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Advanced Pharm For NA 1 > Exam 2 Numbers Only (doses and whatnot) > Flashcards

Exam 2 Numbers Only (doses and whatnot) Flashcards

1
Q

Sevoflurane (Ultane)
MAC
B/G
O/G

A

2%
0.6
50
-5evoflurane
six-sevo (start w/ “s”)

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2
Q

Isoflurane (Forane)
MAC
B/G
O/G

A

1.15%
1.4
99
.15oflurane
1.forane
quite literally a tank of an anesthetic, slow and potent

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3
Q

N2O
MAC
B/G
O/G

A

105%
0.47
1.4
fast but weak lil guy

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4
Q

Desflurane (Suprane)
MAC
B/G
O/G

A

5.8%
0.42
18.7
De5.8
Supr8
-like a sport car without a lot of horsepower, not super strong but the fastest

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5
Q

Brain is happy and can autoregulate CBF with a MAP in the range of:

A

60-180mmHg

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6
Q

Hypervent pt or perform low normal vent to compensate increased ICP and cerebral vasodilation in pts by trying to shoot for PaCO2 in range of:

A

30-35

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7
Q

Epi doses should be no stronger than:

A

1:100,000 or 0.01mg/mL
no more than 10mL or 0.1mg within 10 min
and no more than 30mL or 0.3mg within 60 min

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8
Q

-% of pts experience Desflurane tachycardia which we give fentanyl to fix

A

10-20%

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9
Q

Sevo has a metabolite level of -%

A

5-8%

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10
Q

N2O causes immune suppression in cases >_ hrs

A

6hrs

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11
Q

Compound A can form and cause renal injury when Sevo is set at a low flow <_L/min

A

<3L/min

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12
Q

N2O is teratogenic and has the highest chance of causing miscarriage within - days postop, if it has to be given, give at low concentration like _ MAC or less.

A

1-7 days
1MAC or less

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13
Q

Neurotoxicity from inhaled anesthetics can occur between ages _ _ to _ yo

A

third trimester
3 yo

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14
Q

Pediatric Emergence Delirium is short term and typically lasts _-_mins

A

10-15mins

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15
Q

Elective procedures should be done in the _ trimester for pregnant pts

A

2nd

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16
Q

Ionizing radiation may cause mental retardation to fetus if mom is exposed during week - gestation

A

8-15wk

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17
Q

MAC-awake=

A

40-50% MAC

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18
Q

MAC-BAR=

A

1.6 x MAC

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19
Q

MAC peaks at _ months old and decreases from there

A

6months

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20
Q

Sevoflurane
-boiling point
-vapor pressure

A

boils: 59*C
vapor:157

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21
Q

Isoflurane
-boiling point
-vapor pressure

A

boils:49*C
vapor:238

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22
Q

Desflurane
-boiling point
-vapor pressure

A

boils: 24*C ~room temp!
vapor: 669~atmospheric pressure (760)

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23
Q

N2O
-boiling point
-vapor pressure

A

boils:-88*C
vapor: 38,770

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24
Q

Drug is considered eliminated after - half lives

A

4-5

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25
Q

1st half life, how much drug remains/gone

A

50% and 50%

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26
Q

2nd half life, how much drug remains/gone

A

25% and 75%

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27
Q

3rd half life, how much drug remains/gone

A

12.5% and 87.5%

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28
Q

4th half life, how much drug remains/gone

A

6.25% and 93.75%

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29
Q

5th half life, how much drug remains/gone

A

3.125% and 96.875%

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30
Q

Volume of Distribution for 70kg person:

A

42L or 0.6L/kg

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31
Q

A drug with a small volume of distribution of < _L/kg will stay mainly in plasma and be water soluble

A

<0.6L/kg

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32
Q

A drug with a large volume of distribution of >_L/kg will be widely distributed in the body and is lipid soluble

A

> 0.6L/kg

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33
Q

Diazepam (Valium)
-class
-beta half life
-volume of distribution
-protein binding

