Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
136 Cards in this Set
- Front
- Back
|
What is the b:g of n2o?
|
.47
|
|
|
What is the mac of n2o?
|
105%
|
|
|
svp of halo
|
245 mmHg
|
|
|
svp of iso
|
238 mmHg
|
|
|
svp of des
|
669 mmHg
|
|
|
svp of sevo
|
170 mmHg
|
|
|
b:g of halo
|
2.4
|
|
|
b:g of iso
|
1.4
|
|
|
b:g of des
|
.42
|
|
|
b:g of sevo
|
.65
|
|
|
mac of halo
|
.75
|
|
|
mac of iso
|
1.17
|
|
|
mac of des
|
6.0
|
|
|
mac of sevo
|
2.0
|
|
|
Dose of edrophonium and atropine for reversal
|
1mg/kg + .01mg/kg
(70/0.7 for 70 kg pt) |
|
|
Onset and duration of edrophonium/atropine reversal
|
1 min, lasts 60 min
|
|
|
Dose of neostigmine/glyco reversal
|
3mg/.6mg
|
|
|
onset and duration of neo/glyco reversal
|
10min, lasts 60 min
|
|
|
dose for pyridostigmine reversal with atropine or glyco
|
pyrido .25mg/kg
plus .015mic/kg atropine or .2mg glyco for every 5 pyrido *so 20mg/1mg pyrido/atro or 20mg/.8mg pyrido/glyco |
|
|
onset and duration of pyridostigmine reversal (with atropine or glyco)
|
10min, lasts 90 min
|
|
|
dose of glycopyrolate for tx secretions preop
|
.1-.2mg, may repeat if needed.
|
|
|
o/d of glycopyrolate iv
|
2min onset
vagal effects last 2 hours, salivation decreased for ~7h |
|
|
dose of scopalimine patch
|
1.5mg patch, place behind ear
|
|
|
o/p/d scopalimine patch
|
30min/3h/3d
|
|
|
hydralizine action
|
vasodilator, art>veins
|
|
|
hydralizine dose
|
5-10mg q15min
|
|
|
o/d hydralizine
|
15m/4h
|
|
|
nitro action
|
venodilator, preload reducer
|
|
|
iv bolus dose of ntg
|
25-50mcg
|
|
|
iv gtt of ntg formula and rates
|
50mg in 250 d5w
start at 5 mic/min and titrate up |
|
|
o/d of ntg gtt
|
1m/5m
|
|
|
nitroprusside action
|
arterio and venous dilator, afterload reducer
probably via NO which is a potent vasodilator |
|
|
nitroprusside o/d
|
1m/5m (same as NTG)
|
|
|
nitroprusside bolus dose
|
25-50mic bolus (same as ntg)
|
|
|
nitroprusside gtt and rates
|
50mg in 250 d5w = 200mic/cc
(same as ntg) start at 0.5 mic/kg/min and increase in 0.5 mic/kg/min increments until effect |
|
|
name the ester local anesthetics
|
procaine, chloroprocaine, tetracaine
|
|
|
name the amide local anesthetics
|
lido, prilo, mepiva, etido, ropiva, bupiva
|
|
|
what is the condition that precludes pts from getting ester anesthetics?
|
atypical plasma cholinesterase
|
|
|
morphine action
|
acts as agonist at mu,kappa, delta receptors in the CNS
|
|
|
morphine iv dose
|
1-4 mg usually
|
|
|
what is the metabolite of morphine and why is it important
|
morphine-6 glucoronide is an active metabolite
|
|
|
does morphine release histamine
|
yes
|
|
|
o/p/d of morphine
|
1m/10m/4h
|
|
|
meperidine action
|
a synthetic atropine-like opioid. agonist at mu, kappa and delta receptors in cns. Also stops shivering via kappa receptors.
