Flash card assignment

1
Q

Succ trade name

A

Anectine

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2
Q

Succ class

A

Depolarizing NMBA

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3
Q

Succ indications

A

Medicated facilitated intubation after administration of sedation/analgesic

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4
Q

Succ contras

A

Hypersensitivity, known or suspected hyperK+, family hx of MH or psuedocholinesterase deficiency, myopathies associated with elevated CK

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5
Q

Succ dose

A

Adults 1.5mg/kg IV/IO

Peds 1.5 - 2.0 mg/kg IV/IO

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6
Q

Succ additional considerations

A

Don’t be a dick
*Consider withhold in difficult airway
Takes 60-90 secs for full effect
Acute airway burns not a cause for hyperK+

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7
Q

Roc trade name

A

Zemuron

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8
Q

Roc class

A

Non depolarizing NMBA

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9
Q

Roc indications

A

Post intubation to facilitate airway control and maintain muscle relaxation

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10
Q

Roc contras

A

Hypersensitivity

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11
Q

Roc dosage

A

Adult 1mg/kg IV/IO repeated 0.5mg/kg IV/IO PRN

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12
Q

Roc ped dose

A

Exact fucking same as adult

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13
Q

Vecuronium trade name

A

Norcuron

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14
Q

Vecuronium class

A

Non depolarizing NMBA

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15
Q

Vecuronium indications

A

Post intubation for airway control and maintain muscle relaxation

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16
Q

Vecuronium contras

A

Hypersensitivity

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17
Q

Vecuronium adult dose

A

0.1mg/kg IV/IO maintain at 0.01-0.05mg/kg IV/IO Q 20-40

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18
Q

Vecuronium peds

A

Exact fucking same as adults

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19
Q

Roc additional considerations

A

Don’t be a dick
Antibiotics (micins) or CCB (dipine) can potentiate effects of roc
Can increase BP, heart rate, induce bronchospasm
NO histamine release
Duration of paralysis 20-40 minutes
Time to onset of paralysis 1-3 minutes

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20
Q

Vecuronium additional considerations

A

Don’t be a dick
Micins and CCBs can potentiate
No histamine release, cardiovascular effects are minimized

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21
Q

Pancuronium Bromide trade name

A

Pavulon

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22
Q

Pancuronium Bromide class

A

Non depolarizing NMBA

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23
Q

Pancuronium Bromide indications

A

Post tube to facilitate airway control and maintain muscle relaxation

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24
Q

Pancuronium Bromide contas

A

Hypersensitivty

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25
Q

Pancuronium Bromide adult dose

A

0.1mg/kg IV/IO maintain at 0.01mg/kg q 20-40 IV/IO

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26
Q

Pancuronium Bromide peds dose

A

Exact fucking same as adults

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27
Q

Pancuronium Bromide additional considerations

A

Don’t be a dick
Is the prototype non depol NMBA
NO histamine release, minimal cardiovasc effects
30-45% of drug undergoes hepatic metabolism

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28
Q

Atropine Sulfate trade name

A

Atropine

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29
Q

Atropine Sulfate Class

A

Anticholinergic, parasympatholytic

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30
Q

Atropine Sulfate indications

A

Symptomatic bradycardia, organophosphate poisoning

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31
Q

Atropine Sulfate contras

A

Hypersensitivity

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32
Q

Atropine Sulfate dose adult for bradycardia

A

0.5mg IV/IO q3-5 max 3mg

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33
Q

Atropine Sulfate adult dose organophosphate poisoning

A

2mgIV/IO/IM q5 prn until sludgem reversed

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34
Q

Atropine Sulfate peds for brady

A

0.02mg/kg IV/IO single max of 0.5

May give q3-5 prn ma of 0.04mg/kg or 1mg

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35
Q

Atropine Sulfate peds organo poisoning

A

0.05mg/kg q5 prn until DJ BMSLUDGE reversed

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36
Q

Atropine Sulfate additional considerations

A

Drug of choice in acute symptomatic bradycardia (if immediately reversible causes are not found)
Immediate pacing may be considered over atropine in 2nd degree type II or 3rd degree block
Atropine should not be administered to pts with a hx of heart transplant

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37
Q

Ipratropium Bromide trade name

A

atrovent

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38
Q

Ipratropium Bromide class

A

Antichol, parasympatholytic

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39
Q

Ipratropium Bromide indications

A

bronchospasm, anaphylaxis

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40
Q

Ipratropium Bromide contras

A

Hypersensitivity

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41
Q

Ipratropium Bromide adult dose

A

Neb 500mcg repeat prn

MDI w/spacer 10 puffs ONLY if pt has no received 3 doses of nebulized atrovent, repeat q 20 max 30

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42
Q

Ipratropium Bromide pediatric dose

A

Less than 20kg - 250mcg with ventolin

Greater than 20kg - 500mcg with ventolin nebbed

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43
Q

Ipratropium Bromide additional considerations

A

Each puff 20mcg
Invert canister multiple times prior to each puff
Depress 3x away prior to
As pt begins to inhale, deliver one puff
Direct pt to continue to inhale slowly then hold breath 5-10 seconds
Allow pt to breath into chamber 5 times
MDI requires 30 seconds between puffs
Alternate single puffs with salbutamol during recharge period

