Pharm: Reversal Drugs

Question 1

Neostigmine drug class

Answer 1

acetylcholinesterase inhibitor

Question 2

Neostigmine concentrations

Answer 2

1mg/mL
0.5mg/mL

Question 3

Neostigmine standard and max dose

Answer 3

0.06-0.08mg/kg
(60-80mcg/kg)

Max dose: 5mg

Question 4

Neostigmine onset

Answer 4

7-11min

Question 5

Neostigmine co administration

Answer 5

administer with glycol 0.007/mg/kg

Question 6

Edrophonium drug class

Answer 6

Acetylcholinesterase inhibitor

Question 7

Edrophonium dose

Answer 7

0.5-1mg/kg

Max: 1-1.5mg/kg

Question 8

Edrophonium onset

Answer 8

rapid

Question 9

Edrophonium co administration

Answer 9

Administer with
atropine 0.007
mg/kg
“double O 7”

Question 10

Glycopyrrolate (Robinol) drug class

Answer 10

Quaternary
anticholinergic

Question 11

Glycopyrrolate (Robinol) dose with neostigmine or pyridostigmine

Answer 11

Neo: 0.2 mg per 1 mg
neostigmine

Pryido: 0.2 mg per 5
mg pyridostigmine
Decrease secretions:

Question 12

Glycopyrrolate (Robinol) onset, duration and vagal block

Answer 12

Onset: rapid
Duration: 4 hr
Vagal block: 2-3 hr

Question 13

Glycopyrrolate (Robinol) order of admin

Answer 13

give 1st to reduce bradycardia of AChE inhibitors

Question 14

Atropine drug class

Answer 14

Quaternary anticholinergic

Question 15

Atropine concentration

Answer 15

0.4mg/mL

Question 16

Atropine dosing with AChE inhibitor or bradycardia

Answer 16

Neo: 0.6-1.2 mg per
0.5-2.5 mg
neostigmine
Bradycardia: 0.5-1mg

Question 17

Atropine onset, duration, peak half life

Answer 17

Onset: immediate
Peak: 2-4 min
Duration: 4-6 hr
half life: 2-3hrs

Question 18

Atropine elimination

Answer 18

kidney and liver

Question 19

Sugammadex (Bridon) drug class

Answer 19

modified gamma cyclodextrin (forms complex with roc and vec)

Question 20

Sugammadex (Bridon) concentrations

Answer 20

100mg/mL

Question 21

Sugammadex (Bridon) TOF dosing

Answer 21

0/4 = 4mg/kh
2/4 = 2mg/kg

Question 22

Sugammadex (Bridon) immediate reversal dose

Answer 22

Immediate reversal: 16
mg/kg (after 1.2-3 min
or rocuronium)

Question 23

Sugammadex (Bridon) dosed on what weight

Answer 23

actual body weight

Question 24

Sugammadex (Bridon) elimination

Answer 24

Kidneys

Question 25

Sugammadex (Bridon) cautions and side effects

Answer 25

ESRD inhibits birth control bradycardia

Question 26

Nalbuphine MOA

Answer 26

Equianalgesic to morphine & structurally r/t naloxone and oxymorphine Partially reverse opioid induced RD from Mu agonist analgesia

Question 27

Nalbuphine dose

Answer 27

10mg IV

Question 28

Nalbuphine onset and duration

Answer 28

onset: 2-3min duration: 3-6hrs

Question 29

Nalbuphine cautions

Answer 29

caution use with opioid dependent patients. can cause withdrawal

Question 30

Naloxone (Narcan) MOA

Answer 30

Pure Mu antagonist Reverses opioid induced RD and analgesia

Question 31

Naloxone (Narcan) dose

Answer 31

1-4mcg/kg Titrate 40mcg to avoid increase SNS

Question 32

Naloxone (Narcan) onset, duration, half life

Answer 32

onset: 1-3min duration: 30-90min HL shorter than narcotic

Question 33

Naloxone (Narcan) cautions

Answer 33

Avoid abrupt reversal of analgesia d/t catecholamine surge

Question 34

Flumazenil (Romazicon) drug class

Answer 34

Benzodiazepine antagonist

Question 35

Flumazenil (Romazicon) dose

Answer 35

0.2mg IV repeat dose 0.1mg (up to 1mg) infusion: 0.1-0.4mg/hr