Saint Francis Drugs..docx

Saint Francis Drugzzzzz +---------+---------+---------+---------+---------+---------+---------+ | | MOA | Class | Inducti | Mainten | Half-Li | Antagon | | | | | on | ance | fe | ist | | | | | Dose | dose |...

Saint Francis Drugzzzzz +---------+---------+---------+---------+---------+---------+---------+ | | MOA | Class | Inducti | Mainten | Half-Li | Antagon | | | | | on | ance | fe | ist | | | | | Dose | dose | | (if | | | | | | | | applica | | | | | | | | ble) | +=========+=========+=========+=========+=========+=========+=========+ | Fentany | 100x | Opioid | 1-2mcg/ | 1-3/mcg | Almost | Narcan | | l | more | | kg | /kg/hr | immedia | (Naloxo | | | potent | | per | | te | ne) | | Concent | than | | dose | Will | maximal | | | ration: | morphin | | initial | have | analges | | | | e | | ly | prolong | ic | | | 50mcg/m | as an | | | ed | | | | l | analges | | **Very | effects | Respira | | | | ic. | | common | if used | tory | | | | | | to see | as drip | depress | | | | It is a | | in | | ant | | | | mu | | rough | | effect | | | | opioid | | 50 mcg | | may not | | | | recepto | | increme | | be | | | | r | | nts** | | noted | | | | | | | | for | | | | agonist | | | | several | | | | with | | | | minutes | | | | high | | | | | | | | lipid | | | | Duratio | | | | solubil | | | | n | | | | ity | | | | after | | | | | | | | 100mcg | | | | and a | | | | is | | | | rapid | | | | 30-60mi | | | | onset | | | | ns | | | | and | | | | | | | | short | | | | Half-li | | | | | | | | fe- | | | | duratio | | | | 2-4 | | | | n | | | | hours | | | | of | | | | | | | | effects | | | | Hepatic | | | |. | | | | metabol | | | | | | | | ism, | | | | | | | | excrete | | | | | | | | d | | | | | | | | by | | | | | | | | kidney | | | | | | | | (\65yo: | | ibution | propofo | | | mbrane | | | | half-li | l | | | CI | | only | | fe: | infusio | | | conduct | | 1-1.5 | | | n | | | ion, | | mg/kg | | 1-2 | syndrom | | | hyperpo | | (smalle | | minutes | e | | | larizes | | r | | | is | | | post | | central | | Elimina | suspect | | | synapti | | distrib | | tion | ed | | | c | | ution | | half-li | | | | cell | | and | | fe: | | | | membran | | slower | | | | | | e | | clearan | | 0.5- | | | | | | ce) | | 1.5 hrs | | | | Inhibit | | | | | | | | ion | | | | Context | | | | of the | | | | sensiti | | | | post | | | | ve | | | | synapti | | | | half-ti | | | | c | | | | me | | | | neuron | | | | is less | | | | | | | | than 40 | | | | Increas | | | | minutes | | | | ing | | | | after | | | | the | | | | an | | | | duratio | | | | 8-hour | | | | n | | | | infusio | | | | of the | | | | n | | | | opening | | | | | | | | of the | | | | Metabol | | | | chlorid | | | | ism- | | | | e | | | | 60% | | | | channel | | | | hepatic | | | | s | | | | , | | | | prolong | | | | 40% | | | | s | | | | kidneys | | | | hyperpo | | | | | | | | larizat | | | | | | | | ion | | | | | | | | and | | | | | | | | thus | | | | | | | | creates | | | | | | | | sedativ | | | | | | | | e | | | | | | | | and | | | | | | | | hypnoti | | | | | | | | c | | | | | | | | effects | | | | | | +---------+---------+---------+---------+---------+---------+---------+ | Etomida | Bind to | GABA | 0.3-0.6 | Prolong | Onset: | N/A | | te | GABA | mimetic | mg/kg | ed | 30-40 | | | | recepto | | | infusio | seconds | | | Concent | r | | **Rarel | n | | | | ration: | and | | y | depress | Peak: 1 | | | | enhance | | used... | es | minutes | | | 2mg/ml | s | | most | adrenoc | | | | | the | | just | ortical | Duratio | | | | recepto | | use | functio | n: | | | | r's | | less | n | 3-10 | | | | affinit | | propofo | and not | minutes | | | | y | | l | recomme | | | | | for the | | and | nded | Half-li | | | | GABA | | pressor | | fe: | | | | neurotr | | s | | 2-5 | | | | ansmitt | | w/ | | hours | | | | er | | inducti | | | | | | | | on** | | | | | | Preferr | | | | | | | | ed | | | | | | | | in | | | | | | | | unstabl | | | | | | | | e | | | | | | | | patient | | | | | | | | s | | | | | | | | or | | | | | | | | cardiac | | | | | | | | patient | | | | | | | | s | | | | | | | | over | | | | | | | | propofo | | | | | | | | l | | | | | | +---------+---------+---------+---------+---------+---------+---------+ | Ketamin | Binds | Phencyc | 1-2mg/k | 1-2mg/k | Onset: | N/A | | e | noncomp | lidine | g | g/hr | 30 | | | | etitive | derivat | IV | | seconds | | | Concent | ly | ive | | | | | | ration: | to | | 6-13mg/ | | Peak: | | | | N-methy | | kg | | 3-5 | | | 50mg/ml | l-D-asp | | IM | | minutes | | | | erate | | | | | | | | (NMDA) | | Peds | | Duratio | | | | | | IV: | | n | | | | | | 1-2mg/k | | 8-15 | | | | | | g | | minutes | | | | | | | | | | | | | | Peds | | Half-li | | | | | | IM: | | fe: | | | | | | 6-13mg/ | | 45 | | | | | | kg | | minutes | | | | | | | | | | | | | | Trauma | | | | | | | | TIVA: | | | | | | | | 200mg | | | | | | | | and | | | | | | | | 10mg | | | | | | | | versed | | | | | | | | | | | | | | | | **Most | | | | | | | | often | | | | | | | | used at | | | | | | | | SFH as | | | | | | | | pain | | | | | | | | adjunct | | | | | | | |. | | | | | | | | Usually | | | | | | | | somethi | | | | | | | | ng | | | | | | | | like 25 | | | | | | | | mg with | | | | | | | | inducti | | | | | | | | on, | | | | | | | | 10 mg | | | | | | | | Q1H up | | | | | | | | to 0.5 | | | | | | | | mg/kg.* | | | | | | | | * | | | | +---------+---------+---------+---------+---------+---------+---------+ | Roc | Competi | NDMB | 0.6 | 0.15 | Onset: | Sugamma | | | tive | | mg/kg | mg/kg | 1-2 | dex, | | Concent | antagon | | | | minutes | Neostig | | ration: | ism | | RSI: | | | mine | | | of ACh | | 1.2 | | Duratio | | | 5mg/ml | at the | | mg/kg | | n: | | | | nAChr | | | | 30 | | | | (NMJ). | | (ED95 | | minutes | | | | Reversi | | is 0.3 | | for 0.6 | | | | ble | | mg/kg; | | mg/kg | | | | by | | so 2-3x | | dose | | | | competi | | ED95) | | and 67 | | | | tive | | | | minutes | | | | antagon | | **Josep | | for 1.2 | | | | ism | | h | | mg/kg | | | | of ACh: | | will | | dose | | | | choline | | argue | | | | | | sterase | | w/ you | | Half-Li | | | | inhibit | | and say | | fe: | | | | ors | | you're | | 60-70 | | | | increas | | overdos | | minutes | | | | e | | ing. | | ; | | | | ACh at | | Just | | 2x as | | | | the NMJ | | smile | | long in | | | | displac | | and | | hepatic | | | | ing | | nod.