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59 Cards in this Set
- Front
- Back
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Flumazenil
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Questions
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Answer
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What is the Brand name of Flumazenil?
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Romazicon
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How is Flumazenil typically supplied (concentration)?
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0.1mg/ml in 5ml Vial
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The usual dose of Flumazenil is?
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0.2-1.0mg IV at 0.2mg/min (wait at least 1min. b/w doses & repeat at least q 20 min. to avoid resedation, with max dosing 3mg/hr
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What is the time to onset of Flumazenil?
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1-3 min.
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What is the time to peak of Flumazenil?
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2-10 min.
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What is the duration of Flumazenil?
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60 min.
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How is Flumazenil metabolized?
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hepatic
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What receptors does Flumazenil act on?
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Competitive antagonism of GABA receptor, antagonizing benzodiazepine effect
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What drug class is Flumazenil in?
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Benzodiazepine antagonist
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What is the mechanism of action of Flumazenil?
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Benzodiazepine antagonist
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What patients would you not give Flumazenil to?
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Do not use in unknown drug overdose, suspected tricyclic antidepressant overdose, or seizure-prone patients
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What are possible effects of this drug?
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CNS excitation including seizures, acute withdrawal, nausea, dizziness, agitation, HTN, arrhythmias.
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What is the Brand name of Edrophonium?
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Tensilon
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How is Edrophonium typically supplied (concentration)?
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2.5mg/ml
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The usual dose of Edrophonium is?
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0.5-1 mg/kg IV Max dose 40mg
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What is the time to onset of Edrophonium?
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.5-1 min
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What is the time to peak of Edrophonium?
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1 min
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What is the duration of Edrophonium?
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45-60 mins
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How is Edrophonium metabolized?
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Renal 70%, Hepatic 30%
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What receptors does Edrophonium act on?
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all receptors
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What drug class is Edrophonium in?
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Cholinesterase Inhibitor/ Anticholinesterase
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What is the mechanism of action of Edrophonium?
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Inhibits junctional acetylcholinesterase at NMJ and also plasma cholinesterase
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What patients would you not give Edrophonium to?
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Possibly renal failure (prolonged clearance time)
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What anticholinergic drug would you add to Edrophonium to counteract bradycardia?
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Most rapid onset & shortest duration of any CIs matches it better with atropine than glycopyrrolate
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What is the Brand name of Physostigimine?
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Antilirium
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How is Physostigimine typically supplied (concentration)?
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1mg/ml
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The usual dose of Physostigimine is?
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0.01 - 0.03mg/kg
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What is the time to onset of Physostigimine?
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4 min
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What is the time to peak of Physostigimine?
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7 minutes
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What is the duration of Physostigimine?
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30 min to 5 hours
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How is Physostigimine metabolized?
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plasma esterases
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What receptors does Physostigimine act on?
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nicotinic and muscarinic receptors
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What drug class is Physostigimine in?
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antidote/ cholinergic agent
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What is the mechanism of action of Physostigimine?
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increases amount of acetylcholine at site of NMJ.
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What patients would you not give Physostigimine to?
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asthma, diabetes, or mechanical obstruction of the intestine or urogenital tract
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What is the Brand name of Neostigmine?
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Prostigmine
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How is Neostigmine typically supplied (concentration)?
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1mg/ml
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The usual dose of Neostigmine is?
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0.03-0.06mg/kg MAX 5mg
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What is the time to onset of Neostigmine?
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<3 mins
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What is the time to peak of Neostigmine?
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~7 mins
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What is the duration of Neostigmine?
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40-60 mins
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How is Neostigmine metabolized?
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hepatic
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What receptors does Neostigmine act on?
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acetylcholinesterase in the NMBJ
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What drug class is Neostigmine in?
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Cholinesterase inhibitor
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What is the mechanism of action of Neostigmine?
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competitive binds to acetylcholinesterase, allowing the build up of acetylcholine
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What patients would you not give Neostigmine to?
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A patient with GI or GU obstruction
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What is the Brand name of Naloxone?
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Narcan
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How is Naloxone typically supplied (concentration)?
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0.4 mg/ml
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The usual dose of Naloxone is?
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0.4-2 mg (post-op 1-2mg)
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What is the time to onset of Naloxone?
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1-2 min
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What is the time to peak of Naloxone?
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5-15 minutes
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What is the duration of Naloxone?
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1-2 hours
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How is Naloxone metabolized?
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Hepatic
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What receptors does Naloxone act on?
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mu receptor
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What drug class is Naloxone in?
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opioid antagonists
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What is the mechanism of action of Naloxone?
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Unknown exactly; believed to antagonizes the opioid effects by competing for the same receptor sites
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What patients would you not give Naloxone to?
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Caution with ESRD, ESHD, opoid addiction
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