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10 Cards in this Set
- Front
- Back
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Who is more likely to have allergic rxns to protamine?
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Pt on NPH insulin
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What are possible triggers for MH?
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Depolarizing muscle relaxant (Sux), All volitile agents except NO2
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What causes MH?
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Triggers act at Ryanodine receptor 1 (RYR1), releasing Ca++ from the sarcoplasmic reticulum into the cytoplasm, causing muscle contraction. Energy dependent reuptake mechanism try to clear the Ca++, increasing metabolic rate.
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What are the signs and symptoms of MH?
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Mneuomic: My Homeboy, Hyper KC, DATeD 3 More Fucking wHores: Hyperkalemia, hypercalemia, Dysrhythmias, Acidosis (metabolic), Tachycardia, Differnce increase d b/t venous/arterial CO2, Masseter spasm, myoglobinuria, muscle ridgidity, Fever, Hypoxemia
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What is MH treatment?
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Notify surgeon, 100% FiO2. Dantrolene 2.5 mg/kg IV stat (NaiL MH), Acidosis: Bicarb, Hyperkalemia: Glucose/insulin, Hyperthermia: Ice lavage, cooling IV/blanket, Renal failure: Maintain u/o > 2 cc/kg/h
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How does dantrolene work?
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Direct skeletal muscle relaxant, binds to RYR1 receptor, prevents Ca++ release. Also contains manitol to promote urine output.
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What is the t1/2 of dantrolene?
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6 hours
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What is the gold standard test for MH?
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in vitro muscle contracture (IVMC), exposed to halothane and caffeine
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Describe the "long term" tx of MH
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1) Continue Dantrolene 1 mg/kg IV or 4-8 mg/kg divided PO Q 6 for 1-3 days
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What are the initial txs for adrenal supression?
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Tx volume, hemodynamics, glycose and electrolyte status
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