Drug Tray

Front 1

Reglan (metoclopramide)
Drug class, concentration, onset, and duration

Back 1

drug class = dopamine antagonist
Concentration= 10mg/2 cc
Onset= 1 to 3 mins
Duration= 1-2 hrs
*give over 1 to 2 mins 15 mins before induction

Front 2

Reglan (metoclopramide)
Action

Back 2

1. stimulates motility of upper GI tract DECREASES gastric emptying time
2. Increases LES tone by 10-20 cmH20 and relases pyloric sphincter
3. DOES NOT ALTER gastric hydrogen ion secretion (pH)
4. antiemetic: blocks dopamine receptors in the CTZ

Front 3

Reglan (metoclopramide)
Side Effects

Back 3

1. Produces extrayramidal symptoms
2. Abdominal Cramping if given <3 mins
3. Cardiac dysrhythmias (if received ondansetron)
4.Feeling of unease and restlessness
5. Increases plasma prolactin concentrations
6. Inhibits plasma cholinesterase (prolonged response of Sux)

Front 4

Reglan (metoclopramide)
Indications

Back 4

Obese, Hiatal hernia/GERD, parturient, Diabetic, Trauma/full stomach

Front 5

Reglan (metoclopramide)
contraindications

Back 5

1. Know obstruction
2. MAOI (increase seizures)
3. TCA(exacerbate depression)
4. Parkinsons(increase EPS), RLS
5. if on haldol
6. Pheochromocytoma (causes release of catacholamines and triggers HTN crisis)

Front 6

Neostigmine
class, concentration, dose, duration, onset

Back 6

1. Class= anticholinesterase (quaternary Ammonium)
2. Concentration= .5mg/cc (may see 1mg/cc)
3. Dose = .04-.08 mg/kg Max dose = 5mg
4. Duration= up to 1 hr
5. Onset= 7 to 11 mins

Front 7

Neostigmine
action

Back 7

1. Reverses (antagonizes) nondeploarizing neuromuscular blockade

Front 8

Neostigmine
Side Effects

Back 8

1. Bradicardia
2. Salivation/increased secretions
3. miosis
4. hyperparistalsis
5. Bronchoconstriction
6. prolonged inhibition of plasma cholinesterase activity
7. N/V

Front 9

Robinul (glycopyrrolate)
class, concentration, dose, duration, onset

Back 9

1. class= anticholinergic (quaternary ammonium)
2. concentration= .2mg/cc
3. dose= .01 mg/kg prior to Neostigmine or give .1-.2 mg for bradycardia

Front 10

Robinul (glycopyrrolate)
action

Back 10

antagonizes ACH at choliergic postganglicic sites (antimuscarinics)

Front 11

Robinul (glycopyrrolate)
Indications

Back 11

1. Buffer SE of anticholinesterase
2. Increase HR
3. antisialagogue (respiratiory and salivary)

Front 12

Robinul (glycopyrrolate)
Side Effects

Back 12

1. antisecretions
2. increase HR
3. relaxes smooth muscles (bronchodilator)

Front 13

Xylocaine (lidocaine) gel

Back 13

-Amide
Class= local anesthetic
Concentration: 2% (20mg/cc)
indications= topical anesthetic for NG, nasal airway, ETT placement, Oral airway

Front 14

Lidocaine (xylocaine)
class, concentration, dosage

Back 14

class= Amide
Concentration= 4% (40mg/cc)
Dose= 1-1.5 mg/kg on induction
MAX DOSE= 4.5 MG/KG PLAIN OR 7 MG/KG W/ EPI

Front 15

Lidocaine (xylocaine)
action

Back 15

blocked Na channels, prevention action potential propagation

Front 16

Lidocaine (xylocaine)
Indications

Back 16

1. given with induction for GA bc it blunts larngoscopy stimulation
2. ease burn from diprivain
3. Used for frequ PVC (phase 4 attenuation)

Front 17

Lidocaine (xylocaine)
side effects

Back 17

1. systemic toxicity (tongue numbness, CNS changes)
2. Myotoxicity/Neurotoxicity if injected directly into the muscle or nerve
3. depression of myocardial automaticity (CV collapse)
4. allergic reaction (most likely from preservative)
5. Depression of hypoxic drive

Front 18

Lidocaine (xylocaine)
contraindications

Back 18

1. WPW and heart blocks
2. allergy to amides

Front 19

Toradol (ketorolac)
concetration, dose, peaks

Back 19

Class= NSAID
concentration= 30mg/cc
Dose= 15 to 30 IVP **.5-1mg/kg in peds
Peaks= 45-60 mins lasting 6-8 hrs

