Induction Meds Per Watson Flashcards
(167 cards)
1
Q
Ancef (Cefazolin) - MOA
A
Inhibits bacterial cell wall synthesis (β-lactam)
2
Q
Ancef (Cefazolin) - Onset
A
<5 minutes
3
Q
Ancef (Cefazolin) - Duration
A
4–8 hours
4
Q
Ancef (Cefazolin) - Dose (Adults)
A
1–2 g IV
5
Q
Ancef (Cefazolin) - Dose (Pediatrics)
A
20–40 mg/kg IV (max 2 g)
6
Q
Atracurium - MOA
A
Non-depolarizing neuromuscular blocker (ACh receptor antagonist)
7
Q
Atracurium - Onset
A
2–4 minutes
8
Q
Atracurium - Duration
A
20–35 minutes
9
Q
Atracurium - Dose
A
0.4–0.5 mg/kg IV (maintenance: 0.1–0.2 mg/kg)
10
Q
Cisatracurium - MOA
A
Non-depolarizing NMB, stereoisomer of atracurium
11
Q
Cisatracurium - Onset
A
2–3 minutes
12
Q
Cisatracurium - Duration
A
30–60 minutes
13
Q
Cisatracurium - Dose
A
0.1 mg/kg IV (maintenance: 0.03 mg/kg)
14
Q
Dexamethasone - MOA
A
Glucocorticoid; reduces inflammation and PONV
15
Q
Dexamethasone - Onset
A
5–10 minutes
16
Q
Dexamethasone - Duration
A
24–72 hours
17
Q
Dexamethasone - Dose
A
0.1–0.2 mg/kg IV (max 10 mg)
18
Q
Etomidate - MOA
A
GABA-A receptor agonist; induces hypnosis
19
Q
Etomidate - Onset
A
30–60 seconds
20
Q
Etomidate - Duration
A
3–10 minutes
21
Q
Etomidate - Dose
A
0.2–0.6 mg/kg IV
22
Q
Fentanyl - MOA
A
μ-opioid receptor agonist
23
Q
Fentanyl - Onset
A
<1 minute
24
Q
Fentanyl - Duration
A
30–60 minutes
25
Fentanyl - Dose
1–2 mcg/kg IV
26
Hydromorphone - MOA
μ-opioid receptor agonist
27
Hydromorphone - Onset
~5 minutes
28
Hydromorphone - Duration
2–4 hours
29
Hydromorphone - Dose
0.015–0.02 mg/kg IV
30
Ketamine - MOA
NMDA receptor antagonist; dissociative anesthetic
31
Ketamine - Onset
30–60 seconds
32
Ketamine - Duration
5–15 minutes
33
Ketamine - Dose (Induction)
1–2 mg/kg IV
34
Ketamine - Dose (Analgesia)
0.2–0.5 mg/kg IV
35
Ketorolac - MOA
NSAID; COX-1/2 inhibitor (↓ prostaglandins)
36
Ketorolac - Onset
30 minutes
37
Ketorolac - Duration
4–6 hours
38
Ketorolac - Dose (Adults)
15–30 mg IV
39
Ketorolac - Dose (Pediatrics)
0.5 mg/kg IV (max 30 mg)
40
Lidocaine - MOA
Na⁺ channel blocker; stabilizes neuronal membranes
41
Lidocaine - Onset
30–60 seconds
42
Lidocaine - Duration
10–20 minutes
43
Lidocaine - Dose
1–1.5 mg/kg IV (max 100 mg)
44
Midazolam - MOA
Benzodiazepine; enhances GABA at GABA-A receptor
45
Midazolam - Onset
1–3 minutes
46
Midazolam - Duration
15–80 minutes
47
Midazolam - Dose
0.02–0.1 mg/kg IV
48
Morphine - MOA
μ-opioid receptor agonist
49
Morphine - Onset
5–10 minutes
50
Morphine - Duration
3–4 hours
51
Morphine - Dose
0.1 mg/kg IV
52
Neostigmine - MOA
Acetylcholinesterase inhibitor; reverses non-depolarizing NMBs
53
Neostigmine - Onset
7–11 minutes
54
Neostigmine - Duration
40–60 minutes
