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Medications > Top Drawer Meds > Flashcards

Top Drawer Meds Flashcards

1
Q

Rocuronium/ Zemuron dose and concentration
RSI
Intubation

A

1 vial= 10 cc (10 mg/cc) draw up 5 cc in a 5 cc syringe
RSI: 0.6-1.2mg/kg
Intubation: 0.45 - 0.6 mg/kg

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2
Q

Rocuronium/ Zemuron MOA

A

Non-depolarizer; acetylcholine receptor antagonist; inhibits depolarization

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3
Q

Rocuronium/ Zemuron onset and duration

A

onset: 6 minutes
duration: 30 minutes

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4
Q

Rocuronium/ Zemuron cautions

A

Histamine can cause anaphylaxis, caution in renal patients

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5
Q

Vecuronium/ Norcuron concentration; doses (RSI; intubation)

A

1 vial = 10 cc (1 mg/ cc) dilute powder in 10 cc NS, syringe = 10mg
RSI: 0.3 mg/kg
Intubation: 0.08-0.1 mg/kg

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6
Q

Vecuronium/ Norcuron MOA

A

Non-depolarizer; acetylcholine receptor antagonist

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7
Q

Vecuronium/ Norcuron onset and duration

A

Onset: 3-5 minutes
Duration: 20-60 minutes

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8
Q

Vecuronium/ Norcuron considerations

A

More predictable than roc, consider for longer cases

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9
Q

Succinylcholine/ Anectine concentration and doses

A

1 vial: 10cc (20 mg/cc) draw up 5 cc
RSI: 1-1.5 mg/kg
Intubation: 0.6mg/kg
Laryngospasm: 0.3mg/kg

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10
Q

Succinylcholine/ anectine MOA

A

Depolarizer, mimics acetylcholine on nicotinic acth receptors (mimics arch depolarizing at motor end plate)

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11
Q

Succinylcholine/ Anectine onset and duration

A

Onset: 30 seconds
Duration: 5 minutes

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12
Q

Succinylcholine/ Anectine cautions and CI

A 
MH trigger
Histamine release
Hyperkalemia (expect 0.5 meq increases)
Stroke etc. for extrajunctional receptors
CI: MD, DMD, MS
Resistant: MG; sensitive: in LEMS
Caution in children
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13
Q

Midazolam/ Versed concentration and doses

A

1 vial: 2 cc (1mg/cc)
Pre-op: 0.02-0.04 mg/kg, usually about 2mg given in prep
Induction: 0.2-0.4 mg/kg

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14
Q

Midazolam/ Versed MOA

A

GABA receptor agonist; chloride influx occurs & cell becomes hyperpolarized

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15
Q

Midazolam/ Versed onset

A

<60 seconds

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16
Q

Midazolam/ Versed caution

A

Elderly & quick cases

Can have paradoxical excitatory effect

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17
Q

Fentanyl/ Sublimaze concentration and doses

A

1 vial= 2 cc (50 mcg/cc)

1-2 mcg/kg or 25-100 mcg/dose

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18
Q

Fentanyl/ Sublimaze MOA

A

Mu opioid receptor agonist

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19
Q

Fentanyl/ Sublimaze onset and duration

A

Rapid, 30-60 minutes

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20
Q

Fentanyl/ Sublimaze cautions

A

Possible cough & itchy nose after administration
Chest wall rigidity
Post-op urinary retention

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21
Q

Lidocaine/ Xylocaine concentration and dose

A

1 vial= 5 cc= 100 mg (20 mg/cc; 2%)

1-1.5 mg/kg

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22
Q

Lidocaine/ Xylocaine MOA

A

Class lb antiarrhythmic; membrane impermeable to NA+ and cell is unable to depolarize

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23
Q

Lidocaine/ Xylocaine onset and duration

A

45-90 seconds

T 1/2 30 minutes

24
Q

Propofol/ Diprivan concentration and dose

A

1 vial = 20 cc (10mg/cc) *always have an extra syringe

2-2.5 mg/kg

25
Q

Propofol/ Diprivan MOA

A

GABA receptor agonist; chloride influx and cell hyperpolorization

26
Q

Propofol/ Diprivan onset and duration

A

<30 seconds, duration 10 minutes

27
Q

Propofol/ Diprivan cautions/ good to know

A

Egg (yolk allergy) typically the allergy is in the protein in white
Sulfa allergy
Histamine release
Burns on administration
Slight increase in HR
Increase dose in alcoholics, decrease dose in acute ETOH intoxication

