Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Summer 2020 - Advanced Anesthesia - CV > Induction for the CV Patient - Quiz 3 > Flashcards

Induction for the CV Patient - Quiz 3 Flashcards

1
Q

What types of meds should be available and preprogrammed for CV cases?

A

Inotrope

Pressor

Vasodilator

Antiarrythmics

Anticoagulants & Reversals

Bolus Syringes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How should CV patients be premedicated before surgery?

A

Continue B-Blockers

Hold ACE & ARBS 24hrs before surgery

Anxiolytics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How does Sufentanil compare to Fentanyl?

A

7-10x more potent than Fentanyl

Shorter Half Life

Higher pKa

Lower Volume Distribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does Remifentanil compare to Fentanyl?

A

Similar Potency

Eliminated via Liver & Esterases

More Post-Op Pain & Hyperalgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are high dose opioid techniques?

A

Morphine 1-2mg/kg

Fentanyl 50-100 mcg/kg

Sufentanil 10-25 mcg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the rationale for High Dose Opioid Techniques?

A

Supresses Stress Response

&

Hemodynamic Stability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the Induction dose for Fentanyl?

A

3 - 10 mcg/kg

Large Volume Distribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the Induction dose for Sufentanil?

A

0.1 - 1 mcg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the Induction dose for Remifentanil?

A

0.5 - 1 mcg/kg

1 Minute Onset

9-20 min Recovery Time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is Remifentanil Hyperalgesia treated?

A

Ketamine & Magnesium Sulfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What Hypnotics are used for Induction?

A

Propofol

Etomidate

Ketamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the Induction dose for Propofol?

A

1 - 2 mg/kg

Comes off quick d/t big redistribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the CV effects of Propofol?

A

↓SVR

↓MAP

↓Cardiac Index

↓Stroke Volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the Induction dose for Etomidate?

A

0.2 mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the CV effects of Etomidate?

A

Small MAP & SVR decrease

↑HR

↑CO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When would you want to avoid using Etomidate?

A

Patients w/ Seizures - can initiate myoclonus

&

High Incidence of PONV

17
Q

How does Etomidate affect Cortisol / Adrenal Response?

A

Profound supression for 24 hrs & Hypotension

18
Q

What is the Ketamine Induction dose?

A

2 mg/kg

19
Q

What does Ketamine do?

A

Causes Cataleptic Trance & Dissociative Anesthesia

Unconscious in 20-60 sec

20
Q

What are the CV effects of Ketamine?

A

↑HR

↑MAP

↑Plasma Epi

↑Coronary Demand

21
Q

What are the Neuro effects of Ketamine?

A

↑ICP

Inhibits Tumor Necrosis Factors –> Anti Inflammatory & Antihyperanalgesic Effects

EEG Theta Waves

22
Q

Which receptor does Ketamine work on?

A

Noncompetitive NMDA Antagonist

23
Q

What are the CV effects of Inhalation Agents?

A

Myocardial Depression

Dose-Dependent Vasodilation

Dose-Dependent Tachycardia - especially Des

24
Q

Out of Des, Sevo, and Isoflurane, which gas has the least Dose-Response relationship in regards to MAP

A

Sevoflurane

25
Q

________ is a short acting NMB

A

Succinylcholine

26
Q

Which NMBs are Intermediate Acting?

A

Cisatracurium

Rocuronium

Vecuronium
(Longer Onset & Acting than Roc)

27
Q

Which NMB is Long Acting?

A

Pancuronium - Vagolytic effect to counter opioids

28
Q

How do pts w/ HTN react to Induction Agents & Larygoscopy?

A

More HTN to Laryngeal Stimulation & More Hypotensive to Induction Agents

29
Q

How does Propofol Distribute throughout the body?

A

Quickly to Brain & Highly Perfused Areas, then to less perfused areas.

Metabolized by Liver & pt breathes it off

30
Q

What is the Induction dose for Precedex?

A

Loading: 1mcg/kg in 10 min (None in CABGs)

Infusion: 0.2 - 1.5 mcg/kg/hr

31
Q

What are the Neuro effects of Precedex?

A

Natural Sleep Sedation

No CMRO2 Change

↓Cerebral Blood Flow

32
Q

What are the CV Effects of Precedex?

A

Hypotension & Bradycardia d/t vasodilation

Loading Dose HTN

No Contractility Change

33
Q

True/False: Fentanyl is metabolized by the liver into active metabolites?

A

False - broken down by liver into inactive metabolites

34
Q

What is the difference b/t Ephedrine & Epinephrine?

A

Similar, but Ephedrine has longer duration & does NOT increase glucose levels

Decreases in effectiveness over time

35
Q

Which receptors does Esmolol work on?

A

Beta 1

Fast Onset

Short Half-life d/t Plasma Esterase Metabolism

36
Q

Which vasopressor increases coronary artery perfusion & preload?

A

Norepinephrine

⬆Coronary perfusion d/t ⬆DBP

First line for CV cases

37
Q

How does Milrinone work?

A

PDE3 Inhibitor - prevents cAMP breakdown

Inotrope & Vasodilation w/o Tachycardia

↓Preload & ↓Afterload

Summer 2020 - Advanced Anesthesia - CV (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions