Boot Camp Drugs Flashcards
(178 cards)
1
Q
Midazolam MOA
A
GABA agonist
2
Q
Midazolam’s other name
A
Versed
3
Q
Midazolam dosing
A
1-4 mg
4
Q
Midazolam onset and duration
A
3 min
1 hour
5
Q
Midazolam advantages (2)
A
1) Rapid onset
2) Minimal respiratory depression when used alone
6
Q
Midazolam disadvantages (2)
A
1) Respiratory depression with opioids
2) Delirium in Elderly
7
Q
Famotidine other name
A
Pepcid
8
Q
Famotidine dose to be given
A
20 mg IV
9
Q
Bacitra dose
A
30 cc PO
10
Q
Bacitra and famotidine MOA
A
Antacid: H2 receptor antagonist
11
Q
Advantages of Bacitra (2)
A
1) Rapid onset
2) Less damaging to lung than other antacids
12
Q
Advantages of Famotidine (pepcid) (1)
A
Reduces gastric acid production
13
Q
Disadvantages of Bicitra (2)
A
1) Increases gastric volume.
2) Bad taste
14
Q
Disadvantages of Famotidine (2)
A
1) Only affects Ph of gastric secretions
2) Does not neutralize what is already there
15
Q
Glycopyrolate MOA
A
anticholinergic
16
Q
Atropine MOA
A
anticholinergic
17
Q
Difference between Glycopyrolate and Atropine
A
Glycopyrolate: does not cross BBB
Atropine: crosses BBB
18
Q
Neostigmine MOA
A
Cholinesterase inhibitor
19
Q
Physiostigmine MOA
A
Cholinesterase inhibitor
20
Q
What is the major difference between Neostigmine and physiostigmine
A
Neostigmine: does not cross BBB
Physiostigmine: Crosses BBB
21
Q
How is Cisatricurium cleared from the body
A
80% hoffman elemination: Plasma dependent. The rest is hepatically cleared.
22
Q
Onset of action Fentanyl
A
30 seconds
23
Q
Duration of action Fentanyl
A
45 minutes
24
Q
Common side effects Fentanyl (4)
A
1) Respiratory depression
2) Itching
3) N/V
4) Muscle rigidity
25
MOA propofol
GABA agonist
26
other name for propofol
Diprovan
27
Concentration of propofol
10mg/cc
28
Induction dose of propofol
1.5-2 mg/kg
29
Advantages of propofol (2)
1) Rapid onset with little hangover
| 2) anti-emetic effects
30
Disadvantages of propofol (4)
1) Pain with injection
2) Contraindicated with egg allergy
3) Respiratory depression
4) Hypotension
4) Decreased SVR
31
MOA Etomidate
GABA agonist
32
Induction dose Etomidate
.2-.3 mg/Kg
33
Onset of action Etomidate
30 seconds
34
Duration of action Etomidate
3-10 min
35
Advantages of Etomidate (2)
1) Little to no hemodynamic depression
| 2) Does not produce apnea
36
Disadvantages of Etomidate (4x)
1) Pain on injection
2) Severe nausea/vomiting
3) Myoclonus is common
4) Adrenal suppression
37
Ketamine MOA
NMDA antagonist
38
Ketamine induction doses
1-2 mg/kg IV
| 5-7 mg/kg IM
39
Ketamine concentrations (2x)
10 mg/cc
or
100mg/cc
40
ketamine onset of action
2 min
41
Ketamine duration of action
10-20 min
42
Ketamine advantages (3x)
1) Tachycardia and hypertension (good with hypovolemia)
2) Bronchodilation
3) No respiratory depression
43
Ketamine disadvantages
Hallucinations/nightmares (use midazolam to help)
44
What is the function of the GABA receptor?
