TxWes Guide pt1 Flashcards by Andrew Everett

BENZOS

Dose (IV, PO), Onset, Duration:
Diazepam

Valium

Valium
0.1mg/kg IV
Onset 1-5mins ⏐Duration 2-6h

0.2mg/kg PO

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BENZOS

Dose, Onset, Duration:
Lorazepam

Ativan

Ativan
0.04mg/kg ⏐ Onset 1-5mins ⏐Duration 6-10h

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BENZOS

Dose, Onset, Duration:
Midazolam

Versed

Versed
1-5mg or 0.01-0.05mg/kg ⏐Onset 1-5mins ⏐Duration 15-80min

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BENZOS

Dose, Onset, Duration:
Flumazenil

Romazicon

Romazicon
0.2mg ⏐ Onset 1-5mins ⏐Duration 30mins!!! (may need redose to outlast BZD)

Repeat 0.1 q 1min –> MAX 3mg

BENZO REVERSAL

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OPIOIDS

Dose (intraOp, postop), Onset, Duration:
Morphine

1-10mg IntraOp
5-20mg PostOp
Onset 10-20mins ⏐ Duration 4-5h

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OPIOIDS

Dose, Onset, Duration:
Fentanyl

1.5-3mcg/kg
Onset 30-60sec ⏐ Duration 1-1.5h

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OPIOIDS

Dose, Onset, Duration:
Sufentanil

0.3-1mcg/kg
Onset 30-60sec ⏐ Duration 1-1.5hr

Infusion: 0.5-1mcg/kg/hr (close to intraop dose)

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OPIOIDS

Dose, Onset, Duration:
Remifentanil

LOAD: 0.5 - 1mcg/kg OVER 1 MIN!
Onset 30-60sec ⏐ Duration 6-8min

gtt: 0.125-0.375 mcg/kg/min

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OPIOIDS

Dose, Onset, Duration:
Meperidine

Demerol

Demerol
12.5mg (Shivering)
Onset 5-15min ⏐ Duration 2-4h

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OPIOIDS

Dose (intra, postop), Onset, Duration:
Hydromorphone

Diluadid

Dilaudid
1 - 4mg IntraOp
1.5 - 4mg PostOp (basically the same)
Onset 5-15min ⏐ Duration 2-4hr

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OPIOIDS

Dose, Onset, Duration:
Naloxone

Narcan

Narcan
40-80mcg ⏐ Onset 1-5 min⏐ Duration 30min

Opioid REVERSAL

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INDUCTION MEDS

Dose (induction, sedation gtt, TIVA gtt), Onset, Duration:
Propofol

1.5-2.5mg/kg Induction
25-100 mcg/kg/min Sedation
100-300 mcg/kg/min TIVA
Onset 30-60sec ⏐ 1-8mins

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Induction

Dose, Onset:
Etomidate

0.3mg/kg ⏐ Onset 1 min

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Induction

Dose (induction, IV analgesia), Onset, Duration:
Ketamine

0.5-1.5mg/kg Induction
0.2-0.5 mg/kg IV Analgesia
Onset 1 min⏐ 10-20min

4 - 8 mg/kg IM

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Induction Dose

Dose, Onset, Duration:
Midazolam

Versed

Versed
0.1-0.2mg/kg Induction
Onset 30-60sec ⏐ Duration 5-10min

*may precede dose w/ Fentanyl 50-100mcg

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Dose (Bolus and Infusion):
Dexmedetomidine

