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Top Drawer Meds Flashcards

(55 cards)

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1
Q

Rocuronium/ Zemuron dose and concentration
RSI
Intubation

A

1 vial= 10 cc (10 mg/cc) draw up 5 cc in a 5 cc syringe
RSI: 0.6-1.2mg/kg
Intubation: 0.45 - 0.6 mg/kg

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2
Q

Rocuronium/ Zemuron MOA

A

Non-depolarizer; acetylcholine receptor antagonist; inhibits depolarization

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3
Q

Rocuronium/ Zemuron onset and duration

A

onset: 6 minutes
duration: 30 minutes

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4
Q

Rocuronium/ Zemuron cautions

A

Histamine can cause anaphylaxis, caution in renal patients

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5
Q

Vecuronium/ Norcuron concentration; doses (RSI; intubation)

A

1 vial = 10 cc (1 mg/ cc) dilute powder in 10 cc NS, syringe = 10mg
RSI: 0.3 mg/kg
Intubation: 0.08-0.1 mg/kg

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6
Q

Vecuronium/ Norcuron MOA

A

Non-depolarizer; acetylcholine receptor antagonist

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7
Q

Vecuronium/ Norcuron onset and duration

A

Onset: 3-5 minutes
Duration: 20-60 minutes

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8
Q

Vecuronium/ Norcuron considerations

A

More predictable than roc, consider for longer cases

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9
Q

Succinylcholine/ Anectine concentration and doses

A

1 vial: 10cc (20 mg/cc) draw up 5 cc
RSI: 1-1.5 mg/kg
Intubation: 0.6mg/kg
Laryngospasm: 0.3mg/kg

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10
Q

Succinylcholine/ anectine MOA

A

Depolarizer, mimics acetylcholine on nicotinic acth receptors (mimics arch depolarizing at motor end plate)

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11
Q

Succinylcholine/ Anectine onset and duration

A

Onset: 30 seconds
Duration: 5 minutes

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12
Q

Succinylcholine/ Anectine cautions and CI

A 
MH trigger
Histamine release
Hyperkalemia (expect 0.5 meq increases)
Stroke etc. for extrajunctional receptors
CI: MD, DMD, MS
Resistant: MG; sensitive: in LEMS
Caution in children
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13
Q

Midazolam/ Versed concentration and doses

A

1 vial: 2 cc (1mg/cc)
Pre-op: 0.02-0.04 mg/kg, usually about 2mg given in prep
Induction: 0.2-0.4 mg/kg

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14
Q

Midazolam/ Versed MOA

A

GABA receptor agonist; chloride influx occurs & cell becomes hyperpolarized

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15
Q

Midazolam/ Versed onset

A

<60 seconds

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16
Q

Midazolam/ Versed caution

A

Elderly & quick cases

Can have paradoxical excitatory effect

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17
Q

Fentanyl/ Sublimaze concentration and doses

A

1 vial= 2 cc (50 mcg/cc)

1-2 mcg/kg or 25-100 mcg/dose

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18
Q

Fentanyl/ Sublimaze MOA

A

Mu opioid receptor agonist

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19
Q

Fentanyl/ Sublimaze onset and duration

A

Rapid, 30-60 minutes

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20
Q

Fentanyl/ Sublimaze cautions

A

Possible cough & itchy nose after administration
Chest wall rigidity
Post-op urinary retention

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21
Q

Lidocaine/ Xylocaine concentration and dose

A

1 vial= 5 cc= 100 mg (20 mg/cc; 2%)

1-1.5 mg/kg

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22
Q

Lidocaine/ Xylocaine MOA

A

Class lb antiarrhythmic; membrane impermeable to NA+ and cell is unable to depolarize