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44
Q

Dopamine trade name

A

Intropin

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45
Q

Dopamine class

A

Adrenergic agonist, vasopressor, inotropic, sympathomimetic

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46
Q

Dopamine indications

A

Shock management, sepsis, pulmonary edema, symptomatic bradycardia,
Beta blocker/ calcium channel blocker OD

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47
Q

Dopamine contras

A
Pheochromocytomo
Tachyarrythmias
V fib
MAOI within 14 days
Allergy to sulphites
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48
Q

Dopamine dose

A

Adult initial 5mcg/kg/minute titrate to max dose of 20

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49
Q

Dopamine peds

A

2-20mcg/kg/minute - titrate to effect

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50
Q

Dopa renal dose

A

Increased renal at 2-5mcg/kg/min

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51
Q

Dopa beta 1 dose

A

5-10mcg/kg/min

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52
Q

Dopa A1 effects

A

10-20mcg/kg/min

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53
Q

Dopa additional notes

A

400mg/250ml saline or D5W = 1600mcg/mL use baxter control-a-flow and a 60 drop set

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54
Q

Dobutamine trade name

A

Dobutrex

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55
Q

Dobutamine class

A

Adrenergic agonist, beta 1 agnoist, inotropic, sympathomimetic

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56
Q

Dobutamine indications

A

Hypotension with symptoms of shock with SBP 70-100 (after fluid)
Hemodynamically significant RV infarct after moderate fluid loading

57
Q

Dobutamine contras

A

Hypersensitivity, pheochromocytoma, tachyarryhtmias

58
Q

Dobutamine dose

A

Dose 5-20mcg/kg/min adults and peds

59
Q

Dobutamine notes

A

ADd 250mg into 250ml (D5 or NS) = 1000mcg/mL

Use with caution if pt has sulfite allergy

60
Q

Epi trade name

A

Adrenalin

61
Q

Epi class

A

Adrenergic agonist, bronchodilator, vasporessor, sympathomimetic

62
Q

Epi indications

A

Symptomatic severe bradycardia with hypotension, not responsive to other therapy
Anaphylaxis refactory
Severe asthma with an allergenic component
Beta blocker/calcium channel blocker OD

63
Q

Epi contras

A

Naw

64
Q

Epi dose

A

Infusion at 1mcg/min increase by 1mcg/min prn

Titrate to SBP 90 or greater

65
Q

Additional epi notes

A

Add 1.5mg epi 1mg/mL to 250mL (NS or D5) concentration of 6mcg/mL
Use 60tts

66
Q

Norepi trade name

A

Levophed

67
Q

Norepi class

A

Adrenergic agonist, vasopressor, sympathomimetic

68
Q

Norepi indications

A

Symptomatic bradycardia
Shock with hypotension after fluid resusication
Cardiogenic shock with refractory hypotension

69
Q

Norepi contras

A

Hypovolemia, profound hypoxia, preggo

70
Q

Norepi contras

A

Dose 0.1mcg/kg/min IV/IO titrate to max of 1mcg/kg/min

71
Q

Norepi mixing

A

16mg into 250mL (D5 or NS) for a conecntration of 64mcg/mL

72
Q

Isoproterenol trade name

A

Ispurel

73
Q

Isoproterenol class

A

B1 and B2 agonist

74
Q

Isoproterenol indications

A

Immediate control AV heart block (after atropine)

75
Q

Isoproterenol contras

A

Hypersensitivity, tachycardia caused by dig tox, angina

76
Q

Isoproterenol contras

A

2-10mcg/minute IV infusion

77
Q

Metoprolol trade names

A

Betaloc, lopressor

78
Q

Metoprolol class

A

Beta 1 selective blocker

79
Q

Metoprolol indications

A

Symptomatic a-fib, a flutter, with BP > 80mmHg

80
Q

Metoprolol contras

A

Hypersensitivity, 2nd or 3r degree AV block, brady under 50, bronchospastic COPD reactive airway disease, severe heart failure

81
Q

Metoprolol Dose

A

5mg SIVP q 5 max of 15 Aim for HR of 110

82
Q

Labetalol trade name

A

Trandate

83
Q

Labetalol classification

A

Alpha 1 B1 and B2 blocker, antihypertensive

84
Q

Labetalol indications

A

Hypertensive emergencies

85
Q

Labetalol contraindications

A
hypersensitivity
Severe and prolonged hypotension
HX of obstructive airway disease
Overt heart failure
2nd or 3rd degree AV block
Cardiogenic shock
Severe bradycardia
86
Q

Adult dose labetalol

A

Initially 20-80mg IV over 2 minutes
Repeat 40-80mg IV q 2 minutes to max of 300mg as needed
Alternatively may give drug as infusion at 0.5-2mg/minute

87
Q

Propranolol trade name

A

Inderal

88
Q

Propranolol class

A

B1 and B2 blocker

89
Q

Propranolol indications

A

Management of SVT

90
Q

Propranolol contras

A
Hypersensitivity
Bronchial asthma
Sinus brad
2nd or 3rd degree AV block
Cardiogenic shock, heart failure (unless secondary to dysrhytmia)
91
Q