Inhibits impulses
45
Ativan real name
Lorazepam
46
Where does Fenoldapam target and what is it used for
D1 receptor agonist
| Anti hypertensive
47
Succinylcholine dosing
1.5-2 mg/kg IV
48
Succinylcholine concentration
20 mg/cc
49
Succinylcholine onset of action and duration
30-60 seconds
| 3-6 minutes
50
Succinylcholine disadvantages (4x)
1) Muscle pain post op
2) Malignant hyperthermia trigger
3) Increased K+
4) Increased ICP's
51
Rocuronium dosing
0.6-1.2 mg/kg
52
Rocuronium concentration
10 mg/cc
53
Rocuronium onset of action and duration
(Depends on dose)
60-90 seconds
~45 minutes
54
Rocuronium advantages (2x)
1) Non depolarizing
| 2) Reversible with sugammadex
55
Vecuronium doses
0. 1 - 0.2 mg/kg induction
| 0. 01 -0.02 mg/kg prn
56
Vecuronium onset of action and duration
3 minutes
| 30 minutes
57
Vecuronium MOA
Non depolarizing competitive Ach antagonist
58
Vecuronium disadvantages (2)
1) Slow onset~ 3 minutes
| 2) 50% renal and 50% hepatic excretion
59
Vecuronium advantages (2)
1) No muscle pain
| 2) Does not trigger MH
60
Cisatracurium doses
0. 1-0.2 mg/kg IV induction
| 0. 3 mg/kg q20min prn IV maintenance
61
Cisatracurium onset of action and duration
6 minutes
| 30 minutes
62
Cisatracurium MOA
Non depolarizing competitive Ach antagonist
63
Cisatrarcurium advantages (1)
Best use for renal or hepatic failure (hoffman degradation)
64
Cisatracurium disadvantages (3)
1) Slow onset time ~3 minutes
2) Very expensive
3) Frequently on national shortage
65
Ephedrine dose
Push: 5-10 mg IV
66
Ephedrine MOA
alpha and beta agonist (both direct and indirect)
67
Ephedrine advantages (5)
1) rapid onset
2) short duration
3) No reflex bradycardia
4) Increased HR
5) Increased SVR
68
Ephedrine disadvantages (1)
Tachyphylaxis-->cannot run as an infusion
69
Phenylephrine dose
50-300 mcg IV push
| 20 mcg/min gtt
70
Phenylephrine concentration in stick
100 mcg/cc in stick
71
Phenylephrine MOA
Alpha 1 agonist
72
Phenylephrine advantages (3)
1) Rapid onset
2) Short duration
3) Can be used as infusion on Alaris pump
73
Phenylephrine disadvantages (1)
Reflex bradycardia
74
Epinephrine dose for 1) hypotension 2) anaphylaxis 3) code
1) hypotension 10-50 mcg
2) Anaphylaxis 0.5-1 mg
3) Code: 1 mg (may be multiple times)
75
If giving epinephrine through ETT how much more do you have to give?
Double the IV dose
76
How much do you figure out your epi doses with concentrations
Take the number on the right and see how many times that number goes into 1,000,000 and that's your mcg of Epi per ml.
1: 1,000 equals 1,000 mcg/ml = 1mg/ml
1: 10,000 equals 100 mcg/ml = .1 mg/ml
1: 100,000 equals 10 mcg/ml = .01 mg/ml
77
what is the concentration of little epi
10 mcg/ml = 0.01 mg/ml
78
what is the concentration of big epi
100 mcg/ml = 0.1 mg/ml
79
What is the MOA of epinephrine
low dose = more Beta, High doses = more alpha
| b1>b2>a1>a2 at low doses
80
Vasopressin dose
Push 1 unit at a time, but start with 1-2 units/hr (max 5u/hr)
81
Vasopressin MOA (2)
1) V1 receptor (G proteins) leads to vasoconstriction (Ideal vasoconstrictor for patients with pulmonary hypertension)
2) V2 receptor (AC) leads to increased water permeability in collecting ducts
82
Esmolol MOA
B1 antagonist
83
Esmolol doses
20-50 mg IV
| Up to 300 mcg/kg/min gtt
84
Esmolol onset of action time
1 minutes
85
Labetalol MOA
Alpha and Beta antagonist
86
Labetalol dose
5-10 mg IV
87
Labetalol onset of action time
Quick but sometimes a little delayed. Wait at least 10 minutes before redosing.
88
Hydralazine MOA
Alpha 1 antagonist like (smooth muscle relaxation with NO release.
