TOTCD 5 (5)

Question 1

LABETALOL (NORMODYNE, TRANDATE) dose, Gtt, max cumulative dose

Answer 1

Single Dose: 2.5-20mg (over 2min)
Gtt: 0.5-2mg/min
Cumulative Dose: 1-4mg/kg

Question 2

LABETALOL (NORMODYNE, TRANDATE) MOA, indications

Answer 2

Nonselective adrenergic receptor blocking agent with mild alpha, and predominant beta activity (Alpha:Beta = 1:7 (IV), 1:3 (PO)). Decreased BP with minimal risk of reflex tachycardia. Risk of bronchospasm

Question 3

LABETALOL (NORMODYNE, TRANDATE)

Answer 3

Crosses placenta

Question 4

PHENYLEPHRINE dose

Answer 4

0.5-1mcg/kg

50-100mcg bolus

Question 5

PHENYLEPHRINE MOA, indication

Answer 5

Direct alpha-1 agonist, produces intense peripheral vasoconstriction, increased SBP & DBP, reflex bradycardia can result in decreased CO. Increased SVR can aid in reducing R-L shunt in Fallot

Question 6

PHENYLEPHRINE concern/complications

Answer 6

Tachyphylaxis may occur

Question 7

EPHEDRINE dose, max dose

Answer 7

2.5-10mg

150mg/24 hours

Question 8

EPHEDRINE MOA, indications

Answer 8

Vasopressor, bronchodilator. Noncatecholamine sympathomimetic with mixed direct and indirect actions. Resistant to MAO and COMT resulting in longer DOA. Increases CO, BP and HR by alpha and adrenergic stimulation. Increases coronary and skeletal blood flow, bronchodilation by beta-2 receptor stimulation. Restores uterine blood flow when used to treat epidural/spinal hypotension.

Question 9

EPHEDRINE concern/complications

Answer 9

Tachyphylaxis may occur once catecholamine stores are depleted

Question 10

ONDANSETRON (ZOFRAN) dose

Answer 10

4mg Q4-8hr

Question 11

ONDANSETRON (ZOFRAN) MOA, indication

Answer 11

Selective serotonin 5HT3 antagonist, receptors are found peripherally on vagal nerve terminals and centrally in the CTZ. Prevention and treatment of chemo induced and post-op N/V

Question 12

ONDANSETRON (ZOFRAN) concerns/complications

Answer 12

Expensive

Question 13

DEXMEDETOMIDINE loading, Gtt dose

Answer 13

Loading: 1mcg/kg over 10min
Gtt: 0.2-0.7mcg/kg/hr

Question 14

DEXMEDETOMIDINE MOA, indications

Answer 14

Selective alpha-2 adrenergic agonist. Binding in the locus ceruleus produces sedation and binding in the spinal cord produces analgesia

Question 15

DEXMEDETOMIDINE concern/complications

Answer 15

Does not decrease resp drive or CRMO2: may decrease cerebral arterial responsiveness to CO2 changes.; bradycardia and hypotension are common side effects; HTN may be seen with rapid admin of large dose due to spillover of alpha-1 adrenergic receptors.