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