Propranolol dose

A

Adult
1-3mg IV in 50mL NS do not exceed 1mg/mL
One repeat dose of 3mg may be fiven in 2 minutes

92
Q

Esmolol trade name

A

Breviblock

93
Q

Esmolol class

A

B1 blocker

94
Q

Esmolol indications

A

TX SVT

95
Q

Esmolol contras

A

Hypersensitivity

96
Q

Esmolol dose adult

A

50-200mcg/kg/min

97
Q

Phentolamine trade name

A

Regitine

98
Q

Phentolamine class

A

Alpha adrenergic antagonist

99
Q

Phentolamine indicatins

A

Antihypertensive for pheochromocytoma
Hypertensive crisis for sympathomimetic amines
TX of dermal necrosis and sloughing of extravasation after IV admin of norepi or dope

100
Q

Phentolamine contras

A

Hypersensitivity
Angina
CAD, MI, or HX of MI

101
Q

Phentolamine dose

A

Inject 5-10mg in 10mL of NS into affected area

102
Q

Benztropine Mesylate trade name

A

Cogentin

103
Q

Benztropine mesylate class

A

Anticholinergic, antiparkinsonian

104
Q

Benztropine mesylate indications

A

Acute dystonic reactions

105
Q

Benztropine mesylate contras

A

Hypersensitivity
Acute angle closure glaucoma
Children under 3

106
Q

Benztropine mesylate dose

A

Adult 1-2mg IV/IO/IM

107
Q

Diazepam trade name

A

Valium

108
Q

Diazepam class

A

Benzodiazepine, skeletal muscle relaxant, amnestic, anticonvulsant, sedative-hypnotic

109
Q

Diazepam indications

A

Satus epilepticus/seizures
Skeletal muscle relaxation
Severely anxious or agitated pts
Cocaine OD

110
Q

Diazepam contras

A

Hypersensitivity to ANY benzo

Acute narrow angle glaucoma

111
Q

Diazepam dose

A

Adult 2.5-5mg IV/IO prn depending on condition

112
Q

Diazepam ped dose

A

0.1-0.3mg/kg slow IV or 0.3mg/kg rectally to total of 5mg in child less than 5 years, 10mg >10mg

113
Q

Lorazepam trade name

A

Ativan

114
Q

Lorazepam class

A

Benzo, skeletal muscle relaxant, amnestic, anticonvulsant, sedative-hypnotic

115
Q

Lorazepam indications

A

ETOH withdrawal, acute anxiety

116
Q

Lorazepam contras

A

Hypersensitivity to ANY benzo

Acute narrow angle glaucoma

117
Q

Lorazepam dose

A

ETOH 1mg SL q 5 max of 4mg

Acute anxiety 1mg SL q5 max of 2mg

118
Q

Midaz trade name

A

Versed

119
Q

Midaz class

A

Benzo, skeletal muscle relaxant, amnestic, anticonvulsant, sedative-hypnotic

120
Q

Midaz indications

A

Active seizure
Combative behavior
Maintenance of paralysis/sedation
Procedural sedation

121
Q

Midaz contras

A

Hypersensitivity
Myasthenia gravis
Hypotension (under 100mg)

122
Q

Midaz dose adult seizure

A

10mg IM or 5mg SIVP/IO total max 20mg

123
Q

Midaz dose adult combative behaviour

A

5mg SIVP or 10mg IV max 20 (same as seizure)

124
Q

Midaz maintenance of paralysis/sedation

A

2.5mg SIVP/IO q 10 PRN

125
Q

Midaz procedural sedation dose

A

0.05mg/kg SIVP max 2.5mg do not repeat

126
Q

Midaz ped seizure dose

A

seizure 0.2mg/kg IM/intranasal max 10mg OR 0.1mg/kg SIVP/IO max 5mg

127
Q

Midaz peds paralysis/sedation dose

A

0.05mg/kg SIVP/IO single max 2.5mg

128
Q

Propfol trade name

A

Diprivan

129
Q

Propofol class

A

Anesthetic

130
Q

Propofol indications

A

Conscious sedation

131
Q

Propofol contras

A

none apparently

132
Q

Propofol dose adult

A

2-2.5mg/kg IV
Usually given in 40mg bolus q 10 seconds until effect achieved
If old or hypovolemic give half dose

133
Q

Ketamine trade name

A

Ketalar

134
Q

Ketamine class

A

Anesthetic

135
Q

Ketamine indications

A

Sedation prior to intubation
Pain management refractory to analgesics
*pushed too fast can cause apnea

136
Q

Ketamine contras

A

Hypersensitivity

Significant elevation of BP - relative consideration as this may lead to angina/heart failure or aneurysms

137
Q

Ketamine dose adult

A

Sedation 1.5mg/kg SIVP/IO do not repeat
Sedation maintenance 0.5mg/kg SIVP/IO Q10 PRN
Pain management 0.2mg/kg SIVP/IO

138
Q

Ketamine peds dose

A

exact fucking same as adult