Anticholinergic Drugs Doses

Question 0

Atropine

Onset, peak, DOA

Answer 0

O: 45-60sec IV (10-20 sec. via ET tube)
P: 2min
DOA: Vagal block 1-2 hours
Antisialagogue: 4 hours

Question 1

Atropine doses

Answer 1

• SB/ACLS: 0.5-1.0mg; may repeat up to 40mcg/kg
• Preop: 0.5-1.0mg
• Reversal: 0.015mg/kg (1mg for 70kg) with neo 0.05mg/kg or Enlon 0.5-1.0mg/kg

Question 2

Atropine Dose for a result of decrease HR and relaxation of gastro-esophageal sphincter

Answer 2

Adults: <0.5mg

Question 3

Scopolamine Doses

Answer 3

• 0.3-0.65mg IV (0.006mg/kg in peds)

- 1.5mg patch

Question 4

Glycopyrrolate doses

Answer 4

• Preop/ vagalytic: 0.1-0.2mg
• Reversal: 0.01mg/kg
• With Neo: 0.05mg/kg (0.2mg for each 1mg of Neo or 5mg of Pyrid)

Question 5

Glycopyrrolate

Onset, Peak, Duration

Answer 5

O: 60 seconds
P: 5 min.
D: Vagal block 2-3hr; Antisialagogue 7 hr

Question 6

Name the Anticholinesterase drugs

Answer 6

• Neostigmine
• Edrophonium
• Pyridostigmine
• Physostigmine

Question 7

Neostigmine (Prostigmine)

• Usage
• Doses

Answer 7

• Reversal
• 0.05mg/kg (max 5mg)
• with Atropine IV, 0.015mg/kg
• with Glycopyrrolate, 0.01mg/kg

Question 8

Edrophonium (Enlon, Tensilon)

• usage
• doses

Answer 8

• Reversal
• 0.5-1.0mg/kg IV (max 40mg)
• with Atropine 0.015mg/kg
• with Glycopyrrolate 0.01mg/kg

Question 9

Neostigmine (Prostigmine)

Onset, peak, DOA

Answer 9

O: <3min
P: 3-14min
D: 40-60 min (50min)

Question 10

Edrophonium (Enlon, Tensilon)

Onset, Peak, DOA

Answer 10

O: 30-60 sec (45sec)
P: 1-5min
D: 5-20min

Question 11

Pyridostigmine (Regonal)

• Usage
• Dosage

Answer 11

• Reversal
• 0.25mg/kg IV (max 30mg)
• With Atropine 0.015 mg/kg
• With Glycopyrrulate 0.01mg/kg

Question 12

Pyridostigmine (Regonal)

Onset, Peak, DOA

Answer 12

O: 2-5min (3min)
P: <15min
D: 2-3hr

Question 13

Physostigmine

• usage
• doses

Answer 13

• For reversal of anticholinergic drugs

- 0.5-2mg IV, repeat Q20min PRN or until reversed

Question 14

Max dose of Neostigmine (Prostigmine)

Answer 14

5mg

Question 15

Max dose of Edrophonium (Enlon, Tensilon)

Answer 15

40mg

Question 16

Max dose of Pyridostigmine (Regonal)

Answer 16

30mg

Question 17

Doses of Atropine & Glycopyrrolate to give with Anticholinesterase drugs (Neostigmine, Edrophonium, Pyridostigmine)

Answer 17

• Atropine 0.015mg/kg

- Glycopyrrulate 0.01mg/kg

Question 18

What is Sugammedex & how dose it work

Answer 18

• A modified y-cyclodextrine that forms tight, 1:1 bonds with aminosteroid relaxants
• Concentration gradient causes aminosteroidal NMBD to detach from nicotinic Ach receptors and return to plasma for encapsulation

Question 19

What drug class/ structure WON’T Sugammedex work on

Answer 19

benzylisoquinolinium

Question 20

What drugs will Sugammedex work on

Answer 20

-Aminosteroids (Rocuronium, Vecuronium, Pancuronium)

Question 21

What will be the benefit of Sugammedex

Answer 21

Rapid results without side effects or need for anticholinergics

Question 22

How much Glycopyrrulate (Robinul) for each 1mg of Neostigmine or 5mg of Pyrid?

Answer 22

0.2mg

Question 23

Define Myasthenia Gravis

Answer 23

AUTOIMMUNE process that decreases FUNCTIONAL nicotinic receptors on endplate. (Not the amount of receptors). There are less places for Ach to bind. Causes weakness. Treated with anticholinesterase drugs.