Drugs and Dosing

Question 1

What is failure rate of catheters left in situ overnight after delivery for a planned tubal ligation the next day?

Answer 1

50% So just take out and do spinal next day.

Question 2

How to treat pruritis from intrathecal morphine?

Answer 2

Naloxone 0.04-0.2 mg IV, Nalbuphine 5-10 mg

Question 3

Intrathecal morphine dose for cesarean?

Answer 3

0.1 mg

Question 4

Epidural morphine dosing?

Answer 4

1.5-2 mg after delivery for 18-24 hrs of analgesia

Question 5

Porth Algorithm for External Cephalic Version?

Answer 5

If possibility of going home then don’t add morphine. Do a single shot spinal with bupivacaine 1.6 cc and fent 15 mcg.

If you will induce patient even if successful then do a CSE with morphine added to epidural.

Question 6

What is the test dose for epidural?

Answer 6

3 cc of Lido 1.5% with Epi 1:200,000 in kit

Question 7

What is loading dose for epidural?

Answer 7

10 cc epidural bag infusate or bupivacaine 1.8% or lido 0.6%

Question 8

What is the maintenance dose for epidural?

Answer 8

Bupiv 1/12% + fent 2 mcg/cc

Question 9

What is the demand dose on pump for epidural?

Answer 9

8 cc. 15 min lockout.

Question 10

Dosing for rebolusing epidurals?

Answer 10

10 cc of Bupivacaine 1/8% or 10 cc lido 1% if questionable catheter

Question 11

What is spinal dose in a CSE?

Answer 11

1 cc of Bupivacaine 1/4% with or without 15 mcg fentanyl

Question 12

How far to thread catheter in epidural?

Answer 12

4-5 cm past the loss

Question 13

How far to thread catheter for intrathecal catheter?

Answer 13

3 cm past loss

Question 14

What is loading dose for intrathecal catheter?

Answer 14

1 cc 1/4% bupivacaine with 15 mcg fentanyl.

May do 1.5 cc Bupi if no fentanyl

Question 15

What is continuous rate for intrathecal catheter?

Answer 15

1-4 cc/hr. Usually 2 cc/hr. No demand dosing

Question 16

Dosing for lidocaine for C-section with epidural?

Answer 16

10-20 cc Lido 2% with epi/HCO3 increments of 5 cc.

Question 17

Dosing for Chloroprocaine 3% for C-section with epidural?

Answer 17

5 cc increments of 2-chloroprocaine 3% May also give Fent 50-100 mcg

Morphine 1.5-2 mg after delivery.

Question 18

Oxytocin dosing perioperatively for delivery?

Answer 18

3U bolus at cord clamp + infusion 300 cc/hr. Additional 3 U bolus and increase to 900 cc/hr.

Question 19

Hemabate dosing for delivery?

Side Effects?

Answer 19

0.25 mg IM q15 min.

Bronchospasm, Nausea

Question 20

Methergine dosing for uterotonic?

Side Effects?

Answer 20

0.2 mg IM q 2-4 hrs

HTN, Cardiogenic pulm edema

Question 21

Which tocolytic? as in a uterine inversion?

How to treat hypotension after?

Answer 21

Use Nitroglycerin 100-400 mcg IV

Follow by Phenylephrine bolus