|
|
|
what is the relative potency of meperidine to mso4
|
1/10th
|
|
|
dose of meperidine for shivering and pain
|
shivering ~25mg iv
pain 25-100 mg slow iv |
|
|
o/p/d meperidine
|
1m/10m/4h (same as mso4)
|
|
|
what is the metabolite of meperidine and why do we care
|
normeperidine is an active CNS stimulant and can cause seizures
|
|
|
What is a SE unique to meperidine (different than other opioids)
|
tachycardia due to atropine-like structure
|
|
|
what is action of fentanyl
|
agonist at mu, kappa and delta receptors in CNS
|
|
|
what is iv dose of fentanyl
|
25-100 mic bolus
|
|
|
o/p/d of fentanyl
|
0.5m/6m/45m
|
|
|
does fentanyl stimulate histamine release
|
no
|
|
|
what is the relative potency of fentanyl
|
100x more potent than ms04
|
|
|
what is the action of sufenta
|
same as other opioids
|
|
|
what is the dose of sufenta
|
2-10 mic/kg for induction
(150-700 mics) 10-40 mic maintenance boluses |
|
|
o/p/d of sufenta
|
1/6/45
|
|
|
what is the relative potency of sufenta
|
1000x more potent than ms04
|
|
|
does sufenta release histamine
|
no
|
|
|
what is the action of alfentanil
|
same as others
|
|
|
what is the dose of alfentanil
|
50-75 mic/kg pre-intubation load
pain: 10-75 mic/kg (must watch resps at doses >50 mic/kg) |
|
|
o/p/d of alfentanil
|
1/2/15m
|
|
|
what is the relative potency of alfentanil
|
25x potency of mso4
|
|
|
what are 2 benefits of alfentanil
|
1. small Vd leads to rapid elimination (short action)
2. lower incidence of PONV than other opioids |
|
|
what is action of remifentanyl
|
same
|
|
|
what is dose of remi
|
induction: 1-3 mic/kg/min
maint: 0.05-2 mic/kg/min |
|
|
o/p/d of remi
|
0.5/5/10m
|
|
|
what is unique about remi
|
ester hydrolysis
|
|
|
what is the relative potency of remi
|
250x more potent than mso4
|
|
|
what are the classic SE of all opioids?
|
cns depression, resp depression, n/v, pruritis, biliary spasm, urinary retention, bradycardia, hypotension
|
|
|
what is action of naloxone
|
competative pure mu, kappa and delta ANTAGONIST
|
|
|
how would you mix and administer naloxone
|
dilute the 0.4mg ampule into 10cc of nss. This makes 0.04mg/cc.
then give 1-2cc at a time to reverse resp depression/sedation while preserving analgesia |
|
|
o/p/d of naloxone
|
1/10/120m
|
|
|
who must naloxone be used cautiously with
|
opioid addicts (may precipitate withdrawl) and cardiac pts (it increased myocardial contractility and may precipitate angina
|
|
|
what is another caution to observed with naloxone
|
the action of naloxone may be shorter than the opioid and rebound resp depression/sedation may occur.
|
|
|
action of succs
|
depolarizing NMB
|
|
|
dose of succs
|
1mg/kg
|
|
|
o/p/d of succs
|
0.5/1/5-10m
|
|
|
what happens if you give a cholinesterase inhibitor after giving succs
|
prolongs the block possibly to a phase 2 block
|
|
|
what happens if you give succs and then give more a few minutes later
|
can lead to a phase 2 block
|
|
|
what are contraindications to succs
|
MH, APC, myopathies, acute denervation injuries
|
|
|
what is action of atracurium
|
blocks Ach at motor endplate.
Benzylisoquinoline. |
|
|
what is dose of atracurium for bolus and drip
|
0.5 mg/kg
3-15 mic/kg/min |
|
|
how is atra elim
|
ester AND hofmann elim
|
|
|
o/p/d of atra
|
3/5/30m
|
|
|
what are 2 problems with atra
|
1. laudanosine toxicity (rare)
2. histamine release (minimal) |
|
|
what is action of cisatracurium
|
non-depol NMBA, benzylisoquinoline
|
|
|
what is dose of cisatracurium as bolus and drip
|
0.2 mg/kg bolus
1-3 mic/kg/min gtt |
|
|
o/p/d of cisatracurium
|
2/5/30m
|
|
|
how is cisatracurium metab
|
hofmann elim
|
|
|
what are benefits of cisatracurium over atracurium
|
1. no histamine release (very good CV stability)
2. virtually no laudanosine toxicity risk |
|
|
what is action of doxacurium
|
non-depol nmba
|
|
|
what is dose of doxacurium
|
0.05 mg/kg
(3.5 mg) |
|
|
o/p/d of doxacurium
|
5/10/60m
|
|
|
what are some key facts about doxacurium
|
1. the most potent nmba and very costly
2. excellent CV stablility 3. no histamine release |
|
|
what is action of mivacurium
|
non-depol nmba
|
|
|
what is dose of mivacurium for bolus and gtt
|
0.2 mg/kg bolus
(~14 mg) bolus gtt is 5-12 mcg/kg/min |
|
|
o/p/d of mivacurium
|
2/3/15m
|
|
|
how is mivacurium metab
|
pseudocholinesterase, so do not use in pts with APC
|
|
|
is mivacurium associated with histamine release
|
yes, give in divided doses to limit histamine release
|
|
|
what is action of pipecuronium
|
non-depol nmba
|
|
|
what is dose of pipecuronium
|
0.1 mg/kg
(7 mg) |
|
|
what is o/p/d of pipecuronium
|
3/5/60m
|
|
|
what is important to know about pipecuronium
(what is it similar to and why are the SE less) |
1. a derivative of pancuronium, but minimal binding to cardiac muscarinic receptors leads to minimal CV SE.