Front 20

Toradol (ketorolac)
action

Back 20

inhibits platelet thromboxane production and platelet aggregration by reversible inhibition of prostaglandin synthesis (prolongs bleeding)

Front 21

Toradol (ketorolac)
indication

Back 21

1. PostOP analgesia (30 mg= 10mg of morphine or 100mg demerol)
**NO vent or cv depression

Front 22

Toradol (ketorolac)
side effects

Back 22

1. bad broncospasm (in nasal polyps, asthma, and asa sensitivity)
2. GI irritation
3. Nausea
4. sedation
5. peripheral edema
6. bleeding time increased

Front 23

Toradol (ketorolac)
contraindications

Back 23

1. aspirin triad
2. renal failure
3. high risk for bleeding

Front 24

Zofran (ondansetron)
class, concentration, dose, indication

Back 24

Class= 5-HT3 receptor antagonist
Concentration= 4mg/2 cc
Dose= 15mg/kg up to 40 kg >40 kg give 4mg
indication= PONV

Front 25

Zofran (ondansetron)
action

Back 25

antagonizes serotonin receptor

Front 26

Zofran (ondansetron)
side effects

Back 26

1. headaches
2. diarrhea
3. increase in liver enzymes
4. cardia dysrhythmia if given with reglan
5. prolonged QT syndrom

Front 27

Decadron (dexamethasone)
class, concentration, dose, half-life

Back 27

Class= coticosteriods
concentration= 10mg/cc
dosage= A: 4 to 10mg P: .1-.5 mg/kg
half life= 36-72 hrs

Front 28

Decadron (dexamethasone)
action

Back 28

anti-inflammatory, possible analgesic, and antiemetic

Front 29

Decadron (dexamethasone)
indications

Back 29

1. high risk of PONV
2. treatment of aspiration pneumonitis
3. traumatic intubation
4. ENT-tonsils
5. Neuro- Crani, cerebral edema, cord trauma (usually 20mg)
6. organ transplant
7. asthma
8. ocular inflammation

Front 30

Decadron (dexamethasone)
side effects

Back 30

1. HTN
2. hyperglycemia
3. Delay wound healing
4. peptic ulcers
5. osteoporosis
6. cataracts
7. aseptic necrosis of femoral head
8. characterisitcs of Cushing syndrome
9. skeletal muscle myopathy

Front 31

Atropine
class, concentration, dosage

Back 31

class= anticholinergic (tertiary amine)
concentration: 1mg/cc
Dose= .5-1mg IVP

Front 32

Atropine
action

Back 32

prevents ACH from binding to and activating the muscarinic receptor

Front 33

Atropine
indications

Back 33

1. bardycardia: faster onset than robinul
2. tx for occulocardiac reflex
3. reversal of Edrophonium BC

Front 34

Atropine
side effects

Back 34

1. increase HR
2. antiseretion
3. relaxes smooth muscle
4. CNS effects
5. Dilation of cutaneous blood vessel

Front 35

Benadryl (diphenhydramine)
class, concentration, dose

Back 35

class= antihistamine (H1 antagonist, antiemetic)
concentration: 50 mg/cc
Does: 15 -50 mg q 4-6 hrs

Front 36

Benadryl (diphenhydramine)
Indications

Back 36

1. Allergic reactions
2. itching from intrathecal narcotics
3. PONV
4. cough supression
5. tx of dyskinesias

Front 37

Benadryl (diphenhydramine)
side effects

Back 37

1. somnolence
2. dry mouth
3. blurred vision
4. tachycardia, QT prolonged, heart block, hypotension

Front 38

Ephedrine
class, concentration, dose, indication

Back 38

class= indirect and direct sympathominetic (stimulates alpha, beta 1 and beta 2)
concentration= 50 mg/cc (dilute in 10 cc NS for 5mg/cc)
Dose= 5-50 mg IVP
Indication= hypotension

Front 39

Ephedrine
action

Back 39

indirectly stimulates endogenous release of Norepi from sympathetic nerve endings and directly stimulates adrenergic receptors

Front 40

Ephedrine
side effects

Back 40

1. increased HR and CO (SVR altered minimally bc vasoconstriction in some vascular beds A1 are being offset by vasodilation in other B2
2. increased BP (SBP and DBP)
3. mydriasis (pupil dilation
4. mild bronchodilation

Front 41

Labetalol
class, concentration, dose,

Back 41

-class= combined alpha 1 and beta 1,2 adrenergic receoptor antagonis
-Beta to alpha blocking= 7:1
-concentration= 100 mg/20cc bottle; 5mg/cc
-dose: .1-1mg/kg titrated to effect q 10 mins (2.5 -10 mg) Max = 300 mg/day