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23
Q

Lidocaine/ Xylocaine onset and duration

Study These Flashcards
A

45-90 seconds

T 1/2 30 minutes

24
Q

Propofol/ Diprivan concentration and dose

Study These Flashcards
A

1 vial = 20 cc (10mg/cc) *always have an extra syringe

2-2.5 mg/kg

25
Propofol/ Diprivan MOA
GABA receptor agonist; chloride influx and cell hyperpolorization
26
Propofol/ Diprivan onset and duration
<30 seconds, duration 10 minutes
27
Propofol/ Diprivan cautions/ good to know
Egg (yolk allergy) typically the allergy is in the protein in white Sulfa allergy Histamine release Burns on administration Slight increase in HR Increase dose in alcoholics, decrease dose in acute ETOH intoxication
28
Etomidate/ Amidate concentration and dose
1 vial= 2 mg/cc (10 cc in 10cc syringe) | 0.2-0.6 mg/kg
29
Etomidate/ Amidate MOA
GABA receptor agonist
30
Etomidate/ Amidate onset and duration
<30 seconds | About 10 minutes
31
Etomidate/ Amidate cautions/ good to knows
Adrenal suppression | More hemodynamically stable than prop or ketamine; consider in cardiac pt
32
Ketamine/ Ketalar IV and IM dose
IV: 1-2 mg/kg IM: 6-13 mg/kg
33
Ketamine/ Ketalar MOA
NMDA receptor antagonist; blocks glutamate | Analgesia, maintains respiratory drive
34
Ketamine onset and duration
30 seconds | 8-15 minutes
35
With ketamine, you should co-administer
Versed for dissociative effects | Glycolic for increased secretions (bronchodilator)
36
Ketamine/ Ketalar good to know/ cautions
Increase IOP & HR 2/2 to catecholamine release | Maintains SVR b/c it indirectly increased catecholamine
37
Sugammadex doses
2 mg/ kg in 2 twitches 4 mg/kg in deep sedation 16 mg/kg with no twitches
38
Sugammadex MOA
Surrounds & inactivates ROC/ VEC molecule, no rush of ACTH
39
Sugammadex onset
30 seconds
40
Neostigmine dose
2. 5-5 mg/dose | 0. 02-0.08 mg/kg
41
Neostigmine MOA
Acetylcholinesterase inhibitor; ACTH not broken down & competes with NMB to overcome paralytic effect
42
Phenylephrine/ Neosynephrine concentration and dose
Dilute 1 vial/ 1cc of phenylephrine (10mg/cc) in 100 cc NS= 100mcg/cc; draw up into a 10 cc syringe post dilution 100-500 mcg/dose Q 10-15 minutes
43
Phenylephrine/ Neo MOA
Potent, alpha 1 agonist; produces systemic arterial vasoconstriction
44
Phenylephrine/ Neo onset and duration
Immediate, 15-20 minutes
45
Phenylephrine/ Neo cautions
Causes bradycardia r/t baroreceptor reflex
46
Ephedrine concentration/ doses
1 vial = 1 cc, dilute 1 vial (1cc) of ephedrine (50 mg/cc) in 4cc of NSS making 10 mg/cc solution 5-25 mg/dose
47
Ephedrine MOA
Beta 1 & alpha 1 agonist; stimulates adrenal medulla to release endogenous norepinephrine
48
Ephedrine cautions
Tachycardia
49
Atropine doses
1 mg/cc or 0.4 mg/cc (varies institutionally) Salivation: 0.01-0.02 mg/kg/dose to max of 0.4mg/dose (min dose 0.1 mg) Bradycardia: 0.02 mg/kg, min dose 0.1 mg, repeat Q3-5minutes total of 1mg
50
Atropine MOA
Blocks Ach at parasympathetic sites in smooth muscle, secretory glands & CNS; increases CO, dries secretions. NO effect on nicotinic receptors responsible for muscle weakness, fasiculations & paralysis
51
Atropine onset
Rapid, tertiary
52
Glycopyrrolate/ Robinul concentration and dose
1 vial= 1 cc (0.2mg/cc) | Administer 0.2mg for each 1mg of neostigmine administered
53
Glycopyrrolate/ Robinul MOA
Blocks Ach at parasympathetic sites of smooth muscle, secretary glands and CNS; indirectly reduces rate of salivation by preventing stimulation of acetycholine receptors
54
Glycopyrrolate/ Robinul onset and duration
1 minute, 2-3 hours (vagal stimulation) and 7 hours (inhibition of salivation)
55
Glycopyrrolate/ Robinul cautions and good to know
Give before Neo* Caution glyco & atropine in CAD r/t increased HR Quat

Medications (1 decks)

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