Pharmacology Flashcards
(40 cards)
2
Q
Midazolam (Versed)
A
Benzodiazepine Uses: Anxiolysis, Sedation, amnesia Supplied 1 mg/mL Dose Sedation: 1-2.5 mg IV Dose PO: 0.5 mg/kg
3
Q
Morphine
A
Supplied: 10mg/mLOnset: 15-30 minutes
Duration: 3-6 hours
Dose Intraoperative: 0.1-1mg/kg (IV)
Dose Postoperative: 0.03-0.15 mg/kg (IV)
4
Q
Fentanyl
A
Supplied: 50 mcg/mL Peak Effect: 3-5 minutes Duration: 30-60 minutes Dose Low: 1-2 mcg/kg Dose Moderate: 2-20 mcg/kg Infusion: 1-2mcg/kg/hr
5
Q
Hydromorphone (Dilaudid)
A
Use: Analgesia Supplied: 2mg ampule Dose: 0.5-2mg Onset: 5 minutes Duration: 3-6 hours
6
Q
Naloxone (narcan)
A
Use: overdose, respiratory depression
Supplied: 0.4 mg vial
Dose: 1-4 mcg/kg
7
Q
Meperidine (Demerol)
A
Use: analgesia, Post-op shivering
Supplied: 2.5%, 5%, 7.5%, 10%
Dose: periop analgesia: 75-100mg IV
Post-op Shivering 12.5-25 mg IV
8
Q
Propofol (Diprivan)
A
Class: Diisopropylphenol Use: Induction, Sedation, MAC Supplied: 10mg/mL (1%) Dose Induction: 1.0-2.5 mg/kg Dose Infusion: 25-200 mcg/kg/min Cautions: Use within 6 hours, soy or egg allergy, HYPOTENSION
9
Q
Etomidate (Amidate)
A
Use: Induction/hypnosis Supplied: 2mg/mL (35% propylene glycol) Dose: 0.2 - 0.3 mg/kg CARDIOVASCULAR STABILITY Caution: Pain on injection, myoclonus, PONV
10
Q
Lidocaine
A
Class: Amide
Use: Local anesthesia, cough, inhalation, cardiac arrythmias
Supplied: 0.5-5%
Dose: IV Induction (0.5-1mg/kg)
11
Q
Ketamine (Ketalar)
A
Class: Phencyclidine (PCP Derivative) Use: Induction, analgesia, amnesia Supplied: 10, 50, 100 mg/mL Dose Analgesia 0.2-0.5 mg/kg Dose Induction 1-2mg/kg IV Dose Induction 4-8mg/kg IM Emergence Delirium
12
Q
Succinylcholine (Anectine)
A
Class: Depolarizing NMBD Use: Intubation, Paralysis, Laryngospasm Supplied: 20 mg/mL Onset: 30 seconds Dose: Intubation: 1-2mg/Kg Laryngospasm: 0.1 mg /kg IV Duration: 3-5 minutes Fasciculations (5-10 mg of Roc prevent) Malignant Hyperthermia
13
Q
Rocuronium (Zemuron)
A
Class: Aminosteroid, non-depolarizing Use: Paralysis, RSI Supplied: 10mg/mL Onset: 1-2 minutes (as short as 30 sec at high conc) Duration: 20-35 minutes Metabolism: Liver and Kidneys Dose Intubation: 0.6 - 1.2 mg/kg Maintenance: 0.1 mg/kg Infusion: 5-12 mcg/kg/min
14
Q
Vecuronium (Norcuron)
A
Class: Aminosteroid, non-depolarizing Use: Paralysis Supplied:10mg powder reconstituted to 1 mg/ml Onset: 3-5 minutes Duration: 20-35 minutes Metabolism: Liver and Kidneys Dose Intubation: 0.08-0.12mg/kg Infusion: 1-2mcg/kg/min Maintenance 0.01 mg/kg
15
Q
Cisatracurium (Nimbex)
A
Class: Benzyl isoquinolinium,non-depolarizing Use: Paralysis Supplied: 20 mg vial ( 2 mg/mL) Dose: Intubation 0.1-0.15 mg/kg Infusion 1-2 mcg/kg/min GOOD FOR RENAL/HEPATIC DYSFUNCTION Onset 3-5 minutes Duration 20-35 minutes
16
Q
Neostigmine
A
Class: Anticholinesterase Use: NMB reversal Supplied: 1mg/mL (0.5 mg/mL) Dose: 0.04-0.07 mg/Kg Caution: BLUDS
17
Q
Atropine
A
Class: Anticholinergic Use: Bradycardia, NMB reversal Supplied: 0.4, 0.5, 1 mg/mL Dose: IM 0.01-0.02 mg/Kg (up to 0.4-0.6 mg) Bradycardia: 0.4-0.6 mg (up to 3 mg)
18
Q
Isoflurane
A
Highly Potent A/W Irritant Min Metabolism- 0.2% CV Changes- minimal at 1 MAC MAC = 1.1% Vapor Pressure: 238
19
Q
Sevoflurane
A
Least A/W Irritant Inhalational induction Metabolized 2-5% Compound A Renal Tubular Injury Prompt Recovery MAC = 2.0% Vapor Pressure: 157
20
Q
Desflurane
A
Pungent A/W irritant Decreased Potency Prompt Recovery CO formation MAC = 6.0% Vapor Pressure: 669
21
Q
Glycopyrrolate (Robinul)
A
Class: Anticholinergic Use: Antisialigogue, NMB reversal Supplied: 0.2 mg/mL Dose: Pre-med: 0.2 mg IM Reversal: 0.2 mg per 1 mg Neostigmine Used with neostigmine because of similar onset and duration times
22
Q
Epinephrine
A