** | | dysfunc | | | | the | | | | tion | | | | NDMB | | | | | | +---------+---------+---------+---------+---------+---------+---------+ | Sux | Mimics | Depolar | 1-1.5 | N/A | Onset: | N/A | | | ACh at | izing | mg/kg | | 1 | | | Concent | the | NMB | | | minute | | | ration: | nAChr | | Resista | | | | | | causing | | nce | | Duratio | | | 20mg/ml | depolar | | to SCh | | n: | | | | ization | | after | | 7-13 | | | | | | NDMR | | minutes | | | | Phase 1 | | (dose | | (depend | | | | block: | | should | | ent | | | | sustain | | be | | on | | | | ed | | increas | | dibucai | | | | opening | | ed) | | ne | | | | of | | | | number) | | | | recepto | | | | | | | | r | | | | Rapid | | | | channel | | | | metabol | | | | s | | | | ism | | | | in | | | | | | | | depolar | | | | | | | | ized | | | | | | | | post-ju | | | | | | | | nctiona | | | | | | | | l | | | | | | | | membran | | | | | | | | e | | | | | | | | cannot | | | | | | | | respond | | | | | | | | to | | | | | | | | further | | | | | | | | ACh | | | | | | | | | | | | | | | | Phase 2 | | | | | | | | block: | | | | | | | | desensi | | | | | | | | tized | | | | | | | | repolar | | | | | | | | ized | | | | | | | | post-ju | | | | | | | | nctiona | | | | | | | | l | | | | | | | | membran | | | | | | | | e | | | | | | | | remains | | | | | | | | unrespo | | | | | | | | nsive | | | | | | | | to ACh | | | | | | +---------+---------+---------+---------+---------+---------+---------+ | Nimbex | Non-dep | NDMB | 0.15-0. | 0.03 | Onset: | Neostig | | | olarizi | | 2 | mg/kg | 2-3 | mine | | | ng | | mg/kg | | minutes | | | | neuromu | | | | | | | | scular | | (ED95 | | Peak/Ma | | | | locker | | is 0.05 | | ximum | | | | competi | | mg/kg, | | block: | | | | tive | | so | | 3-7 | | | | antagon | | 2-3x) | | minutes | | | | ism | | | | | | | | of ACh | | \*Ideal | | Duratio | | | | at the | | body | | n: | | | | nAChr | | weight | | 50 | | | | (NMJ) | | | | minutes | | | | | | | | | | | | Reversi | | | | Half-Li | | | | ble | | | | fe: | | | | by | | | | 22-29 | | | | competi | | | | minutes | | | | tive | | | | | | | | antagon | | | | | | | | ism | | | | | | | | of Achà | | | | | | | | choline | | | | | | | | sterase | | | | | | | | inhibit | | | | | | | | ors | | | | | | | | **­** | | | | | | | | ACh at | | | | | | | | the NMJ | | | | | | | | displac | | | | | | | | ing | | | | | | | | the | | | | | | | | NDMB | | | | | | | | | | | | | | | | **Rarel | | | | | | | | y | | | | | | | | used at | | | | | | | | SFH in | | | | | | | | the age | | | | | | | | of | | | | | | | | Sugamma | | | | | | | | dex | | | | | | | | (even | | | | | | | | though | | | | | | | | it | | | | | | | | isn't | | | | | | | | approve | | | | | | | | d | | | | | | | | in | | | | | | | | renal | | | | | | | | failure | | | | | | | | )** | | | | | | +---------+---------+---------+---------+---------+---------+---------+ | Phenyle | Sympath | Alpha | 5-20 | 10-200 | Onset: | Hydrala | | phrine | omimeti | Adrener | mcg/kg | mcg/min | immedia | zine | | | c | gic | bolus | ute | te | or | | Concent | alpha-a | Agonist | | or | | Labetal | | ration: | drenerg | | **Nate: | 0.1-2 | Duratio | ol? | | | ic | | I'd say | mcg/kg/ | n: | | | Vial- | agonist | | this is | min | 15-20 | | | 10mg/ml |. | | low...m | | minutes | | | | Constri | | ore | | | | | One | cts | | like | | | | | 10mg | both | | 100 | | | | | vial in | arteria | | mcg-200 | | | | | 250ml | l | | mcg | | | | | is | and | | boluses | | | | | 40mcg/m | venous | | ** | | | | | l | blood | | | | | | | | vessels | | | | | | | Two | , | | | | | | | 10mg | increas | | | | | | | vial in | ing | | | | | | | 250ml | systemi | | | | | | | is | c | | | | | | | 80mcg/m | vascula | | | | | | | l | r | | | | | | | | resista | | | | | | | | nce | | | | | | | | without | | | | | | | | changin | | | | | | | | g | | | | | | | | cardiac | | | | | | | | dynamic | | | | | | | | s | | | | | | +---------+---------+---------+---------+---------+---------+---------+ | Ephedri | Sympath | Alpha/B | Initial | Additio | Onset: | Hydrala | | ne | omimeti | eta | 5-10 mg | nal | immedia | zine | | | c | Adrener | IV | boluses | te | or | | Concent | amine | gic | bolus | as | | Labetal | | ration: | that | Agonist | | needed | Duratio | ol? | | | directl | | | not to | n: | | | 50mg/ml | y | | | exceed | 1 hour | | | | acts as | | | a total | | | | | an | | | cumulat | Half-Li | | | | agonist | | | ive | fe | | | | at | | | dosage | 2.5-3.6 | | | | alpha | | | of 50 | hours | | | | and | | | mg | | | | | betaadr | | | | | | | | energic | | | | | | | | recepto | | | | | | | | rs | | | | | | | | and | | | | | | | | indirec | | | | | | | | tly | | | | | | | | causes | | | | | | | | the | | | | | | | | release | | | | | | | | of | | | | | | | | norepin | | | | | | | | ephrine | | | | | | | | from | | | | | | | | sympath | | | | | | | | etic | | | | | | | | neurons | | | | | | | |. | | | | | | | | | | | | | | | | Results | | | | | | | | in | | | | | | | | increas | | | | | | | | ed | | | | | | | | HR, BP, | | | | | | | | CO, and | | | | | | | | PVR. | | | | | | +---------+---------+---------+---------+---------+---------+---------+ | Norepi | -Acts | Alpha | IV | 0.05-0. | Onset: | | | | on both | adrener | bolus | 5 | immedia | | | Concent | alpha-1 | gic | of | mcg/kg/ | te | | | ration: | and | agonist | 10-12mc | min | | | | | alpha-2 | | g | infusio | Duratio | | | \*typic | adrener | | for | n | n | | | ally\* | gic | | hypoten | | : 1-2 | | | | recepto | | sion | | min | | | 8mg/250 | rs | | related | | after | | | ml | to | | to | | infusio | | | | cause | | sympath | | n | | | 32mcg/m | vasocon | | ectomy | | stopped | | | l | stricti | | from | | | | | | on. | | spinal | | Half | | | | | | anesthe | | life: 2 | | | | -Cautio | | sia | | min | | | | n | | | 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ation. | | | | | | | | Low | | | | | | | | dose | | | | | | | | anti-in | | | | | | | | flammat | | | | | | | | ory | | | | | | | | high | | | | | | | | dose | | | | | | | | immunos | | | | | | | | uppress | | | | | | | | ive. | | | | | | +---------+---------+---------+---------+---------+---------+---------+ | Zofran | Blocks | 5HT3 | | 4-8mg | Onset: | | | | the | recepto | | adult | 10 min | | | Concent | seroton | r | | IVP | | | | ration: | in | inhibit | | | Duratio | | | | recepto | or | | 0.1mg/k | n | | | 4mg/2ml | rs | | | g | 2-7 | | | | in the | | | for | hours | | | 2mg/ml | CTZ. | | | peds | | | | | This | | | | Half | | | | reduces | | | | life- 3 | | | | the | | | | hours | | | | communi | | | | | | | | cation | | | | | | | | to the | | | | | | | | vomitin | | | | | | | | g | | | | | | | | center | | | | | | | | in the | | | | | | | | brain | | | | | | | | and | | | | | | | | decreas | | | | | | | | es | | | | | | | | the | | | | | | | | nausea | | | | | | | | and | | | | | | | | vomitin | | | | | | | | g | | | | | | | | the | | | | | | | | patient | | | | | | | | experie | | | | | | | | nces. | | | | | | +---------+---------+---------+---------+---------+---------+---------+ | Benadry | Diphenh | antihis | **By | 25-50mg | Onset : | | | l | ydramin | tamine | far the | adult | IV | | | | e | | most | | immedia | | | Concent | competi | | common | 1mg/kg | te | | | ration: | tively | | 3^rd^ | peds | | | | | inhibit | | line | | PO | | | 50mg/ml | s | | antieme | | 15-30 | | | | the | | tic | | min | | | | [histam | | you'll | | | | | | ine](ht | | see at | | Duratio | | | | tps://p | | SFH. | | n: | | | | ubchem. | | 4-8 mg | | 4-6 | | | | ncbi.nl | | Decadro | | hours | | | | m.nih.g | | n, | | | | | | ov/comp | | 4 mg | | Half | | | | ound/hi | | Zofran, | | life:5. | | | | stamine | | 12.5-25 | | 4 | | | | )-1 | | mg | | hours | | | | (H1) | | Benadry | | metabol | | | | recepto | | l | | ized | | | | r, | | very | | by | | | | thereby | | common. 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minutes | | | | carbamy | | people | | | | | | lated | | are | | Half | | | | ester | | going | | life: | | | | at the | | to give | | 50 | | | | esterat | | 3 mg | | minutes | | | | ic | | neo/ | | (metabo | | | | site | | 0.4 mg | | lized | | | | \--\> | | glycol | | by | | | | allows | | or 5 mg | | kidneys | | | | massive | | neo/0.8 | | ) | | | | accumul | | mg | | | | | | ation | | glyco** | | | | | | of Ach | | ) | | | | | | at the | | | | | | | | NMJ | | Other | | | | | | | | method: | | | | | | | | | | | | | | | | (weight | | | | | | | | /2)\*0. | | | | | | | | 1 | | | | | | | | | | | | | | | | Eg. 50 | | | | | | | | kg | | | | | | | | \--\> | | | | | | | | 2.5 mg | | | | | | | | neo | | | | +---------+---------+---------+---------+---------+---------+---------+ | Glycopy | Binds | Anticho | With | n/a | Onset: | | | rrolate | to | linergi | reversa | | immedia | | | | muscari | c | l: | | te | | | Concent | nic | - | neostig | | (less | | | ration: | recepto | Quatern | mine | | than 1 | | | | r | ary | + glyco | | minute) | | | 4mg/20m | sites | | to | | | | | l | and | | prevent | | Half-li | | | | competi | | brady: | | fe: | | | 0.2mg/m | tively | | | | 50 | | | l | antagon | | 0.2 mg | | minutes | | | | izes | | glyco | | | | | | (blocks | | per 1 | | Clearan | | | | ) | | mg neo | | ce | | | | Ach at | | (1:5) | | more | | | | that | | | | rapid | | | | site | | **Most | | than | | | | | | everyon | | atropin | | | | Less | | e | | e | | | | Ach | | shorts | | (80% | | | | \--\> | | this | | unchang | | | | less | | dosage | | ed | | | | brady | | by 0.2 | | in | | | | | | mg to | | urine) | | | | | | avoid | | | | | | | | tachyca | | | | | | | | rdia.