55
Neostigmine - Dose
0.04–0.08 mg/kg IV (max 5 mg)
56
Propofol - MOA
GABA-A receptor agonist; induces hypnosis
57
Propofol - Onset
30–45 seconds
58
Propofol - Duration
3–10 minutes (bolus)
59
Propofol - Dose (Induction)
1–2.5 mg/kg IV
60
Propofol - Dose (Maintenance)
100–300 mcg/kg/min infusion
61
Rocuronium - MOA
Non-depolarizing neuromuscular blocker
62
Rocuronium - Onset
1–2 minutes
63
Rocuronium - Duration
30–60 minutes
64
Rocuronium - Dose
0.6–1.2 mg/kg IV (maintenance: 0.1–0.2 mg/kg)
65
Succinylcholine - MOA
Depolarizing NMB; causes sustained depolarization
66
Succinylcholine - Onset
30–60 seconds
67
Succinylcholine - Duration
4–6 minutes
68
Succinylcholine - Dose
1–2 mg/kg IV
69
Sugammadex - MOA
Encapsulates and inactivates rocuronium/vecuronium
70
Sugammadex - Onset
~3 minutes
71
Sugammadex - Duration
Depends on dose and depth of block
72
Sugammadex - Dose
2–16 mg/kg IV
73
Tranexamic Acid - MOA
Antifibrinolytic; inhibits plasminogen activation
74
Tranexamic Acid - Onset
5–15 minutes
75
Tranexamic Acid - Duration
2–8 hours
76
Tranexamic Acid - Dose
10–15 mg/kg IV ± infusion
77
Vancomycin - MOA
Inhibits bacterial cell wall synthesis (glycopeptide antibiotic)
78
Vancomycin - Onset
30–60 minutes (infusion)
79
Vancomycin - Duration
6–12 hours
80
Vancomycin - Dose
15–20 mg/kg IV (max 2 g)
81
Vecuronium - MOA
Non-depolarizing neuromuscular blocker
82
Vecuronium - Onset
2–4 minutes
83
Vecuronium - Duration
30–60 minutes
84
Vecuronium - Dose
0.08–0.1 mg/kg IV (maintenance: 0.01–0.015 mg/kg)
85
Zofran (Ondansetron) - MOA
5-HT₃ serotonin receptor antagonist (CTZ + GI tract)
86
Zofran (Ondansetron) - Onset
~30 minutes
87
Zofran (Ondansetron) - Duration
4–8 hours
88
Zofran (Ondansetron) - Dose (Adults)
4–8 mg IV
89
Zofran (Ondansetron) - Dose (Pediatrics)
0.1 mg/kg IV (max 4 mg)
90
Gas Speed of Onset/Offset (Fastest to Slowest)
Desflurane > Sevoflurane > Isoflurane
91
MAC (Potency) order from most to least potent
Isoflurane (~1.15%) > Sevoflurane (~2%) > Desflurane (~6%)
## Footnote
Lower MAC = more potent
92
What is the MAC (Potency) of Isoflurane?
Isoflurane has a MAC of approximately 1.15%.
93
What is the MAC (Potency) of Sevoflurane?
Sevoflurane has a MAC of approximately 2%.
94
What is the MAC (Potency) of Desflurane?
Desflurane has a MAC of approximately 6%.
95
What is the MAC (Potency) of N2O?
N2O has a MAC of approximately 104%.
96
What is the mechanism of action (MOA) of Metoclopramide (Reglan)?
Dopamine D₂ receptor antagonist (in CTZ) and prokinetic: enhances gastric motility via 5-HT₄ agonism.
97
What are the effects of Metoclopramide (Reglan)?
Increases LES tone and accelerates gastric emptying.