Class: Catecholamine Use: Increase HR/BP, Anaphylaxis, bronchospasm Supplied: 16 µg/mL syringe; 4 µg/mL (1 mg in 250mL) Dose: Bolus (8-16mcg) Small Doses (1-2 µg/min) – β2 Medium Doses(4 µg/min)- β1 Large Doses (10-20 µg/min)- α and β
23
Q
Phenylephrine
A
Class: Synthetic non-catecholamine Action: Direct Stimulates alpha receptors Use: Increase Blood pressure, nasal decongestant Supplied: **100mcg/mL (1mg vial)** Dose: Bolus: **50-100 mcg** Infusion: 0.25-1 mcg/kg/min Caution: Increased Afterload Reflex bradycardia
24
Q
Ephedrine
A
Class: Synthetic non-catecholamine Action: Direct and Indirect Stimulated the release of norepinephrine to act on alpha receptors Use: increase heart rate and blood pressure Acts on the heart Supplied **5mg/mL (25 or 50mg in 1 mL)** Dose: **5-20mg** Caution: Tachyphylaxis Depletion of Norepinephrine
25
Q
Esmolol (Brevibloc)
A
Class- Cardioselective Beta blocker Use: Decrease heart rate Supplied: **100 mg (10 mg/mL in 10 mL)** Dose: 0.2-0.5 mg/kg Normal initial dose is 10mg Decrease HR, Contractility, BP Onset: 5 minutes Duration 10-30minutes Metabolism: Plasma cholinesterases
26
Metoprolol (Lopressor)
```
Class: Beta-blocker
Long acting….selective for beta-1 (heart)
Use: Decrease HR
Supplied: 5 mg (1 mg/mL)
Dose: 1-2 mg
Duration can be in hours not minutes
```
27
Labetalol (normodyne)
Class: Mixed antagonist α1, β1, β2
(Beta: Alpha = 7:1)
Use: Control HR and BP
Supplied: 5mg/mL (20 mL vial)
Dose: 0.1-0.25 mg/kg (5mg initial)
Can decrease BP through beta effects on the heart but also through vascular dilation by alpha receptors
Ashtma---B2 antagonist can cause broncho CONSTRICTION
28
Nitroglycerin
```
Class: Hypotensive agent
Use: Angina, HTN
Supplied: 100 µg/mL
Dose:
Bolus: 50-100 µg
Infusion: 0.5-10 µg/kg/min
Caution
Principally Venous Dilator
Decreases Ventricular Wall Tension
```
29
Hydralazine
```
Class: Hypotensive agent
Use: HTN
Supplied: 20 mg in 1 mL
Dose: 5-20 mg
Onset: 20 minutes
Duration: 6-8 hours
Principal Arterial Dilator
```
30
Droperidol (inapsine)
```
Class: Antidopaminergic
Use: Antiemetic
Supplied: 0.3125 mg/mL
Dose: 0.625 mg
Caution:
Parkinsons
Prolonged QT interval
Abnormal EKG
```
31
Odansetron (zofran)
```
Class: Serotonin receptor antagonist
Use: Antiemetic
Decreased PONV in susceptible patients
Supplied: 4 mg/2mL
Dose: 4 mg
```
32
*Cefazolin (Ancef)*
Antibiotic (Cephalosporin)
*Derivative of Penicillin*
Dose: *1-2g IV*
Given within 60 minutes of incision
33
Cefoxitin
Antibiotic (Cephalosporin)
More gram negative coverage specific to GI flora
2g IV within 60 minutes
34
Ampicillin
Antibiotic Penicillin cross reactive
Subacute bacterial endocarditis prophylaxis (SBE)
Mechanical Heart Valves, Congenital Heart Disease
35
Gentamicin
```
Antibiotic
Often used with ampicillin for SBE
Common in Urology Cases
Given slowly
Ototoxicity
Can cause deafness (ideally transient)
```
36
Levaguin
Antibiotic
Often used for additional gram negative coverage
Abdominal Cases, ENT involving the mouth
37
Nafcillin
Antibiotic Penicillin Cross reactive
| Often Used for Neuro Cases
38
*Vancomycin*
*90kg 1.5g IV given over one hour*
Increases risk of VRE (vancomycin resistant enterococci)
Used as broad spectrum treatment against over hospital acquired infections due to drug resistant bacteria
Given slowly over one hour to prevent Redman Syndrome where too much histamine is released causing hypotension and flushing of the torso
39
*Clindamycin*
Dose: *600 or 900mg IV*
Usually first choice for somebody with PCN allergy
Redose every 6 hours (q6h)
40
Pancuronium
```
Non-Depolarizing Neuromuscular Blocker
Can cause Tachycardia
Initial Dose: 0.06-0.1mg/kg
pH is 4 ish
Provided 1-2mg/mL
Duration: 60-90 minutes
```
41
Pancuronium
```
Non-Depolarizing Neuromuscular Blocker
Can cause Tachycardia
Initial Dose: 0.06-0.1mg/kg
pH is 4 ish
Provided 2mg/mL
Duration: 60-90 minutes
```
