Flash card assignment
1
Q
Succ trade name
A
Anectine
2
Q
Succ class
A
Depolarizing NMBA
3
Q
Succ indications
A
Medicated facilitated intubation after administration of sedation/analgesic
4
Q
Succ contras
A
Hypersensitivity, known or suspected hyperK+, family hx of MH or psuedocholinesterase deficiency, myopathies associated with elevated CK
5
Q
Succ dose
A
Adults 1.5mg/kg IV/IO
Peds 1.5 - 2.0 mg/kg IV/IO
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+
7
Q
Roc trade name
A
Zemuron
8
Q
Roc class
A
Non depolarizing NMBA
9
Q
Roc indications
A
Post intubation to facilitate airway control and maintain muscle relaxation
10
Q
Roc contras
A
Hypersensitivity
11
Q
Roc dosage
A
Adult 1mg/kg IV/IO repeated 0.5mg/kg IV/IO PRN
12
Q
Roc ped dose
A
Exact fucking same as adult
13
Q
Vecuronium trade name
A
Norcuron
14
Q
Vecuronium class
A
Non depolarizing NMBA
15
Q
Vecuronium indications
A
Post intubation for airway control and maintain muscle relaxation
16
Q
Vecuronium contras
A
Hypersensitivity
17
Q
Vecuronium adult dose
A
0.1mg/kg IV/IO maintain at 0.01-0.05mg/kg IV/IO Q 20-40
18
Q
Vecuronium peds
A
Exact fucking same as adults
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
20
Q
Vecuronium additional considerations
A
Don’t be a dick
Micins and CCBs can potentiate
No histamine release, cardiovascular effects are minimized
21
Q
Pancuronium Bromide trade name
A
Pavulon
22
Q
Pancuronium Bromide class
A
Non depolarizing NMBA
23
Q
Pancuronium Bromide indications
A
Post tube to facilitate airway control and maintain muscle relaxation
24
Q
Pancuronium Bromide contas
A
Hypersensitivty
25
Pancuronium Bromide adult dose
0.1mg/kg IV/IO maintain at 0.01mg/kg q 20-40 IV/IO
26
Pancuronium Bromide peds dose
Exact fucking same as adults
27
Pancuronium Bromide additional considerations
Don't be a dick
Is the prototype non depol NMBA
NO histamine release, minimal cardiovasc effects
30-45% of drug undergoes hepatic metabolism
28
Atropine Sulfate trade name
Atropine
29
Atropine Sulfate Class
Anticholinergic, parasympatholytic
30
Atropine Sulfate indications
Symptomatic bradycardia, organophosphate poisoning
31
Atropine Sulfate contras
Hypersensitivity
32
Atropine Sulfate dose adult for bradycardia
0.5mg IV/IO q3-5 max 3mg
33
Atropine Sulfate adult dose organophosphate poisoning
2mgIV/IO/IM q5 prn until sludgem reversed
34
Atropine Sulfate peds for brady
0.02mg/kg IV/IO single max of 0.5
| May give q3-5 prn ma of 0.04mg/kg or 1mg
35
Atropine Sulfate peds organo poisoning
0.05mg/kg q5 prn until DJ BMSLUDGE reversed
36
Atropine Sulfate additional considerations
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
37
Ipratropium Bromide trade name
atrovent
38
Ipratropium Bromide class
Antichol, parasympatholytic
39
Ipratropium Bromide indications
bronchospasm, anaphylaxis
40
Ipratropium Bromide contras
Hypersensitivity
41
Ipratropium Bromide adult dose
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
42
Ipratropium Bromide pediatric dose
Less than 20kg - 250mcg with ventolin
| Greater than 20kg - 500mcg with ventolin nebbed
43
Ipratropium Bromide additional considerations
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
44
Dopamine trade name
Intropin
45
Dopamine class
Adrenergic agonist, vasopressor, inotropic, sympathomimetic
46
Dopamine indications