Precedex

Precedex
Bolus 0.5-1mcg/kg over 10mins
Infusion 0.2 - 0.7 mcg/kg/hr

Usually on-hand 200mcg/2ml > mix with 48cc NS ⇒ 4mcg/ml

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Inhalation

MAC, VP, Blood:Gas Co.:
Sevoflurane

Ultane
MAC 1.8
VP 157
Blood:gas Coefficient 0.69

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Inhalation

MAC, VP, Blood:Gas Co.:
Desflurane

Suprane
MAC 6.6
VP 669
Blood:gas Coefficient 0.42

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Inhalation

MAC, VP, Blood:Gas Co.:
Isoflurane

Forane
MAC 1.17
VP 238
Blood:gas Coefficient 1.46

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Inhalation

MAC, VP, Blood:Gas Co.:
Nitrous Oxide

MAC 104
VP 🚀 38,770 gas
Blood Coefficient 0.46

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Muscle Relaxants

Dose, Onset, Duration:
Succinylcholine

Anectine

Anectine
1-1.5 mg/kg
Onset 30-60sec ⏐Durations 5-10min

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Muscle Relaxants

Dose, Onset, Duration:
Cisatricurium

Nimbex

Nimbex
0.1 mg/kg
Onset 2-3min ⏐ Duration 40-75min

Hoffman Elimination

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Muscle Relaxants

Dose, Onset, Duration:
Vecuronium

Norcuron

Norcuron
0.1 mg/kg
Onset 2-3min⏐ 45-90min

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Muscle Relaxants

Dose (1st & 2nd), Onset, Duration:
Rocuronium

Zemuron

Study These Flashcards

Zemuron
0.6 mg/kg Onset 2-3mins
1.2 mg/kg Onset 1.5 mins
Duration 35-75mins

# Muscle Relaxants Dose, Onset, Duration: **Pancuronium** | Pavulon

Pavulon 0.1 mg/kg Onset 2-3min ⏐Duration 60-120min ## Footnote [Common]: 2mg/mL

# Muscle Relaxants Reversals Dose, Onset, Duration, Anticholinergic buddy: **Neostigmine**

0.04-0.07 mg/kg Onset 5-10min ⏐ Duration 60min | **Glycopyrrolate 0.2mg/ml of Neo to avoid bradycardia**

# Muscle Relaxants Reversals Dose, Onset, Duration: **Sugammadex**

2-16 mg/kg (depends on TOF & PTP) Onset 1 - 4min ⏐ Duration 1.5 - 3hrs

# REGIONAL MEDS Amide/Ester? Regional MAX dose (mg/kg) w/ & w/o EPI? **Lidocaine**

Amide Max w/o Epi: 5 mg/kg w/ Epi: 7 mg/kg

# REGIONAL MEDS Amide/Ester? MAX dose (mg/kg) w/ & w/o EPI? **Prilocaine**

Amide Max w/o Epi: 6 mg/kg w/ Epi: 8.5 mg/kg

# REGIONAL MEDS Amide/Ester? MAX dose (mg/kg) w/ & w/o EPI? **Mepivicaine**

Amide. Max w/o Epi: 5 mg/kg w/ Epi: 7 mg/kg

# REGIONAL MEDS Amide/Ester? MAX dose (mg/kg) w/ & w/o EPI? **Bupivicaine**

Amide. Max w/o Epi: 2.5 mg/kg w/ Epi: 2.5 mg/kg | EPI DONT MAKE NO DIFFERENCE! 😅

# REGIONAL MEDS Amide/Ester? MAX dose (mg/kg) w/ & w/o EPI? **Ropivicaine**

Amide. Max w/o Epi: 3 mg/kg w/ Epi: 4 mg/kg

# REGIONAL MEDS Amide/Ester? MAX dose (mg/kg) w/ & w/o EPI? **Procaine**

Ester. Max w/o Epi: 7 mg/kg w/ Epi: 8.5 mg/kg

# REGIONAL MEDS Amide/Ester? MAX dose (mg/kg) w/ & w/o EPI? **Chloroprocaine**

Ester. Max w/o Epi: 6 mg/kg w/ Epi: 14 mg/kg

# REGIONAL MEDS Amide/Ester? MAX dose (mg/kg) w/ & w/o EPI? **Tetracaine**

Ester. Max w/o Epi: 3 mg/kg w/ Epi: 3 mg/kg | EPI MAKES NO DIFFERENCE 😅

# CSE LABOR ANALGESIA Epidural (%) & Spinal (mg) doses? **Bupivicaine**

Epidural: 0.0625-0.125% Spinal: 1.25 - 2.5 mg

# CSE LABOR ANALGESIA Epidural (%) & Spinal (mg) doses? **Ropivicaine**

Epidural: 0.08 - 0.2% Spinal: 2.5-4.5 mg

# CSE LABOR ANALGESIA Epidural (%) & Spinal (mL) doses? **Lidocaine + Epi**

Epidural: 2% in 5cc bolus Spinal: N/A | No spinal dose.

