Sedation and Analgesia

Question 1

Main opioid in patients with renal failure

Answer 1

Hydromorphone (dilaudid)

Question 2

Opioid that lowers seizure threshold

Answer 2

Meperidine (demerol)

Question 3

Opioid that prolongs the QT interval

Answer 3

Methadone

Question 4

Typical scale in the ICU for agitation and sedation

Answer 4

Richmond Agitation-Sedation Scale (RASS)

Question 5

Are intermittent or continuous sedation medications preferred?

Answer 5

Intermittent

Question 6

Preferred benzo in patients with renal failure

Answer 6

Lorazepam

Question 7

Benzo that can cause propylene glycol toxicity if given as infusion (causes HAGMA)

Answer 7

Lorazepam

Question 8

4 key features of propofol infusion syndrome

Answer 8

Rhabdo
Metabolic acidosis
Hyperkalemia
Renal failure

Question 9

Most common method of evaluating delirium score in the ICU

Answer 9

CAM-ICU

Question 10

Medication initially for delirium that worsens outcomes and is now contraindicated

Answer 10

Rivastigmine

Question 11

Is SIMV, PSV, or T-piece better for weaning off vent?

Answer 11

PSV (NEJM 1995)

Question 12

Duration of SBT trial needed

Answer 12

30 minutes (JAMA 2019 and AJRCCM 1999)

no better than 2 hours

Question 13

3 issues that each contribute 33% chance of failing extubation?

Answer 13

Poor cough effort
Secretions
Can’t complete 4 simple commands

(CHEST 2006)

Question 14

CO2 threshold that has improved mortality if extubated to NIPPV

Answer 14

> 45

Question 15

Treatment that if done with extubation failure will increase mortality the longer you use it

Answer 15

NIPPV (if they fail extubation, reintubate)