28
Q

Etomidate/ Amidate concentration and dose

A

1 vial= 2 mg/cc (10 cc in 10cc syringe)

0.2-0.6 mg/kg

29
Q

Etomidate/ Amidate MOA

A

GABA receptor agonist

30
Q

Etomidate/ Amidate onset and duration

A

<30 seconds

About 10 minutes

31
Q

Etomidate/ Amidate cautions/ good to knows

A

Adrenal suppression

More hemodynamically stable than prop or ketamine; consider in cardiac pt

32
Q

Ketamine/ Ketalar IV and IM dose

A

IV: 1-2 mg/kg
IM: 6-13 mg/kg

33
Q

Ketamine/ Ketalar MOA

A

NMDA receptor antagonist; blocks glutamate

Analgesia, maintains respiratory drive

34
Q

Ketamine onset and duration

A

30 seconds

8-15 minutes

35
Q

With ketamine, you should co-administer

A

Versed for dissociative effects

Glycolic for increased secretions (bronchodilator)

36
Q

Ketamine/ Ketalar good to know/ cautions

A

Increase IOP & HR 2/2 to catecholamine release

Maintains SVR b/c it indirectly increased catecholamine

37
Q

Sugammadex doses

A

2 mg/ kg in 2 twitches
4 mg/kg in deep sedation
16 mg/kg with no twitches

38
Q

Sugammadex MOA

A

Surrounds & inactivates ROC/ VEC molecule, no rush of ACTH

39
Q

Sugammadex onset

A

30 seconds

40
Q

Neostigmine dose

A
  1. 5-5 mg/dose

0. 02-0.08 mg/kg

41
Q

Neostigmine MOA

A

Acetylcholinesterase inhibitor; ACTH not broken down & competes with NMB to overcome paralytic effect

42
Q

Phenylephrine/ Neosynephrine concentration and dose

A

Dilute 1 vial/ 1cc of phenylephrine (10mg/cc) in 100 cc NS= 100mcg/cc; draw up into a 10 cc syringe post dilution
100-500 mcg/dose Q 10-15 minutes

43
Q

Phenylephrine/ Neo MOA

A

Potent, alpha 1 agonist; produces systemic arterial vasoconstriction

44
Q

Phenylephrine/ Neo onset and duration

A

Immediate, 15-20 minutes

45
Q

Phenylephrine/ Neo cautions

A

Causes bradycardia r/t baroreceptor reflex

46
Q

Ephedrine concentration/ doses

A

1 vial = 1 cc, dilute 1 vial (1cc) of ephedrine (50 mg/cc) in 4cc of NSS making 10 mg/cc solution
5-25 mg/dose

47
Q

Ephedrine MOA

A

Beta 1 & alpha 1 agonist; stimulates adrenal medulla to release endogenous norepinephrine

48
Q

Ephedrine cautions

A

Tachycardia

49
Q

Atropine doses

A

1 mg/cc or 0.4 mg/cc (varies institutionally)
Salivation: 0.01-0.02 mg/kg/dose to max of 0.4mg/dose (min dose 0.1 mg)
Bradycardia: 0.02 mg/kg, min dose 0.1 mg, repeat Q3-5minutes total of 1mg

50
Q

Atropine MOA

A

Blocks Ach at parasympathetic sites in smooth muscle, secretory glands & CNS; increases CO, dries secretions. NO effect on nicotinic receptors responsible for muscle weakness, fasiculations & paralysis

51
Q

Atropine onset

A

Rapid, tertiary

52
Q

Glycopyrrolate/ Robinul concentration and dose

A

1 vial= 1 cc (0.2mg/cc)

Administer 0.2mg for each 1mg of neostigmine administered

53
Q

Glycopyrrolate/ Robinul MOA

A

Blocks Ach at parasympathetic sites of smooth muscle, secretary glands and CNS; indirectly reduces rate of salivation by preventing stimulation of acetycholine receptors

54
Q

Glycopyrrolate/ Robinul onset and duration

A

1 minute, 2-3 hours (vagal stimulation) and 7 hours (inhibition of salivation)

55
Q

Glycopyrrolate/ Robinul cautions and good to know

A

Give before Neo*
Caution glyco & atropine in CAD r/t increased HR
Quat

Medications (1 decks)

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