Top Drawer Meds

Question 1

MOA of Propofol

Question 2

Induction Dose Propofol

Answer 2

0.5-2.5mg/kg IV

(0.5 for some elderly. 2.5 for some kids or high drug use history)

Question 3

Infusion Dose of Propofol

Answer 3

25-200mcg/kg/min

(0.025mg-0.2mg/kg/min)

Question 4

Common Concentration of Propofol

Answer 4

10mg/mL

Question 5

Onset of action for propofol bolus

Answer 5

Usually 30-60seconds

Question 6

Duration of Action of Propofol Bolus

Answer 6

5-15minutes, dose dependent
D/t redistribution not body elimination

Question 7

Common Clinical Induction Dose of Propofol

Answer 7

150-200mg

Question 8

Neuro Effects of Propofol

Answer 8

Decreased CMRO2, Cerebral Blood Flow, ICO, IOP

Question 9

MOA of Etomidate

Question 10

Induction dose of Etomidate

Answer 10

0.2-0.4mg/kg IV

Common dose 20mg

Question 11

Onset and Duration of Action of Etomidate

Answer 11

Onset: 30-60s
Duration: 5-15min (redistribution, not metabolism)

Question 12

Side Effects and Considerations for Etomidate

Answer 12

Stable Hemodynamics (HR, SV, CO)
Decrease SVR

*Does NOT block SNS response to laryngoscopy
*No Analgesia
*Increases Nausea/Vomiting
*Adrenocortical Suppression for 5-8hrs (can be up to 24) via inhibition of 11-Beta Hydroxylase
*Myoclonus

Question 13

MOA of Ketamine

Answer 13

NMDA Antagonist

Secondary Receptors: Opioid, MAO, Serotonin, NE, Muscarinic, Na+ Channels

Question 14

IV and IM Induction Dose of Ketamine

Answer 14

IV: 1-2mg/kg

IM: 4-8mg/kg

Question 15

Analgesia Infusion Dose for Ketamine

Answer 15

0.1-0.5mg/kg

Question 16

Onset (IV and IM) and DOA of Ketamine

Answer 16

Onset IV: 30-120s
Onset IM: 2-4min

DOA: 10-20min

Question 17

Neuro effects of Ketamine

Answer 17

Cerebral Vasodilation –>Increased ICP
Nystagmus
Emergence Delirium
Decreased Seizure Threshold

Question 18

Common concentration of Ketamine

Answer 18

10mg/mL

Question 19

Side Effects and Considerations of Ketamine

Answer 19

Maintains Respiratory Drive
Increased Oral Secretions
Increased SNS Tone - SVR/ HR/CO

Question 20

Metabolite and its potency of Ketamine

Answer 20

Liver P450 to Norketamine (1/3-1/5 as potent)

Question 21

MOA of Dexmedetomidine

Question 22

IV Loading Dose of Precedex

Answer 22

1 mcg/kg over 10min

Question 23

Infusion Dose of Precedex

Answer 23

0.2-0.7mcg/kg/HR

Question 24

Concentration and Common Dilution of Precedex

Answer 24

100mcg/mL (2mL Vial)

Dilution: 4mcg/mL (place 200mcg [2mL] vial into 50mL bag)

Question 25

Onset and Duration of Action of Precedex

Answer 25

Onset: 2-5min DOA: 15-30min

Question 26

Common clinical adjuvant dose of Precedex

Answer 26

4-8mcg (MAX 20mcg or 0.25 mcg/kg)

Question 27

Side Effects and Considerations for Precedex

Answer 27

Bradycardia and Hypotension No Respiratory Depression Decreased Cerebral Blood Blood Flow (no change in CMRO2/ICP) Anti-Shivering Does not impair EPs

Question 28

Clinical Effect of Rapid Administration of Precedex

Answer 28

HTN from peripheral Alpha 2B vasoconstriction before centrally mediated Alpha 2A/C overpowers.

Question 29

Standard concentration of Succinylcholine

Answer 29

200mg/10mL

Question 30

Standard concentration of phenylephrine

Answer 30

100mcg/mL L

Question 31

Standard concentration of lidocaine in Pyxis for IV admin

Answer 31

2% usually 20mg/mL

Question 32

Standard Etomidate concentration

Answer 32

2mg/mL

Question 33

Standard Midazolam concentration

Answer 33

1mg/mL

Question 34

Standard Rocuronium concentration

Answer 34

50mg/5mL 10mg/mL

Question 35

Usual concentration of Labetalol

Answer 35

5mg/mL

Question 36

Standard VIAL concentration of Ephedrine

Answer 36

50mg/mL

Question 37

Standard Fentanyl concentration

Answer 37

50mcg/mL