A

class: benzo
beta: 20-50 hr **
volumedist: 0.8-1.3L/kg
protein: 98% **

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34
Q

Lorazepam (Ativan)
-class
-beta
-protein binding

A

class: benzo
beta: 10-16hr**
-protein: 90%**

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35
Q

Midazolam (Versed)
-class
-beta
-protein binding

A

class: benzo
beta: 2-4hr
protein: 94%**

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36
Q

Etomidate (Amidate)
-class
-beta
-protein

A

class: Imadazole compound
beta: 2-5hr
protein: 75%

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37
Q

Propofol (Diprivan/generic)
-class
-beta
-protein

A

class: sedative/hypnotic
beta: 1-5hr
protein: 98%**

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38
Q

Ketamine (Ketelar)
-class
-beta
-protein

A

class: DISSOCIATIVE anesthetic ***
beta:2-3hr
protein:12%

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39
Q

Dexmedetomidine (Precedex)
-class
-beta
-protein

A

class: alpha 2 adrenergic AGonist
beta: 2-2.6hr
protein:94%**

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40
Q

Propofol
-onset of action
-duration
-beta half life
-total time in body

A

OOA: 10-15 sec
duration: 8-10min
beta: ~1hr
total time: 4hr
-fast distribution and fast REDISTRIBUTION

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41
Q

What % of protein binding is considered significant?

A

90% or more

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42
Q

Most benzos have long half lives (except versed) so this makes seamlessly reversing these medications difficult without giving multiple doses due to Flumazenil’s short half life of:

A

0.7-1.3hrs

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43
Q

Etomidate:
-induction dose
-onset
-duration
-beta

A

0.2 to 0.3mg/kg

<30sec

5-10min

3hr

What I Eat On My Date
2 to 3 appetizers in 30 seconds
5-10 minutes to eat a 3 course meal

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44
Q

Propofol:
-induction dose
-onset
-duration
-beta

A

1-3mg/kg

<30sec

3-8min

1-2hr

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45
Q

Ketamine:
-induction dose
-onset
-duration
-beta

A

1-2mg/kg

45-60sec**

10-20min

2hr

kid of mine is misbehaving,
1…2…
ok go stand in the corner for 45sec-1minute
ok go to your room for 10-20minutes
ok fine, bed time is 2hr earlier now

46
Q

Dexmedetomidine:
-induction/loading dose/infusion range
-onset
-duration
-beta

A

load:1mcg/kg over 20 min
infusion: 0.2-0.7mcg/kg/hr

2-5min

10-30min

2hr

Dexter tries to mediate 1 time a day for 20minutes
Every 2-7 minutes he loses focus
So 2-5 minute mediations are easy for him
He’s working on staying focused for 10-30 minutes
His ultimate goal is to meditate for 2 hours

47
Q

Midazolam:
-induction
-onset
-duration

A

0.2-0.4mg/kg

30-60sec

15-30min

48
Q

Lorazepam:
-induction
-onset
-duration

A

0.03-0.06mg/kg

60-120sec

60-120min

49
Q

Diazepam:
-induction
-onset
-duration

A

0.3-0.6mg/kg

45-60sec

15-30min

50
Q

Brain receives about _% of CO

A

15%

51
Q

Propofol infusion syndrome can occur ~_hrs of infusion

A

48hrs

52
Q

Ketamine induction doses:
-IV
-IM
-PO

A

IV: 0.5-2mg/kg

IM:4-6mg/kg

PO:6-8mg/kg

53
Q

Ketamine maintenance doses
-w/ N2O
-w/o N2O

A

W/ N2O: 0.5-1mg/kg IV

W/O N2O: 0.9mcg/kg/min IV

If this kid of mine wants to go out at night,
with friends, Nate and Miller, can hang out from 5-1
just with friend, Mike, must be home by 9, by the minute

54
Q

Ketamine doses:
-sedation
-analgesia

A

Sedation: 0.2-0.8mg/kg IV over 2-3 min

Pain: 2-4mg/kg IM

55
Q

Ketamine dose for preventing pain:

A

0.15-0.25mg/kg IV

I need just 15 to 25 minutes to myself a day to deal with this kid of mine

56
Q

Propofol induction apnea:

A

40sec

57
Q

Etomidate induction apnea:

A

20 sec

58
Q

Ketamine induction apnea:

A

VERY RARE (when given fast)

59
Q

Droperidol (tranquilizer) blocks dopamine receptors was used for PONV and came with a lot of bad stuff and has a dose range of:

A

0.625mg-1.25mg

60
Q

Flumazenil dosing:

A

0.2mg Q 2-3min up to 1mg over 15-20 min or continuous infusion if needing more

61
Q

Haldol can be used as an antiemetic at which dose?