89
Hydralazine dose
2-10 mg IV
90
Hydralazine concentration
20 mg/cc
91
Clonidine MOA
Alpha 2 agonist
92
Clonidine dose
25-50 mcg
93
Clonidine concentration
100 mcg/cc
94
Sevoflurane MAC
2.2%
95
Desflurane MAC
6.1%
96
Isoflurane MAC
1.1%
97
NO MAC
105%
98
Sevoflurane advantages (3)
1) Can be used for induction
2) Brochodilation
3) Fast onset & offset
99
Sevoflurane disadvantages (3)
1) Expensive
2) Decreases SVR
3) Myocardial depressant
100
Desflurane advantages (2)
1) Fastest onset
| 2) Bronchodilation
101
Desflurane disadvantages (4)
1) Most irritating to the airways
2) Can cause HTN and tachycardia if concentration increased too quickly
3) Decreases SVR
4) Myocardial depressant
102
Isoflurane advantages (2)
1) Bronchodilation
| 2) Cheap
103
Isoflurane disadvantages (3)
1) Slow onset & offset
2) Decreases SVR
3) Myocardial depressant
104
Nitrous Oxide advantages (3)
1) Cheap
2) Reduces amount of other gasses needed
3) Less CV depression than other gasses
105
Nitrous Oxide disadvantages (2)
1) Expands air-filled spaces
| 2) Combustible just like oxygen
106
Fentanyl dose
1-2 mcg/kg IV
107
Fenanyl concentration
50 mcg/cc
108
Remifentanyl dose
Gtt only: 0.05-2.0 mcg/kg/min
109
Remifentanyl onset of action and duration
Onset: 30 seconds
Duration: 5 minutes
110
Remifentanyl advantages (3)
1) Peak effect time 1.5 minutes
2) Metabolized by plasma esterases
3) Predictable Offset time 5-10 minutes
111
Sufentanyl doses
Load: give up to 1 mcg/kg
Gtt: 0.1-0.6 mcg/kg/hr
112
Sufentanyl onset of action and duration
Onset: 30 seconds
Duration: 20-45 minutes
113
Sufentanyl advantages (3)
1) Fast onset (slightly slower than fentanyl
2) 10 times more potent than fentanyl
3) For every hour gtt is running, stop 10 minutes prior to wake up.
114
Morphine dose
5-10 IV
| 15-30 mg P.O.
115
Morphine onset and duration
Onset: 4 minutes
Duration: 4 hours
116
Morphine disadvantages (3)
1) Respiratory depression
2) High histamine release (itching)
3) N/V
117
Dilaudid onset and duration
Onset: 5 minutes
Duration: 3 hours
118
Dilaudid advantages
Can be used in renal failure
119
Dilaudid disadvantages (2)
1) Respiratory depression
| 2) N/V
120
Naloxone concentration
0.4 mg/ml
121
Naloxone dose (to give patient)
0.04 mg-->wait for 1 minute then redose
122
Naloxone disadvantage
Wears off before the opioid so you need to redose
123
Neostigmine dose
.04-.07 mg/kg IV (max of 5 mg)
124
Neostigmine MOA
acetylcholine esterase inhibitor
125
Neostigmine concentration
1mg/cc
126
Neostigmine advantages
Antagonizes non depolarizing muscular blockade
127
Neostigmine disadvantages (2)
1) Can cause bradycardia and severe heart block
| 2) Must give with Glycopyrolate
128
Glycopyrollate MOA
Anticholinergic
129
Glycopyrollate dose
0.01 mg/kg IV or
| 20% of Neostigmine dose
130
Glycopyrolate advantage (1)
1) Prevents bradycardia from Neostigmine
131
Glycopyrolate disadvantage (1)
1) Can cause tachycardia (caution with CAD)
132
Ketoralac's other name
Toradol
133
Ketoralac MOA
NSAID
134
Ketoralac dose
15-30 mg IV
135
Ketoralac advantage (1)
Adjunct to opiods
136
Ketoralac disadvantages (3)
1) Caution with bleeding
2) Caution with Elderly
3) Caution with renal dysfunction
137
Ondansetron's other name
Zofran
138
Zofran dose
4-8 mg IV
139
Zofran MOA
Serotonin 5-HT3 antagonist
140
Zofran advantages (3)
1) Safe
2) Effective
3) Ok in elderly
141
Zofran disadvantages (2)
1) Prolongs QTc
| 2) Small risk of bronchospasm (caution with asthmatics)
142
What is droperidol?