# CSE LABOR ANALGESIA Epidural & Spinal doses? (mcg) **Fentanyl**

Epidural: 50-100 mcg Spinal: 10-25 mcg

# CSE LABOR ANALGESIA Epidural & Spinal doses? (mcg) **Sufentanil**

Epidural: 5 - 10 mcg Spinal: 1.5 - 5 mcg

# CSE LABOR ANALGESIA Epidural (%) & Spinal (mg) doses? **Morphine**

NO epidural dose. Spinal: 0.1 - 0.2 mg

# ANTIEMETICS Dose, Onset, Duration: **Droperidol** | Inapsine

0.625mg⎪O: 1-5min⎪D: 2-3hrs

# ANTIEMETICS Dose, Onset, Duration: **Promethazine** | Phenergan

6.25 - 25 mg⎪O: 1-5mins⎪D: 4-6hrs

# ANTIEMETICS Dose, Onset, Duration: **Ondansetron** | Zofran

4mg⎪O: 10mins⎪D: 4-9hrs

# ANTIEMETICS Dose, Onset, Duration: **Dexamethasone** | Decadron

4mg⎪O: 10-30mins⎪D: 2-10hrs

# ANTIEMETICS Dose, Onset, Duration: **Metoclopramide** | Reglan

10-20mg⎪O: 10mins⎪D: 2hrs

# ANTIEMETICS Dose, Onset, Duration: **Scopolamine**

Patch⎪O: 2-4hrs⎪D: 72hrs | Non-hairy area - dont touch eyes after handling --> can cause mydriasis.

# ANTIEMETICS Dose, Onset, Duration: **Propofol** | Diprivan

Antiemetic Dose 10-15mg IV followed by 10**mcg**/kg/**min**

List some PONV risk factors.

Female, <40yrs, Hx of PONV or Motion Sickness, vertigo, non-smokers *Surgeries:* Laparotomy, Laparoscopy, Major Breast, Strabismus, Intraocular, Middle Ear, Tonsils, Adenoids, Neuro (intracranial), Gynecologic, Testicular, Scrotum, Kidney stones

If I have 0 PONV risk factors, what is the chance I will have PONV?

10% | This requires NO prophylactic drugs.

If I have 3 PONV risk factors, what is the chance I will have PONV? What drugs will you treat your patient with?

> 60% chance. Give at least 3 treament drugs: 5HT blocker, steroid, propofol + TIVA??

My patient requires 2 pre-treatment drugs for PONV; I gave zofran and decadron before her surgery. How many risk factors do you think she has? What are her chances of developing PONV based on this info?

2 risk factors = 40% chance of developing PONV

My chance of PONV is 20%. How many risk factors do I have? What drug(s) will you give me?

I have 1 risk factor and you should give me a 5HT-blocker like zofran :)

# NON OPIOID ANALGESICS Dose & daily MAX dose. **Acetaminophen** | Ofirmev

1000mg q 4-6hr MAX: 3-4g qd

# NON OPIOID ANALGESICS Dose & daily MAX dose. **Ketorlac** | Toradol

15-30mg q6h Max: 60-120mg qd

# NON OPIOID ANALGESICS 1x Dose & daily MAX dose. **Ibuprofen** | Caldor

200-800mg q6h Max: 3200mg qd

List some symptoms of LAST. | Local Anesthetic Systemic Toxicity

* Analgesia, lightheadedness * tinnitis * tongue/circumoral numbness * tingling of mouth, funny/metallic taste * SZ, LOC * respiratory arrest, cardiovascular arrest.

Explain the lipid rescue for LAST.

In addition to CPR - * BOLUS 20% intralipids 1.5mL/kg over 1min * ⇒ Infusion 0.25mL/kg/min * Circulate lipids w/ CPR * Repeat bolus q3-5 mins UP TO 3ml/kg total dose until ROSC. * ⬆ infusion to 0.5mL/kg/min if BP declines - continue infusion until hemodynamically stable. *MAX DOSE: 8ml/kg ## Footnote If you dont have 20% lipids immediately handy - give what you have until you obtain the 20%.

TxWes Guide pt1 Flashcards

(58 cards)