A

1-2mg

62
Q

You should avoid propofol us in pts with an EF less than -%

A

30-40%

63
Q

A pt experiencing MH could have an EtCO2 in the range of -

A

50-80

64
Q

Your pt is experiencing MH with peaked T waves and your buddy is helping mix up a K+ cocktail. While you’re slamming dantrolene and cold fluids, they will be preparing _units/kg of insulin and _mL of D50. If the pt is an adult your buddy can just prep _units of insulin without mathing.

A

0.1unit/kg
50mL D50
10 units

65
Q

When cooling a pt experiencing MH, give _ mL boluses of NS and don’t start cooling until the pt is _C and don’t stop cooling efforts until pt is under _C

A

20mL
39C
38C

66
Q

Risky to use less than _L/min of Sevo

A

2
-says 3 somewhere else?

67
Q

Never run sevo for more than _ MAC hrs at FGF 1L

A

2

68
Q

Never run sevo low if case is less than _min

A

15

69
Q

Morphine Sulfate doses
-pain
-anesthesia
-potency ratio

A

pain: 10mg
anesthesia: 1-5mg/kg
potency: 1

70
Q

Meperidine (Demerol) doses:
-pain
-anesthesia
-potency ratio

A

pain: 100mg
anesthesia: N/A
potency: 0.1

71
Q

Fentanyl doses:
-pain
-anesthesia
-potency ratio

A

pain:100mcg
anesthesia: 50-150mcg/kg
potency: 100

72
Q

Sufentanyl doses:
-pain
-anesthesia
-potency

A

pain: 10-20mcg
anesthesia: 5-20mcg/kg
potency: 500-1000 *** (damn, son)

73
Q

Alfentanyl doses:
-pain
-anesthesia
-potency
-i can’t read this word without seeing ALF in my head

A

pain: 500-1000mcg
anesthesia: 100-200mcg/kg
potency: 10-20

74
Q

Remifentanyl doses:
-pain
-anesthesia
-potency

A

pain: infusion
anesthesia: infusion
potency: 100

75
Q

Hydromorphone doses:
-pain
-anesthesia
-potency

A

pain: 2mg
anesthesia: N/A
potency: 5

76
Q

Butorphanol (Stadol) doses:
-pain
-anesthesia
-potency

A

pain:2mg
anesthesia:N/A
potency:5

77
Q

Nalbuphine (Nubaine) doses:
-pain
-anesthesia
-potency

A

pain: 10mg
anesthesia: N/A
potency: 1
-partial agonist

78
Q

Buprenorphine (Buprenex) doses:
-pain
-anesthesia
-potency

A

pain:0.3mg
anesthesia: N/A
potency: 30

79
Q

Heroin:
-potency
-why are we learning this???

A

potency: 2 -used for euphoric feeling

80
Q

Codeine doses:
-pain
-anesthesia
-potency

A

pain:30mg
anesthesia: N/A
potency: 0.04 (weak lil guy who needs tylenol to do the heavy lifting)

81
Q

Remifentanyl is metabolized by non-specific esterase enzymes via hydrolysis and needs something else to be given to pts for pain when they wake up bc its duration of action is:

A

5min

82
Q

Morphine:
-protein binding
-duration
-beta

A

protein: 35%
duration: 3-5hr
beta: 1.7-3hr

83
Q

Meperidine:
-protein binding
-volume distribution
-beta
-duration

A

protein: 70%
volumedist: 3-5L/kg
beta: 3-5hr
duration: 2-4hr

84
Q

Methadone:
-protein binding
-beta
-duration

A

protein: 90%**
beta: 15-20hr**
duration: 4-8hr

85
Q

Codeine:
-protein binding
-beta
-duration

A

protein: 20%
beta: 2-4hr
duration:N/A

86
Q

Oxycodone:
-protein binding
-volume distribution
-beta
-duration

A

protein: 45%
volumedist:2-3L/kg
beta:3-4hr
duration:2-4hr

87
Q

Fentanyl:
-protein binding
-duration
-beta

A

protein:86%
duration:1-1.5hr (very dose dependent)
beta:2-4hr

88
Q

Alfentanyl:
-protein binding
-beta
-duration

A

protein:92%*
beta:1-2hr
duration:0.25-0.4hr*

89
Q

Sufentanyl:
-protein binding
-volume dist
-beta
-duration

A

protein: 93%**
volume dist: 2.5-3L/kg
beta: 2-3.5hr
duration: 0.8-1.3hr

90
Q

Remifentanyl:
-protein binding
-volume dist
-beta
-duration

A

protein: 66-93%?
volume dist: 0.3-0.4L/kg (very water soluble and barely leaves plasma)*
beta:0.1-0.2hr*
duration: 2-5min***

91
Q

You gave an opioid during your case but it ended way earlier than you expected and your pt’s EtCO2 sucks and is >_mmHg so you have to either ask PACU for a vent or give some narcan. Bummer.