An antipsychotic that is frequently use for treating nausea and vomiting
143
What is the other name for meperidine and what is it commonly used for
Demerol he is frequently use for post operative shivering
144
What is another name for diazepam
ValIum
145
What dose of diazepam do you give to stop a Seizure
.1 mg per kilogram of diazepam
146
How much more potent is Midozolam compared to diazepam?
2-3 times
147
What is the breakdown product of Morphine
morphine-6-glucuronide
148
What is dilaudid (real name)
Hydromorphone
149
What is the strength of dilaudid vs morphine
1 mg Dilaudid = 7 mg morphine
150
What is the active metabolite of dilaudid?
No active metabolites, & no histamine release
151
What is the other name for demerol
Meperidine
152
What is the active metabolite for demerol
Active metabolite: Normeperidine and it lowers the seizure threshold
153
How is demerol excreted
renally excreted
154
what is Vicoden
Acetaminophen / Hydrocodone
155
what is the difference between Vicoden and Lortab
Tylenol amount mixed with the hydrocodone
156
what is percocet
Acetaminophen / Oxycodone
157
What is the biggest difference to increase you CO between adults and children
– In infants, SV is fixed, so CO is dependent on HR.
| – In adults, SV plays a much more important role, particularly when increasing HR is not favorable.
158
How do you calculate CO
– CO = 80([MAP-CVP]/SVR)
159
What value is considered a normal pulse pressure
Normal PP is ~40 mm Hg at rest, and up to ~100 mm Hg with strenuous exercise.
160
What should you think of with a wide pulse pressure
Wide PP (e.g. > 40 mm Hg)
1) aortic regurgitation
2) atherosclerotic vessels
3) High output state (e.g. thyrotoxicosis, AVM, pregnancy, anxiety)
161
What is cushing's triad with increased ICP's
(Cushings triad: HTN, bradycardia, irregular respirations)
162
Drugs that commonly cause hypotension in OR
1) volatile agents
2) opioids
3) Anticholinesterases
4) local anesthetic toxicity
5) vancomycin
6) protamine
163
What is another name for Phenylephrine
Neosynephrine
164
What is so significant about Milrinone, Dobutamine as Ionotropes
They function as Ionotropes and Vasodilators
165
What is the dose of roc necessary for RSI
1-1.2 mg/kg
166
what are the concentrations of NS solutions
154 Na+,
154 Cl-
308 Osm
167
What are the concentrations of LR solutions
```
130 Na+
109 Cl-
4 K+
3 Ca+
28 lactate buffer
273 Osm
```
168
What is the Ph of LR
6.6
169
What is the Ph of NS
5.0
170
What are the concentrations of Plasmalyte solutions
```
148 Na+
98 Cl-
5 K+
0 Ca+
27 acetate
294 Osm
7.4 Ph
```
171
How do you calculate the amount of fluid (deficit) with burns
Parkland Formula
| Volume = %BSA x 4 ml/kg x kg
172
What are the Solutions incompatible with pRBC's (2)
LR (theoretical clot formation due to calcium)
| D5W or other hypotonic solutions (hemolysis)
173
What is required for compatability of FFP when transfusing?
Use ABO-compatible; Rh-incompatible is OK
174
What is required for compatability of platelets when transfusing?
Can give ABO-incompatible platelets, Rh tested only
175
What does cryoprecipitate have in it?
Contains Factors VIII, XIII, I (fibrinogen), and fibronectin
176
Arterial oxygen content equation
Arterial oxygen content= (Hb x 1.36 x SaO2 /100) + (PaO2 x 0.003)
177
Allowable Blood Loss equation
Allowable Blood Loss
= [ Hct (start) - Hct (allowed) ] x EBV
_______________________
Hct (start)
178
How do you calculate estimated blood volume
Male 70
Female 65
Obese <60
