RSI Pharmacology

Question 1

succinylcholine (trade name)

Answer 1

Anectine

Question 2

Anectine (generic name)

Answer 2

succinylcholine

Question 3

rocuronium (trade name)

Answer 3

Zemuron

Question 4

Zemuron (generic name)

Answer 4

rocuronium

Question 5

vecuronium (trade name)

Answer 5

Norcuron

Question 6

Norcuron (generic name)

Answer 6

vecuronium

Question 7

midazolam (trade name)

Answer 7

Versed

Question 8

Versed (generic name)

Answer 8

midazolam

Question 9

etomidate (trade name)

Answer 9

Amidate

Question 10

Amidate (generic name)

Answer 10

etomidate

Question 11

ketamine (trade name)

Answer 11

Ketalar

Question 12

Ketalar (generic name)

Answer 12

ketamine

Question 13

Succinylcholine classification

Answer 13

Depolarizing neuromuscular blocker

Question 14

Succinylcholine action

Answer 14

Competes with the ACh receptor of the muscle cell, resulting in depolarization

Question 15

Succinylcholine indications

Answer 15

To induce neuromuscular blockade for the facilitation of ET intubation

Question 16

Succinylcholine contraindications

Answer 16

Malignant hyperthermia, burns, trauma, known hyperkalemia

Question 17

Succinylcholine dosage (adult)

Answer 17

0.6 mg/kg IV
0.3-1.1 mg/kg IO
3-4 mg/kg IM (max dose 150 mg)

Question 18

Succinylcholine dosage (pediatrics)

Answer 18

1 mg/kg IV/IO (adolescents)
2 mg/kg IV/IO (small children)
3-4 mg/kg IM (max dose 150 mg)

Question 19

Rocuronium classification

Answer 19

Nondepolarizing neuromuscular blocker

Question 20

Rocuronium action

Answer 20

Antagonizes ACh at the receptor, producing muscle paralysis

Question 21

Rocuronium indications

Answer 21

To induce neuromuscular blockade for the facilitation of ET intubation

Question 22

Rocuronium contraindications

Answer 22

Known sensitivity to bromides. Use with caution in heart/liver disease

Question 23

Rocuronium dosage (adult)

Answer 23

06-1.2 mg/kg IV/IO

Question 24

Rocuronium dosage (pediatric)

Answer 24

0.9-1.2 mg/kg IV/IO (>3 months)

Question 25

Succinylcholine onset and duration

Answer 25

Onset is 0.5-1 minute IV, 2-3 minutes IM | Duration is approximately 5 minutes

Question 26

Succinylcholine considerations

Answer 26

``` Can produce profound bradycardia in pediatrics Pregnancy class C ```

Question 27

Rocuronium onset and duration

Answer 27

Onset is 0.5-2 minutes | Duration is approximately 30 minuntes

Question 28

Rocuronium considerations

Answer 28

Pregnancy class B

Question 29

Vecuronium classification

Answer 29

Nondepolarizing neuromuscular blocker

Question 30

Vecuronium action

Answer 30

Antagonizes ACh at the receptor, producing skeletal muscle paralysis

Question 31

Vecuronium indications

Answer 31

To induce neuromuscular blockade for the facilitation of ET intubation

Question 32

Vecuronium contraindications

Answer 32

Known sensitivity to bromides. Use with caution in heart/liver disease

Question 33

Vecuronium dosage (adult)

Answer 33

0.08-0.1 mg/kg IV/IO

Question 34

Vecuronium dose (pediatrics)

Answer 34

0.1-0.15 mg/kg IV/IO

Question 35

Vecuronium onset and duration

Answer 35

Onset is 1-3 minutes | Duration is 25-40 minutes

Question 36

Vecuronium considerations

Answer 36

Pregnancy class C

Question 37

Midazolam classification

Answer 37

Benzodiazepine, Schedule C-IV

Question 38

Midazolam action

Answer 38

Enhances GABA, producing short-acting CNS depression

Question 39

Midazolam indications

Answer 39

Sedation, anxiety, skeletal muscle relaxation

Question 40

Midazolam contraindications

Answer 40

Acute-angle glaucoma, pregnant women, known sensitivity

Question 41

Midazolam dosage (adult)

Answer 41

1-2.5 mg IV/IO, max of 5 Less may be needed for older, more ill patients (generally max of 3) 0.02-0.1 mg/kg/hr for continuous infusion

Question 42

Midazolam dosage (pediatrics)

Answer 42

12-16 yo: same as adults, max 10mg 6-12 yo: 0.025-0.05 mg/kg IV/IO, max 0.4 mg/kg not to exceed 10mg 6mo-5yo: 0.05-0.1 mg/kg IV/IO, max 0.6mg/kg not to exceed 6 mg <6mo: 0.05-0.1 mg/kg IV/IO

Question 43

Midazolam considerations

Answer 43

Pregnancy class D

Question 44

Etomidate classification

Answer 44

Hypnotic, anesthesia induction agent

Question 45

Etomidate action

Answer 45

GABA-like effects

Question 46

Etomidate indications

Answer 46

Induction for RSI and pharmacologic-assisted intubation; induction of anesthesia

Question 47

Etomidate contraindications

Answer 47

Known sensitivity. Use in pregnancy only if the benefits outweigh the risks. Do not use during labor or in nursing mothers

Question 48

Etomidate dosage (adult)

Answer 48

0.2-0.6 mg/kg slow IV

Question 49

Etomidate dosage (pediatric)

Answer 49

>10 yo: 0.2-0.6 mg/kg slow IV | <10 yo: safety has not been established

Question 50

Etomidate considerations

Answer 50

Pregnancy class C. Only use if benefits outweigh risks

Question 51

Ketamine classification

Answer 51

General anesthetic, analgesic, sedative

Question 52

Ketamine action

Answer 52

Produces a state of anesthesia while maintaining airway reflexes and stable vitals

Question 53

Ketamine indications

Answer 53

Pain and as anesthesia for procedures of short duration

Question 54

Ketamine contraindications

Answer 54

Patients in whom a significant elevation in BP would be hazardous (HTN, stroke, head trauma, MI), caution in patients with increased ICP and patients with hypovolemia, dehydration, or cardiac disease

Question 55

Ketamine dosage (adult)

Answer 55

1-4.5 mg/kg slow IV/IO | 6.5-13 mg/kg IM

Question 56

Ketamine dosage (pediatric)

Answer 56

0.5-2 mg/kg slow IV/IO | 4-5 mg/kg IM

Question 57

Ketamine considerations

Answer 57

Pregnancy class C