Front 42

Labetalol
action

Back 42

1. lowers SBP by decreasing SVR (alpha 1 blockade)
2. Relex tachycardia by vasodilation

Front 43

Labetalol
indication

Back 43

1. Used to lower BP and HR (effect in 5 to 10 mins)
2. used for pheochromocytoma and rebound HTN after withdrawl of clonidine

Front 44

Labetalol side effects

Back 44

1. orthostatic hypotension
2. bronchospasm/constrition (esp with obstructive airway dx
3. CHF

Front 45

Labetalol contraindications

Back 45

asthma, heart blocks >1st degree, HF, severe low BP

Front 46

Narcan (naloxone)
class, concentration, dose,

Back 46

-class= opiod antagionst (mu receptor)
-concentration= .4mg/cc diluted in 10 cc = 40mcg/cc

Front 47

Narcan (naloxone)
indication

Back 47

1. rx opioid induced resp depression
2. facilitates tx of opioid OD

Front 48

Narcan (naloxone)
action

Back 48

1. displaces opiod agonist from mu receptor
2. effects last 30-45 mins

Front 49

Narcan (naloxone)
side effects

Back 49

1. reversal of analgesia
2. N/V
3. increased SNS activity d/t reversal of analgesia and perception of pain (increased HR, HTN, pulm edema, dysrhythmias)

Front 50

Neosynephrine (phenylephrine)
class, concentration, dose, indication

Back 50

-class= direct acting alpha 1 adrenergic agonist
-concentration= 1% 10 mg/cc
***10mg in 9cc NS= 100mcg/cc
***10mg in 250 cc= 40 mcg/cc
***20mg in 250 cc= 80mcg/cc
-Dose= 50 to 100 mcg IVP
-Indication= hypotension

Front 51

Neosynephrine (phenylephrine)
action

Back 51

venoconstriction > arterial constrication

Front 52

Neosynephrine (phenylephrine)
side effects

Back 52

1. increase SBP w/ decrease CO
2. dec HR
3. inc PAP and coronary blood flow
4. dec renal splanchnic, and cutaneous blood flow
5. uterine vasoconstriction

Front 53

Neosynephrine (phenylephrine)
contraindication

Back 53

pheochromocytoma, MOAI

Front 54

Zemuron (rocuronium)
class, concentration, dose, onset, duration

Back 54

-class= intermediate nondepolarizing neuromuscular blocker
-concentration- 10 mg/cc
-dose: .6-1.3 mg/kg
-onset: 1-2 mins
-duration: 20-35 mins

Front 55

Zemuron (rocuronium)
indications

Back 55

1. most common NDMR

Front 56

Zemuron (rocuronium)
side effects

Back 56

1. NO CV effects
2. 30% of dose is renally excreted

Front 57

Diprivan (propofol)
class, concentration, onset

Back 57

-class= sedative hypnotic
-concentration: 1%- 10mg/cc
(oil in water emulsion contians egg lecithin, glycerol, and soybean oil)
-Dose: .5-2.5 mg/kg for induction, 25-75 mcg/kg/min for sedation, 100-300 mcg/kg/min for GA
-Onsest: 30 sec
-Duration: 3 to 8 mins

Front 58

Diprivan (propofol)
action

Back 58

interacts with GABA (inhibitory neurotransmitter)

Front 59

Diprivan (propofol)
indicatoins

Back 59

1. induction for GA
2. sedation for MAC
3. sedation for ICU
4. antiemetic (10-20 mg IVP)
5. amnestic
6. anticonvulsant
7. antipruritic

Front 60

Diprivan (propofol)
effects on organs

Back 60

1. dec BP, HR, CO, preload and SVR
2. apenic
3. Cerbrovascular depressant: dec CBF, ICP and CMRO2
4. same memory impairment as versed
5. rapid reawakening (3-8mins) d/t redistribution from highly perfused brain to poorly perfused skeletal muscle

Front 61

Diprivan (propofol)
side effects

Back 61

1. burning on injectino
2. allergic reaction
3. hallucinationss, amorous behavior
4. emulsion support bacterial growth
5. antioxidant properties vit E
6. temporarily abolish tremors w/ parkinsons
7. hiccupping and muscle twitching

Front 62

Succinylcholine (anectine, quelicin)
class, concentration, dose, ED 95

Back 62

-class: depolarizing neuromuscular blocker
-concentration: 20/mg/cc
-dose: .5-1.5 mg/kg IVP
-onset 30 to 60 sec
-duration 3-5 mins
ED95: .25mg/kg

