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NUAN 604- Intro to Sim > Emergence > Flashcards

Emergence Flashcards

(82 cards)

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1
Q

Trade Name

Atropine

A

Atropine Sulfate

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2
Q

Trade Name

Glycopyrrolate

A

Robinul

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3
Q

Trade Name

Flumazenil

A

Romazicon

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4
Q

Trade Name

Naloxone

A

Narcan

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5
Q

Trade Name:

Neostigmine

A

Prostigmine

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6
Q

Trade Name:

Sugammadex

A

Bridion

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7
Q

Trade Name:

Metoclopramide

A

Reglan

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8
Q

Trade Name:

Ondansetron

A

Zofran

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9
Q

Trade Name:

Decadron

A

Dexamethasone

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10
Q

Trade Name:

Toradol

A

Ketorolac

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11
Q

Indications for Use:

Glycopyrrolate

A

-Anticholinergic
-prevent/reverses the muscarinic S/E of cholinesterase inhibitors

(such as bradycardia, increased secretions, pupillary constriction, etc)

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12
Q

Indications for Use:

Atropine

A
  • Anticholinergic

-Reverses muscarinic side effects of cholinesterase inhibitors

  • symptomatic bradycardia
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13
Q

Indications for Use:

Flumazenil

A
  • Pure Benzo Antagonist

-reversal of benzodiazepines

Romazicon

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14
Q

Indications for Use:

Narcan

A
  • Opioid Antagonist

-treatment of opioid-induced pruritus

Naloxone

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15
Q

Indications for Use:

Robinul

A

-Anticholinergic
-prevent/reverses the muscarinic S/E of cholinesterase inhibitors

(such as bradycardia, increased secretions, pupillary constriction, etc)

Glycopyrrolate

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16
Q

Indications for Use:

Physostigmine Salicylate

A
  • Cholinesterase Inhibitor
  • Treats Overdose
    Atropine / Scopolamine

Antilerium

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17
Q

Indications for Use:

Prostigmine

A

-Reversal of effects of nondepolarizing neuromuscular blocking agents after surgery

Neostigmine

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18
Q

Indications for Use:

Sugammadex

A

Selective muscle relaxant binding and reversal agent

Works only for
Rocuronium, Vecuronium and Pancuronium

Bridion

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19
Q

Indications for Use:

Metoclopramide

A
  • PONV
  • gastric aspiration prophylaxis
  • accelerates GI motility

Reglan

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20
Q

Indications for Use:

Zofran

When is it administered?

A
  • PONV

-administered at end of case

Ondansetron

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21
Q

Indications for Use:

Dexamethasone

When do you administer?

A
  • PONV at induction

Decadron

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22
Q

Indications for Use:

Ketorolac

A

-Post Op Pain
-anti-inflammatory
-anti-pyretic

Toradol

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23
Q

Contraiindications:

Atropine

A

-Asthma

-Patient with CAD may not tolerate increased myocardial O2 demand

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24
Q

Contraiindications:

Glycopyrralate

A

Caution with:

Glaucoma

Asthma

CAD

GI/GU obstruction

Parkinson’s Disease

Robinul

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25
Contraiindications: Romazicon
-Can cause seizure activity in chronic benzo patients | Flumazenil
26
Contraiindications: (S/E) Naloxone
Side Effects - Nausea and vomiting (give slowly) -acute withdrawal syndrome, nausea, vomiting, tachycardia, hypertension, seizures, and pulmonary edema. | Narcan
27
Contraiindications: Physostigmine
Aspirin allergy because "salicylate" | Antilerum
28
Contraiindications: Prostigmine
-Peritonitis or mechanical obstruction of the intestinal or urinary tract -Brady dysrhythmias Needs to be given with an anticholinergic to counteract the side effects of this medication a (atropine/glycol) | Neostigmine
29
Contraiindications: Bridion
-known hypersensitivity -severe renal impairment -Can negate birth control | Sugammmadex
30
Contraiindications: Reglan
give intraop to decrease feeling of abdominal pain -mechanical GI obstruction, perf, or hemmorhage -Prolong QT interval -Tardive dyskinesisa - parkinson’s, seizure disorder, GI obstruction | Metoclopramide
31
Contraiindications: Zofran
-should not be used in patients with congenital long QT syndrome = risk for Torsades. -Can prolong QT -Can mask progressive ileus and gastric distention -Risk for serotonin syndrome
32
Contraiindications: Decadron
- HYPERglycemia (use judgement) -uncontrolled infections
33
Contraiindications: Ketorolac
- Renal Insufficiency - Aspirin induced Asthma - Prolong Bleeding Time (ask surgeon) - ↓ Dose in Elderly | Toradol
34
Mechanism of Action: Atropine
-Anticholinergic - Antimuscarinic (antagonizes muscarinic effects of Ach and prevents stimulation of the Ach receptor)
35
Mechanism of Action: Glycopyrrolate
-Anticholinergic (Muscarinic Antagonist- antagonizes muscarinic effects of Ach) - quaternary amine- does NOT cross BBB | Robinul
36
Mechanism of Action: Flumazenil
- Competitive antagonist at the GABA(a) receptor | Romazicon
37
Mechanism of Action: Narcan
- Competitive Mu Receptor Antagonist: -reverses both the therapeutic and adverse effects of mu agonists.
38
Mechanism of Action: Antilerium
antagonizes NDMR permits accumulation of ACh at NMJ, displaces NMDR from postsynaptic receptors | Physostigmine Salicylate
39
Does Antilerium cross the BBB?
Yes Tertiary Amine | Physostigmine Salicylate
40
Mechanism of Action: Prostigmine
- Cholinesterase Inhibitor Permits accumulation of Ach at NMJ Displaces NDMR from postsynaptic receptor and reverses paralysis | Neostigmine
41
Does Prostigmine cross the BBB?
No Quaternary Amine | Neostigmine
42
Mechanism of Action: Bridion
- Encapsulates Rocuronium (Zemuron) or Vecuronium (Norcuron) and forms rigid complex -1:1 ratio | Sugammadex
43
Mechanism of Action: Reglan
-Dopamine Antagonist
44
Mechanism of Action: Zofran
- Serotonin Antagonist (5-HT3 receptor Antagonist) -blocks serotonin centrally at the chemoreceptor trigger zone and peripherally. Despite acting centrally, it is free of neurologic effects
45
Mechanism of Action: Decadron
No body knows | 👻 Dexamethasone
46
Mechanism of Action: Toradol
- Non-selective Competitive Cox-1 and Cox-2 Inhibitor | Ketorolac
47
Dose of **Atropine** with Neostigmine?
0.4 mg/IV per 1 mg Neostigmine -give atropine before neo with kids
48
What is the dose of Atropine for **Bradycardia**?
For Bradycardia: 0.5 mg/IV (q3-5min) (up to 3 mg TOTAL)
49
Dose of **Robinul** with Neostigmine reversal
With Neostigmine: 0.2 mg/IV per 1 mg neo With reversal: 0.01-0.02 mg/kg IV (Adults give Glyco first) (Can mix Neostig & Glyco in same syringe bc Glyco will kick in 1st)
50
What is the dose of Glyco for Bradycardia?
0.1-0.2 mg/IV
51
Dosing: Romazicon
0.2 mg q1min (max: 0.6 – 1 mg) | Flumazenil
52
Dosing: Narcan
0.5 – 1 mcg/kg/iv OR 40 mcg iv until respirations return (small doses to get breathing but keep some analgesia)
53
Dosing: Antilerium
0.01–0.03 mg/kg/iv | Physostigmine Salicylate
54
Dosing: Prostigmine
0.04–0.08 mg/kg/iv (up to 5 mg Total) | Neostigmine
55
What is the maximum dose of Prostigmine? ## Footnote `
5 mg Total
56
Dosing: Sugammadex
TOF 2/4= 2 mg/kg/iv TOF 0/4 PTC > 1 = 4 mg/kg/iv RSI dose of Roc = 16 mg/kg/iv (3 mins after Roc)
57
Dosing: Reglan
10 mg/IV SLOWLY (can cause Abd pain)
58
Dosing: Zofran
4 mg/IV Admin at end of case
59
Dosing: Decadron
4 – 8 mg/iv Admin at induction
60
Dosing: Toradol
30 mg/iv q6h (or 15mg is just as effective)
61
Standard Concentration: Atropine
0.4 mg/mL or 1 mg/ml
62
Standard Concentration: Glyco
0.2 mg/mL
63
Standard Concentration: Romazicon
0.1 mg/mL | flumazenil
64
Standard Concentration: Narcan
0.4 mg/mL Dilute 9mL NSS and 1 mL (0.4mg) Narcan for 40 mcg/mL
65
Standard Concentration: Antilerium
1 mg/mL | Physostigmine Salyclate
66
Standard Concentration: Neostigmine
1 mg/mL
67
Standard Concentration: Sugammedex
100mg/ml and can be diluted to 10 mg/ml with NSS
68
Standard Concentration: Reglan
10 mg/mL
69
Standard Concentration: Zofran
4 mg/mL
70
Standard Concentration: Decadron
4 or 8 mg/mL
71
Standard Concentration: Toradol
30 mg/mL
72
Metabolism: Atropine
Liver enzymatic hydrolisis
73
Metabolism: Glyco
Urine Bile
74
Metabolism: Romazicon
Liver
75
Metabolism: Narcan
Liver
76
Metabolism: Antilerium
Plasma esterases
77
Metabolism: Neostigmine
50% liver 50% renal
78
Metabolism: Sugammadex
Primarily eliminated unchanged via renal excretion
79
Metabolism: Reglan
Liver CYP450
80
Metabolism: Zofran
Liver CYP450
81
Metabolism: Decadron
Liver
82
Metabolism: Toradol
-Liver Excreted by kidneys

NUAN 604- Intro to Sim (3 decks)

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