2. no histamine release |
|
|
what is action of pancuronium
|
non-depol nmba
|
|
|
what is dose of pancuronium, bolus and gtt
|
0.1 mg/kg bolus
(~7 mg) gtt: 1-15 mic/kg/min |
|
|
o/p/d of pancuronium
|
3/5/60m
|
|
|
what is a key SE of pancuronium
|
tachycardia via blockade of cardiac muscarinic receptors
|
|
|
what is action of vec
|
non-depol nmba
|
|
|
what is dose of vec, bolus and gtt
|
0.2 mg/kg (~14mg)
gtt: 0.8-1.2 mic/kg/min |
|
|
o/p/d of vec
|
3/5/30m
|
|
|
what effects will liver or renal failure have on vec
|
slight prolongation with liver failure.
Effect will be prolonged with renal failure. |
|
|
what is vec similar to
|
it is a derivative of vec with improved SE profile.
|
|
|
what is action of roc
|
non-depol nmba
(aminosteroid) |
|
|
what is dose of roc
bolus and gtt |
1 mg/kg bolus (use 1.2-1.5mg/kg for RSI)
5-12 mcg/kg/min |
|
|
o/p/d roc
|
1.5/3/30m
|
|
|
how does renal and hepatic disease effect roc
|
block is prolonged by liver failure but NOT by renal failure.
|
|
|
Which nmba's are prolonged with renal failure
|
pan and vec
|
|
|
which nmba's are prolonged with hepatic failure
|
pan, roc and vec
|
|
|
which nmba's are prolonged with APC
|
succs and mivacurium
|
|
|
which nmba's are not affected by renal or hepatic status
|
atracurium and cisatracurium.
Also to a certain extent succs and mivacurium unless the hepatic failure is so severe as to impair plasma cholinesterase production. |
|
|
What is action of epi
|
A1, B1, B2 agonist
|
|
|
What is dose for epi gtt
|
1-2 mic/min = B2
4-6 mic/min = B1 10-20 mic/min = mostly A1 with some B1 |
|
|
How do you mix an epi gtt
|
1mg epi in 250 NSS or D5W
= 4mcg/cc |
|
|
o/p/d of epi gtt
|
immediate onset
lasts a few minutes max |
|
|
What is action of norepi
|
A and B1 with no effect on B2.
|
|
|
What is dosage of norepi gtt
|
start at 1 mic/min
(avg dose is 2-12 mic/min) |
|
|
How do you mix a norepi gtt
|
4mg of norepi in 250 cc D5W
|
|
|
What is action of phenylephrine?
|
pure alpha1 agonist. No effect on Beta
|
|
|
What is dose of phenylephrine as bolus and gtt?
|
100 mic bolus
or 20-50 mic/min gtt |
|
|
o/d of phenylephrine
|
IV instant onset
lasts 15 min |
|
|
what is a problematic SE of phenylephrine?
|
reflex bradycardia
|
|
|
How do you mix a phenylephrine drip
|
10mg in 250cc NSS or D5W
= 40mic/cc |
|
|
What is action of ephedrine
|
indirect alpha and beta agonist
|
|
|
what is dose of ephedrine
|
5-10mg
|
|
|
what is improtant to remember about ephedrine dosing
|
tachyphylaxis, so larger doses are required with redosing
|