Front 63

Succinylcholine (anectine, quelicin)
action

Back 63

1. attaches to nicotinic cholinergic receopt and mimics action of ACH a tthe post junction membrane (phase 1 block)
2. broken down by plasma cholinesterase (pseudocholinesterase)
***larger doses could cause phase 2 block (bradycardia)

Front 64

Succinylcholine (anectine, quelicin)
indications

Back 64

1.RSI
2. Procedures in which NDMR are not indications (short cases)

Front 65

Succinylcholine (anectine, quelicin)
side effects

Back 65

1. myalgia (dt muscle fasiculations)
2. hyperkalemia (.5 -1 mEq increase bu can see up to 5-10 mEq with burn, trauma, head injury)
3. myoglobinuria
4. increased intragastirc pressure
5. cardiac dysrhythmia
6. increased itraocular pressure
7. increased intracranial pressure
8 MH

Front 66

Caution giving Succinylcholine (anectine, quelicin) in:

Back 66

myopatheis, unhealed 3rd degree burn, severe, muscle trauma, open eye injury, renal failure, plasma cholinesterase deficiencies (pregnancy, liver disease, renal failure)

Front 67

Epinephrine (adrenalin)
class, concentration, dose,

Back 67

-class: sympathomietic (alpha and beta adrenergic agonist)
-concentration: 1:1000 (1mg/cc)
-Dose: .1-1mg IVP or 1 mg via ETT q 5 mins .01 mg/kg Peds

Front 68

Epinephrine (adrenalin)
indications

Back 68

1. severe hypotension
2. cardiac arest
3. bronchospasm
4. anaphylasix
5. prolonged LA blockade

Front 69

Epinephrine (adrenalin)
side effects

Back 69

1. inc SBP, CO, HR (beta 1)
2. arrhythmias (beta 1)
3. bronchodilatin (beta 2)
4. hyperglycemia
5. mydriasis (alpha)
6. blood coagulation acceleration (inc. factor V)

Front 70

Albuterol (ventolin, proventil)
class, concentration

Back 70

-class: beta 2 adrenergic agonist
-concentration: 100 mcg/ puff
-given down ett: decreases by 50-70% the amount of drug that a mdi can deliver
-indication: bronchospasm/wheezing

Front 71

Albuterol (ventolin, proventil)
side effects

Back 71

1. tremors
2. bronchodilation
3. tachycardia
4. hyperhlycemia
5. hypokalemia
6. hypomagnesemia

Front 72

Ofirmev (IV acetaminophen)
class, concentration, dosing

Back 72

-class: analgesic
-concentration: 10 mg/cc= 1000mg/100 cc
-dosing: <50 kg- give 15 mg/kg IV q 6
> 50 give 1 g not exceeding 4g

Front 73

Ofirmev (IV acetaminophen)
uses

Back 73

1. pain control
2. antipyretic

Front 74

Ofirmev (IV acetaminophen)
side effects

Back 74

1. N/V
2. HA
3. insomnia
4. rash

Front 75

Ofirmev (IV acetaminophen)
contraindications

Back 75

1. severe liver impairment
2. active liver dx

Front 76

Versed (midazolam)
class, concentration, uses,

Back 76

-class: benzodiapiane
-concentration: 1mg/cc, very lipid soluble
-uses: preop 1-2 mg peds .5 mg/kg
IV sedation, induction (.1-.3 mg/kg), suppression of seizure (.1mg/kg)

Front 77

Versed (midazolam)
action

Back 77

activation of GABA leading to hyperpolarization of neurons and reduced exitability

Front 78

Versed (midazolam)
desired effects, side effects

Back 78

Desired effects: anterograde amneisa, anxiolysis, anticonvulsant
-side effects: CNS= dec CBF; CV= dec BP; resp= minimal depression, synergistic with opiods

Front 79

Fentanyl (sublimaze)
class, concentration, doses

Back 79

-class: synethtetic opioid agonist
-concentrations: 50mcg/cc (75-125 times as potent as MSO4)
-dose: 2-20 mcg/kg for DL; nitrous/narcotic technique (50-150 mcg/kg)
-onset 6 to 8 mins

Front 80

Fentanyl (sublimaze)
side effects

Back 80

1. bradycardia
2. synergism with opioids
3. dose dependent depresion (decreased CO2 responsiveness)
4. dec RR and inc TV
5. stiff chest
6. dec CBF and ICP
7. dec MAC of inhaled anesthics
8. dec peristalitc activity (delayed GI emptying)
9. NV
10. tolerance and dependance
11. prolonged exposure causes immunosupression