question 12

Vercuronium MOA

Answer 12

Inhibits neuromuscular transmission by competitively binding with acetylcholine motor endplate receptors resulting in muscle paralysis

Question 13

Vecuronium Indications

Answer 13

Pharmacologically assisted endotracheal intubation or RSI

Question 14

Fentanyl Trade Name

Answer 14

SUBLIMAZE

Question 15

Fentanyl Classification

Answer 15

Narcotic Analgesic

Question 16

Fentanyl MOA

Answer 16

Provides Analgesic and sedation by acting on the opiate receptors in the brain, blocking sensation of pain

Question 17

Fentanyl Indications

Answer 17

• Sedation during RSI

- moderate to severe pain

Question 18

Fentanyl Contraindications

Answer 18

• PT’s who have received MAO inhibitors in the last 14 days

- myasthenia gravis

Question 19

Fentanyl Dose

Answer 19

25-100 mcg or IM (over 2-3 minutes)

Peds: 2.0 mcg/kg slow IVP or IM

Question 20

Fentanyl Routes

Answer 20

IV IO IM TD

Question 21

Fentanyl Adverse Effects

Answer 21

• Cardiovascular: hypotension, bradycardia, circulatory depression, cardiac arrest
• Neurological: Sedation, euphoria, dizziness, diaphoresis, seizures with high doses, delirium,
• Respiratory: Respiratoy Depression, Arrest , bronchi constriction, laryngospasm
• G.I.: Nausea/ vomiting , constipation

Question 22

Fentanyl Precautions

Answer 22

Use with caution in head injuries, suspected or known increased ICP, the elderly, debilitated or immunocompromised pt’s, COPD or other respiratory problems and those with kidney or liver dysfunction. Use caution in pregnancy and in children <2 years old due to respiratory paralysis side effects

Question 23

Fentanyl Onset and Duration or Action

Answer 23

Onset is immediate, peak effect in 3-5 minutes IV, 5-15 IM, duration is 30-60 minutes (or hours with transdermal patch)

Question 24

Fentanyl interactions

Answer 24

Alcohol and other CNS depressants potentiate effects or fentanyl; MAO inhibitors May precipitate hypertensive crisis

Question 25

Flumazenil Classification

Answer 25

Benzodiazepine Antagonist

Question 26

Flumazenil MOA

Answer 26

Competes with Benzodiazepines at the binding site

Question 27

Flumazenil Indications

Answer 27

• Benzodiazepine overdose

- reversal of sedation in RSI