98
What is the onset and duration of Metoclopramide (Reglan)?
Onset: 1–3 minutes (IV); Duration: 1–2 hours.
99
What is the recommended dose of Metoclopramide (Reglan)?
10 mg IV over 1–2 minutes.
100
What are the precautions for using Metoclopramide (Reglan)?
Avoid in bowel obstruction and Parkinson’s disease.
101
What are the risks associated with repeated use of Metoclopramide (Reglan)?
Risk of extrapyramidal symptoms (EPS) and tardive dyskinesia.
102
What is the mechanism of action (MOA) of Promethazine?
H₁ histamine receptor antagonist with anticholinergic and antidopaminergic effects.
103
What are the onset and duration of Promethazine?
Onset: 3–5 minutes (IV), 20 minutes (IM); Duration: 4–6 hours.
104
What is the recommended dose of Promethazine?
6.25–25 mg IV/IM.
105
What are the precautions for using Promethazine?
Vesicant — must dilute IV (prefer deep vein); extravasation can lead to tissue necrosis.
106
What side effects are associated with Promethazine?
Causes sedation and may potentiate opioid effects; anticholinergic side effects include dry mouth and blurry vision.
107
What is the mechanism of action (MOA) of Bicetra (Sodium Citrate & Citric Acid)?
Alkalinizes gastric contents to prevent acid aspiration pneumonitis (e.g., Mendelson’s syndrome).
108
What are the onset and duration of Bicetra?
Onset: Immediate (acts locally in stomach); Duration: ~1 hour.
109
What is the recommended dose of Bicetra?
30 mL PO (typically 0.3 M sodium citrate solution).
110
When should Bicetra be administered?
Administer 15–30 minutes before induction for aspiration prophylaxis.
111
What are the effects of Bicetra?
Raises gastric pH to >2.5 and reduces acidity-related lung injury.
112
What side effects can Bicetra cause?
Can cause transient nausea or abdominal discomfort.
113
What is the mechanism of action (MOA) of Aprepitant (Emend)?
Neurokinin-1 (NK1) receptor antagonist; blocks substance P in the CNS.
114
What are the onset and duration of Aprepitant?
Onset: 1–2 hours (oral); Duration: 24–72 hours.
115
What is the recommended dose of Aprepitant?
40 mg PO (commonly used preop for PONV prophylaxis).
116
Who is Aprepitant used for?
Used for high-risk PONV patients (especially with opioid use or history of motion sickness).
117
What is a common combination therapy with Aprepitant?
Often combined with ondansetron and dexamethasone.
118
What should be monitored when using Aprepitant?
CYP3A4 substrate — monitor for interactions with other drugs (e.g., steroids).
119
What are depolarizing neuromuscular blockers?
Depolarizing neuromuscular blockers mimic acetylcholine and bind to nicotinic ACh receptors at the neuromuscular junction.
120
What is the mechanism of action (MOA) of succinylcholine?
It causes sustained depolarization, leading to transient fasciculations and flaccid paralysis.
121
How does succinylcholine affect synaptic transmission?
It cannot be broken down quickly at the synapse, resulting in prolonged depolarization that blocks further impulses.
122
What is the onset time for succinylcholine?
Rapid onset (30–60 seconds).
123
What is the duration of action for succinylcholine?
Very short duration (4–6 minutes).
124
How is succinylcholine reversed?
It is not reversed by acetylcholinesterase inhibitors; recovery is spontaneous via plasma cholinesterase.
125
What are key features of succinylcholine?
It causes fasciculations before paralysis and has risks of hyperkalemia, malignant hyperthermia, bradycardia, and increased ICP/IOP.
126
In which conditions is succinylcholine contraindicated?
It is contraindicated in burns, neuromuscular diseases, spinal cord injury, and severe trauma (>24–48 hrs).
127
What are non-depolarizing neuromuscular blockers?
Examples include Rocuronium, Vecuronium, Cisatracurium, and Atracurium.
