RSI drugs

Question 1

What are the commonly used induction agents for RSI?

Answer 1

-etomidate
-propofol
-ketamine
-midazolam

Question 2

What are the commonly used paralytics for RSI?

Answer 2

-succinylcholine
-rocuronium
-vercuronium
-pancuronium

Question 3

What type of drug is etomidate?

Answer 3

-imidazole derivative
-activates GABA receptors

Question 4

What type of drug is propofol?

Answer 4

-alkylphenol derivative
-potentiates GABA receptors

Question 5

What type of drug is ketamine?

Answer 5

-phencyclidine derivative
-non-competitive antagonist of NMDA

Question 6

What type of drug is midazolam?

Answer 6

benzodiazepine

Question 7

What type of drug is succinylcholine?

Answer 7

depolarizing agent

Question 8

What type of drug is rocuronium?

Answer 8

non-depolarizing agent

Question 9

What type of drug is vecuronium?

Answer 9

non-depolarizing agent

Question 10

What type of drug is pancuronium?

Answer 10

non-depolarizing agent

Question 11

What are the pros of using etomidate?

Answer 11

-no hypotension
-no increase in ICP
-short onset of action and half-life
-preferred in trauma

Question 12

What are the pros of using propofol?

Answer 12

-may be neuroprotective
-quick onset and short duration

Question 13

What are the pros of using propofol?

Answer 13

-may be neuroprotective by reducing intracranial pressure
-has anticonvulsive and anti-emetic properties
-quick onset and short duration
-can be used as an infusion

Question 14

What are the pros of using ketamine?

Answer 14

-provides sedation and analgesia
-preserves respiratory drive
-can increase MAP
-has bronchodilator properties that make it good in severe asthma

Question 15

What are the pros of using midazolam?

Answer 15

-good for providing amnesia

Question 16

What are the pros of using midazolam?

Answer 16

-good for providing amnesia
-anticonvulsant

Question 17

What are the pros of using succinylcholine?

Answer 17

-best choice, if one of its many contraindications isn’t a problem

Question 18

What are the pros of using succinylcholine?

Answer 18

-best choice, if one of its many contraindications isn’t a problem

Question 19

What are the pros of using rocuronium?

Answer 19

similar to SCh, but without all the contraindications

Question 20

What are the pros of using rocuronium?

Answer 20

similar to SCh, but without all the contraindications

Question 21

What are the adverse effects of etomidate?

Answer 21

-transient adrenal suppression
-controversial concerns in sepsis and trauma
-transient myoclonus

Question 22

What are the adverse effects of propofol?

Answer 22

-myocardial depression
-peripheral vasodilation –> decreased MAP
-needs to be avoided in hypovolemic pt

Question 23

What are the adverse effects of midazolam?

Answer 23

-drops MAP 10-25% in healthy pts
-does not provide analgesia

Question 23

What are the adverse effects of ketamine?

Answer 23

-may increase ICP (controversial)

Question 24

What are the adverse effects of succinylcholine?

Answer 24

-increases ICP -in peds causes bradycardia (get the atropine ready)

Question 25

What are the contraindications to using succinylcholine?

Answer 25

-hyperkalemia -h/o malignant hyperthermia -muscular dystrophy -rhabdomyolysis -burns >72hr old

Question 26

What are the adverse effects of rocuronium?

Answer 26

-long acting so if a difficult airway be careful because the pt will be paralyzed and unable to breath on their own

Question 27

What is the dosing for rocuronium?

Answer 27

1mg/kg

Question 28

What is the dosing for succinylcholine?

Answer 28

1.5-2mg/kg

Question 29

What is the dosing for midazolam?

Answer 29

0.-0.3mg/kg

Question 30

What is the dosing for midazolam?

Answer 30

0.1-0.3mg/kg

Question 31

What is the dosing for ketamine?

Answer 31

1-2mg/kg

Question 32

What is the dosing for propofol?

Answer 32

1.5-3mg/kg

Question 33

What is the dosing for etomidate?

Answer 33

0.3mg/kg

Question 34

What is the onset and duration of etomidate?

Answer 34

-15-45s -3-12min

Question 35

What is the onset and duration of propofol?

Answer 35

-15-45s -5-10min

Question 36

What is the onset and duration of ketamine?

Answer 36

-45-60s -10-20min

Question 37

What is the onset and duration of midazolam?

Answer 37

-30-60s -15-30min

Question 38

What is the onset and duration of succinylcholine?

Answer 38

-45-60s -6-10min

Question 39

What is the onset and duration of rocuronium?

Answer 39

-45-60s -45-80min

Question 40

What is the onset and duration of vecuronium?

Answer 40

-1.5-3min -45-90min

Question 41

What are the pros of using succinylcholine?

Answer 41

-best choice, if one of its many contraindications isn't a problem

Question 41

What are the adverse effects of ketamine?

Answer 41

-may increase ICP (controversial)

Question 41

What is the onset and duration of pancuronium?

Answer 41

-3-5min -60-90min

Question 41

What are the adverse effects of propofol?

Answer 41

-myocardial depression -peripheral vasodilation --> decreased MAP -needs to be avoided in hypovolemic pt

Question 41

What is the onset and duration of vecuronium?

Answer 41

-1.5-3min -45-90min

Question 42

What are the adverse effects of propofol?

Answer 42

-myocardial depression -peripheral vasodilation --> decreased MAP -needs to be avoided in hypovolemic pt

Question 42

What are the adverse effects of ketamine?

Answer 42

-may increase ICP (controversial)

Question 43

What medications can cause a prolonged effect of nondepolarizing agents?

Answer 43

-aminoglycosides -clindamycin

Question 44

What disorders/conditions can cause a prolonged effect of nondepolarizing agents?

Answer 44

-hypermagnesemia -myasthenia gravis -hypothermia

Question 45

Which nondepolarizing agents have a metabolite that can cross the blood brain barrier and cause seizures?

Answer 45

-cistatracurium and atracurium -metabolized to laudanosine

Question 46

How are cisatracurium and atracurium metablized?

Answer 46

-Hofmann elimination -so can use in liver failure

Question 47

How are rocuronium, vecuronium, pancuronium metabolized?

Answer 47

-metabolized in the liver -eliminated by the kidney