Shock management, sepsis, pulmonary edema, symptomatic bradycardia,
Beta blocker/ calcium channel blocker OD
47
Dopamine contras
```
Pheochromocytomo
Tachyarrythmias
V fib
MAOI within 14 days
Allergy to sulphites
```
48
Dopamine dose
Adult initial 5mcg/kg/minute titrate to max dose of 20
49
Dopamine peds
2-20mcg/kg/minute - titrate to effect
50
Dopa renal dose
Increased renal at 2-5mcg/kg/min
51
Dopa beta 1 dose
5-10mcg/kg/min
52
Dopa A1 effects
10-20mcg/kg/min
53
Dopa additional notes
400mg/250ml saline or D5W = 1600mcg/mL use baxter control-a-flow and a 60 drop set
54
Dobutamine trade name
Dobutrex
55
Dobutamine class
Adrenergic agonist, beta 1 agnoist, inotropic, sympathomimetic
56
Dobutamine indications
Hypotension with symptoms of shock with SBP 70-100 (after fluid)
Hemodynamically significant RV infarct after moderate fluid loading
57
Dobutamine contras
Hypersensitivity, pheochromocytoma, tachyarryhtmias
58
Dobutamine dose
Dose 5-20mcg/kg/min adults and peds
59
Dobutamine notes
ADd 250mg into 250ml (D5 or NS) = 1000mcg/mL
| Use with caution if pt has sulfite allergy
60
Epi trade name
Adrenalin
61
Epi class
Adrenergic agonist, bronchodilator, vasporessor, sympathomimetic
62
Epi indications
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
Epi contras
Naw
64
Epi dose
Infusion at 1mcg/min increase by 1mcg/min prn
| Titrate to SBP 90 or greater
65
Additional epi notes
Add 1.5mg epi 1mg/mL to 250mL (NS or D5) concentration of 6mcg/mL
Use 60tts
66
Norepi trade name
Levophed
67
Norepi class
Adrenergic agonist, vasopressor, sympathomimetic
68
Norepi indications
Symptomatic bradycardia
Shock with hypotension after fluid resusication
Cardiogenic shock with refractory hypotension
69
Norepi contras
Hypovolemia, profound hypoxia, preggo
70
Norepi contras
Dose 0.1mcg/kg/min IV/IO titrate to max of 1mcg/kg/min
71
Norepi mixing
16mg into 250mL (D5 or NS) for a conecntration of 64mcg/mL
72
Isoproterenol trade name
Ispurel
73
Isoproterenol class
B1 and B2 agonist
74
Isoproterenol indications
Immediate control AV heart block (after atropine)
75
Isoproterenol contras
Hypersensitivity, tachycardia caused by dig tox, angina
76
Isoproterenol contras
2-10mcg/minute IV infusion
77
Metoprolol trade names
Betaloc, lopressor
78
Metoprolol class
Beta 1 selective blocker
79
Metoprolol indications
Symptomatic a-fib, a flutter, with BP > 80mmHg
80
Metoprolol contras
Hypersensitivity, 2nd or 3r degree AV block, brady under 50, bronchospastic COPD reactive airway disease, severe heart failure
81
Metoprolol Dose
5mg SIVP q 5 max of 15 Aim for HR of 110
82
Labetalol trade name
Trandate
83
Labetalol classification
Alpha 1 B1 and B2 blocker, antihypertensive
84
Labetalol indications
Hypertensive emergencies
85
Labetalol contraindications
```
hypersensitivity
Severe and prolonged hypotension
HX of obstructive airway disease
Overt heart failure
2nd or 3rd degree AV block
Cardiogenic shock
Severe bradycardia
```
86
Adult dose labetalol
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
Propranolol trade name
Inderal
88
Propranolol class
B1 and B2 blocker
89
Propranolol indications
Management of SVT
90
Propranolol contras
```
Hypersensitivity
Bronchial asthma
Sinus brad
2nd or 3rd degree AV block
Cardiogenic shock, heart failure (unless secondary to dysrhytmia)
```
91
Propranolol dose
Adult
1-3mg IV in 50mL NS do not exceed 1mg/mL