128
What is the MOA of non-depolarizing neuromuscular blockers?
They competitively block ACh from binding to nicotinic receptors, preventing depolarization without activating the receptor.
129
What is the onset time for Rocuronium?
1–2 minutes (fastest).
130
What is the onset time for Vecuronium?
2–4 minutes.
131
What is the onset time for Cisatracurium?
2–3 minutes.
132
What is the duration of action for non-depolarizing neuromuscular blockers?
Intermediate duration (20–60 minutes depending on the drug).
133
How are non-depolarizing neuromuscular blockers reversed?
They can be reversed by acetylcholinesterase inhibitors (e.g., neostigmine + glycopyrrolate) or Sugammadex for aminosteroid NMBs.
134
What are key features of non-depolarizing neuromuscular blockers?
They do not cause fasciculations and are safer in patients with hyperkalemia risk.
135
What are the metabolism routes for Rocuronium and Vecuronium?
They are metabolized hepatically.
136
What is the metabolism route for Cisatracurium?
It undergoes Hofmann elimination (organ-independent), making it ideal for renal/liver failure.
137
What is MAC?
MAC is the alveolar concentration of an inhaled anesthetic at which 50% of patients do not move in response to a painful surgical stimulus (typically a skin incision).
138
What does 0.5 MAC refer to?
0.5 MAC refers to an alveolar concentration of the inhaled anesthetic that is 50% of the MAC value.
## Footnote
At 0.5 MAC, a significant level of anesthesia is achieved, generally associated with: Unconsciousness + Amnesia.
139
What is MAC Bar (MAC-BAR)?
MAC-BAR is the minimum alveolar concentration of an inhaled anesthetic required to block the autonomic (sympathetic) nervous system response to a noxious stimulus in 50% of patients.
## Footnote
Autonomic responses include changes in heart rate, blood pressure, and catecholamine (stress hormone) release.
140
What is MAC Awake (MAC-awake)?
MAC-awake is the minimum alveolar concentration of an inhaled anesthetic at which 50% of patients will respond to a verbal command during emergence from anesthesia.
## Footnote
Often around 0.3 - 0.4 MAC.
141
What is the concentration of Versed (Midazolam)?
1 mg/mL
142
What is the dose per syringe for Versed (Midazolam)?
2 mg
143
What is the syringe size for Versed (Midazolam)?
3 mL
144
What is the concentration of Fentanyl?
50 mcg/mL
145
What is the dose per syringe for Fentanyl?
100 mcg
146
What is the syringe size for Fentanyl?
3 mL
147
What is the concentration of Lidocaine 1%?
10 mg/mL
148
What is the dose per syringe for Lidocaine 1%?
100 mg
149
What is the syringe size for Lidocaine 1%?
5 mL
150
What is the concentration of Propofol 1%?
10 mg/mL
151
What is the dose per syringe for Propofol 1%?
200 mg
152
What is the syringe size for Propofol 1%?
20 mL
153
What is the concentration of Rocuronium?
10 mg/mL
154
What is the dose per syringe for Rocuronium?
50 mg
155
What is the syringe size for Rocuronium?
5 mL
156
What is the concentration of Succinylcholine?
20 mg/mL
157
What is the dose per syringe for Succinylcholine?
200 mg
158
What is the syringe size for Succinylcholine?
10 mL
159
What is the concentration of Phenylephrine?
100 mcg/mL
160
What is the dose per syringe for Phenylephrine?
1000 mcg
161
What is the syringe size for Phenylephrine?
10 mL
162
What is the concentration of Ephedrine?
10 mg/mL
163
What is the dose per syringe for Ephedrine?
50 mg
164
What is the syringe size for Ephedrine?
5 mL
165
What is the concentration of Glycopyrrolate?
0.2 mg/mL
166
What is the dose per syringe for Glycopyrrolate?
1 mg
167
What is the syringe size for Glycopyrrolate?
5 mL
