Peds week 5 Flashcards by John Meyers

Dose Propofol IV

2-4 mg/kg

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Dose Propofol gtt

25-400 mcg/kg/min

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Pentothal IV

4-6 mg/kg (about twice the propofol dose)

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Etomidate IV

0.3 mg/kg (about a tenth of the propofol dose)

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Ketamine IV

1-2 mg/kg (half of propofol)

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ketamine IM

3-7 mg/kg (three times the IV dose, ~ as PO)

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ketamine PO

3-6 mg/kg (3x iv dose, ~ as IM dose)

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dexmedetomidine load (>20 min)

0.5 - 1 mcg/kg

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dexmedetomidine IV gtt

0.2-1 mcg/kg/hr (almost the same as the loading dose, but run over an hour instead of 20 minutes

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AvoidpropofolinductionthroughPICClines

increased risk of infection / occlusion

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Barbiturates are contraindicated in patients with __ and should be used cautiously in patients who are __ or have limited __ reserve

contraindicated porphyria

caution hypovolemia or limited cardiac reserve

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A couple of drawbacks to ketamine

hypersalivation could lead to laryngospasm (give glyco), increases CBF/ICP/CROM so not great for neuro, and increases IOP and nystagmus, so not great for eye surgery

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Some drawbacks to etomidate

Suppresses adrenal function, but great for head injury and unstable CV status

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fentanyl induction dose

1-2 mcg/kg

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hydromorphone

10-20 mcg/kg (10x fentanyl dose)

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morphine

100 mcg/kg (100x fentanyl dose)

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sufenta induction

1-10 mcg/kg (1-10x fentanyl dose)

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remi gtt

0.05-2 mcg/kg/min

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fentanyl is highly lipid soluble and crosses the __ rapidly

BBB

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Is dilaudid a good choice for infants and small children who are doing same day surgery and going to be discharged home?

NO due to resp depression

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Drawbacks to morphine

histamine release causing hypotension, PONV

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sufenta gtt

0.1-1.5 mcg/kg/hr

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remi gtt

0.05-2 mcg/kg/min

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methadone is __-__% protein bound. The main determinant of free factor is the __ acid glycoprotein

60-90% protein bound, a1 acid glycoprotein (think of A1 steak sauce being 60-90% protein bound on your steak)

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midazolam po

0.5-0.7 mg/kg MAX 20 mg

midazolam IV

0.05-0.1 mg/kg (about a tenth of the IV dose)

acetaminophen PO

10-15 mg/kg/dose q 6h (about the same as IV)

acetaminophen rectal

30-40 mg/kg x1 loading dose (2-3x the IV dose)

ketorolac IM

0.5-1 mg/kg (max 30mg)

ketorolac IV

0.5 mg/kg (max 30 mg)

acetaminophen do not exceed

90 mg/kg/24 hours

ketorolac caution

renal and asthma

compared to aspirin, ketorolac's platelet inhibition is __ and no longer an issue when the drug has been excreted

reversible

narcan IV

10 mcg/kg (same as flumazenil)

flumazenil IV

10 mcg/kg (same as narcan)

succs IV

1.5-2 mg/kg

Roc RSI

0.6-1.2 mg/kg

Roc regular induction

0.45-0.6 mg/kg

vec IV

0.1 mg/kg

cisatracurium IV

0.1-0.2 mg/kg (either same or double vec dose)

pancuronium IV

0.1 mg/kg (same as vec)

neonates appear more sensitive to roc than older infants

duration closer to 90 minutes

how is nimbex metabolized?

hoffman elimination and ester hydrolysis

why give panc?

when increased HR and BP is desired, along with a lengthy block

glyco IV

10 mcg/kg

atropine IV

10-20 mcg/kg (min. 100 mcg)

neostigmine IV

70 mcg/kg (max 5 mg)

decadron antiemetic IV

0.1 mg/kg (max 10 mg)

decadron airway IV

0.5 mg/kg (max 10 mg)

zofran IV

0.1 mg/kg (max 4 mg)

caution with atropine and some children with Down syndrome due to

narrow-angle glaucoma

amides are metabolized by

cytochrome p450

esters are metabolized by

plasma cholinesterase

bup with epi max dose

2.5 mg/kg

lidocaine w/wo epi infiltrate max

4.5 mg/kg

rope max dose

2 mg/kg

epi for cardiac arrest, hypotension, heart failure

10 mcg/kg q3-5 min or 0.01-1 mcg/kg/min

epi to treat bronchospasm

1-2 mcg/kg

racemic epi

less than 2 years = 6 mg in 3 mls | greater than 2 years = 12 mg in 3 mls

ancef IV

25 mg/kg

clinda IV

10 mg/kg

gent IV

2 mg/kg

ampicillin IV urology

20 mg/kg

ampicillin IV general

25-50 mg/kg

vanco IV

15 mg/kg (20 mg/kg neuro)

what is the hallmark of congenital diaphragmatic hernia?

abnormal compression of pulmonary structures, lung growth is severely retarded

congenital diaphragmatic hernia manifests as severe resp distress in the neonate due to

lung hypoplasia and inadequate gas exchange

neonate is born with congenital diaphragmatic hernia, what do you do

avoid masking, tube quickly and rate high with Vt low, low peak pressures <30, NG tube, avoid nitrous,

which lung is usually affected by congenital diaphragmatic hernia?

left lung through the foramen of bochdalek

during repair of congenital diaphragmatic hernia the sat and heart rate fall, increased peak pressures, what's going on?

tension pneumo on contralateral side, insert chest tube

what pH abnormality with pyloric stenosis?

metabolic alkalosis, also hypokalemia, hypochloremia

pyloric stenosis is considered a __ stomach and requires RSI

full | awake extubation

which way does the oxyhemoglobin curve shift with pyloric stenosis?

left due to alkalosis d/t vomiting

Peds week 5 Flashcards

(73 cards)