One repeat dose of 3mg may be fiven in 2 minutes
92
Esmolol trade name
Breviblock
93
Esmolol class
B1 blocker
94
Esmolol indications
TX SVT
95
Esmolol contras
Hypersensitivity
96
Esmolol dose adult
50-200mcg/kg/min
97
Phentolamine trade name
Regitine
98
Phentolamine class
Alpha adrenergic antagonist
99
Phentolamine indicatins
Antihypertensive for pheochromocytoma
Hypertensive crisis for sympathomimetic amines
TX of dermal necrosis and sloughing of extravasation after IV admin of norepi or dope
100
Phentolamine contras
Hypersensitivity
Angina
CAD, MI, or HX of MI
101
Phentolamine dose
Inject 5-10mg in 10mL of NS into affected area
102
Benztropine Mesylate trade name
Cogentin
103
Benztropine mesylate class
Anticholinergic, antiparkinsonian
104
Benztropine mesylate indications
Acute dystonic reactions
105
Benztropine mesylate contras
Hypersensitivity
Acute angle closure glaucoma
Children under 3
106
Benztropine mesylate dose
Adult 1-2mg IV/IO/IM
107
Diazepam trade name
Valium
108
Diazepam class
Benzodiazepine, skeletal muscle relaxant, amnestic, anticonvulsant, sedative-hypnotic
109
Diazepam indications
Satus epilepticus/seizures
Skeletal muscle relaxation
Severely anxious or agitated pts
Cocaine OD
110
Diazepam contras
Hypersensitivity to ANY benzo
| Acute narrow angle glaucoma
111
Diazepam dose
Adult 2.5-5mg IV/IO prn depending on condition
112
Diazepam ped dose
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
Lorazepam trade name
Ativan
114
Lorazepam class
Benzo, skeletal muscle relaxant, amnestic, anticonvulsant, sedative-hypnotic
115
Lorazepam indications
ETOH withdrawal, acute anxiety
116
Lorazepam contras
Hypersensitivity to ANY benzo
| Acute narrow angle glaucoma
117
Lorazepam dose
ETOH 1mg SL q 5 max of 4mg
| Acute anxiety 1mg SL q5 max of 2mg
118
Midaz trade name
Versed
119
Midaz class
Benzo, skeletal muscle relaxant, amnestic, anticonvulsant, sedative-hypnotic
120
Midaz indications
Active seizure
Combative behavior
Maintenance of paralysis/sedation
Procedural sedation
121
Midaz contras
Hypersensitivity
Myasthenia gravis
Hypotension (under 100mg)
122
Midaz dose adult seizure
10mg IM or 5mg SIVP/IO total max 20mg
123
Midaz dose adult combative behaviour
5mg SIVP or 10mg IV max 20 (same as seizure)
124
Midaz maintenance of paralysis/sedation
2.5mg SIVP/IO q 10 PRN
125
Midaz procedural sedation dose
0.05mg/kg SIVP max 2.5mg do not repeat
126
Midaz ped seizure dose
seizure 0.2mg/kg IM/intranasal max 10mg OR 0.1mg/kg SIVP/IO max 5mg
127
Midaz peds paralysis/sedation dose
0.05mg/kg SIVP/IO single max 2.5mg
128
Propfol trade name
Diprivan
129
Propofol class
Anesthetic
130
Propofol indications
Conscious sedation
131
Propofol contras
none apparently
132
Propofol dose adult
2-2.5mg/kg IV
Usually given in 40mg bolus q 10 seconds until effect achieved
If old or hypovolemic give half dose
133
Ketamine trade name
Ketalar
134
Ketamine class
Anesthetic
135
Ketamine indications
Sedation prior to intubation
Pain management refractory to analgesics
*pushed too fast can cause apnea
136
Ketamine contras
Hypersensitivity
| Significant elevation of BP - relative consideration as this may lead to angina/heart failure or aneurysms
137
Ketamine dose adult
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
Ketamine peds dose
exact fucking same as adult