A

50mmHg, you’ve upset Father Nagelhout.

92
Q

You want to avoid giving glucocorticoids for antiemetics in diabetics bc it will spike their BG for _-_hrs postop and that’s mean.

A

6-12

93
Q

Palonosetron (Aloxi) is a 2nd gen 5-HT3 receptor ANTAgonist and is great for treating PDNV because its half life is _ hrs

A

44

94
Q

Droperidol is a Butyrophenone drug that was used all the time for PONV until the FDA ruined its life with a black box warning for prolonging QT intervals, but it was given at a dose of _-_mg if that even matters

A

0.625-1.25mg

95
Q

Metoclopramide (Reglan) antiemetic doses are around _mg but can be bad because they cause EPS and have a sucky half life at _-_minutes

A

20mg
30-40min

96
Q

Transdermal Scopolamine patches are useful if they’re put on the evening before surgery because they have an onset of about - hrs and a minimum duration of _hrs, making them great for ppl with motion sickness on cruises.

A

2-4hr onset
min duration 24hr

97
Q

Ondansetron(Zofran) PONV dose:
-drug class
-adult +kid
-everything in this drug class sound like names of Transformer characters tbh

A

5-HT3 Receptor ANTAgonist
Adult: 4-8mg IV
Kid:50-100mcg/kg up to 4mg max IV

98
Q

Palonosetron (Aloxi) PDNV dose:
-drug class

A

5-HT3 Receptor ANTAgonist
0.075mg IV

99
Q

Droperidol (Inapsine) PONV dose:
-drug class (for PONV)

A

Dopamine ANTAgonist
0.625-1.25mg IV

100
Q

Haloperidol (Haldol) PONV dose:
-drug class (for PONV)

A

Dopamine ANTAgonist
1-2mg IV

101
Q

Metoclopramide (Reglan) PONV dose:
-drug class

A

Dopamine ANTAgonist
10-20mg IV

102
Q

Prochlorperazine (Compazine) PONV dose:
-drug class (for PONV)

A

Dopamine ANTAgonist
10mg IV

103
Q

Hydroxazine (Atarax) PONV dose:
-drug class

A

Antihistamine
12.5-25mg IV

104
Q

Promethazine (Phenergan) PONV dose:
-drug class

A

Antihistamine
12.5-25mg IV

105
Q

Diphenhydramine (Benadryl) PONV dose:
-drug class

A

Antihistamine
25mg IV or IM

106
Q

Dexamethasone ( Decadron) PONV dose:
-drug class (adult +kid)

A

Glucocorticoid
adult: 4-8mg IV
kid: 150mcg/kg up to 8mg IV

107
Q

Scopolamine patch PONV dose:
-drug class

A

Anticholinergic
2.5cm ^2 patch has 1.5mg scopolamine

108
Q

Aprepitant (Emend) PONV dose:
-drug class

A

Neurokinin-1 ANTAgonist
40mg PO

109
Q

Rolapitant (Varubi) PONV dose:
-drug class

A

Neurokinin-1 ANTAgonist
90mg PO

110
Q

To stop itching from opioids, especially spinal and epidurals, can give droperidol at _mg, propofol at _mg, or alizapride at _, check hosp policy tho

A

droperidol 1.25mg
propofol 20mg
alizapride 100mg

111
Q

Merperidine (Demerol) works for antishivering by acting on the KAPPA receptor and can be given at _ mg IV

A

10mg

112
Q

Mixing Narcan from 0.4mg/mL vials for titration:
-use 5mL syringe and draw up the 1mL of Narcan
-draw up _mL of sterile water for a total of _ mL in the syringe
-you now have _mg/mL and can “titrate” narcan

A

3mL
4mL
0.1mg/mL

Advanced Pharm For NA 1 (4 decks)

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