** | | | | | | | | | | | | | | | | Anti-si | | | | | | | | alagogu | | | | | | | | e: | | | | | | | | 0.1-0.2 | | | | | | | | mg IV | | | | | | | | | | | | | | | | Mild | | | | | | | | brady | | | | | | | | (vagoly | | | | | | | | sis) | | | | | | | | with | | | | | | | | hypoten | | | | | | | | sion: | | | | | | | | | | | | | | | | 0.1-0.2 | | | | | | | | mg | | | | | | | | | | | | | | | | when | | | | | | | | ephedri | | | | | | | | ne | | | | | | | | is not | | | | | | | | first | | | | | | | | choice | | | | +---------+---------+---------+---------+---------+---------+---------+ | Sugamma | Encapsu | Selecti | Depends | n/a | Refer | This is | | dex | lates | ve | on TOF | | to | the | | | the | muscle | twitche | | dosing | antagon | | Concent | steroid | relaxan | s | | | ist | | ration: | al | t | | | \*do | for | | | muscle | binding | 2-4 | | not | steroid | | 100mg/m | relaxan | and | TOF: | | need | al | | l | t | reversa | | | anticho | NMB | | | molecul | l | 2 mg/kg | | linergi | (Roc, | | | e | agent | \--\> | | c | Vec, | | | with a | | | | co-admi | Panc) | | | 1:1 | | 1.5 min | | nistrat | | | | ratio | | reversa | | ion | | | | | | l | | | | | | Clycode | | | | \*minim | | | | xtrin | | 0 TOF | | um | | | | that | | 1-2 | | wait | | | | noncova | | PTT: 4 | | time of | | | | lently | | mg/kg | | 5 | | | | binds | | \--\> | | minutes | | | | the | | 3-min | | if | | | | steroid | | reversa | | sugamma | | | | al | | l | | dex | | | | muscle | | | | 2-4 | | | | relaxan | | Emergen | | mg/kg | | | | t | | cy | | given | | | | within | | reversa | | to give | | | | the | | l | | redose | | | | sugar | | (3 min | | of | | | | ring of | | after | | rocuron | | | | the | | max Roc | | ium | | | | suggama | | intubat | | 1.2 | | | | dex | | ing | | mg/kg | | | | molecul | | dose | | | | | | e | | (1.2 | | \*\*if | | | | prevent | | mg/kg): | | rocuron | | | | ing | | | | ium | | | | Roc | | 16 | | is | | | | (Vec/Pa | | mg/kg | | redosed | | | | nc) | | \--\> | | within | | | | from | | | | 30 | | | | binding | | 3 min | | minutes | | | | the Ach | | reversa | | of | | | | recepto | | l | | sugamma | | | | rs, | | | | dex | | | | permitt | | | | \--\> | | | | ing | | | | onset | | | | immedia | | | | of NMB | | | | te | | | | delayed | | | | reversa | | | | up to 4 | | | | l | | | | minutes | | | | | | | | and | | | | | | | | duratio | | | | | | | | n | | | | | | | | of NMB | | | | | | | | shorten | | | | | | | | ed | | | | | | | | to 15 | | | | | | | | minutes | | +---------+---------+---------+---------+---------+---------+---------+ | Precede | Binds | Alpha 2 | Bolus: | Infusio | Onset: | Alpha 2 | | x | with | agonist | 1mcg/kg | n | \ | | **I've | | Elimina | ezole)) | | | causes | | never | | tion | from | | | decreas | | seen | | Half-li | google. | | | e | | someone | | fe: | | | | in NE | | at SFH | | 2-3 hr | | | | levels | | start a | | | | | | \--\> | | drip.** | | Almost | | | | sedativ | | | | complet | | | | e | | **More | | e | | | | and | | commonl | | biotran | | | | analges | | y, | | sformat | | | | ic | | you'll | | ion | | | | effects | | see | | very | | | | | | people | | little | | | | | | giving | | unchang | | | | | | boluses | | ed | | | | | | of 5-10 | | | | | | | | mcg up | | | | | | | | to 0.5 | | | | | | | | mcg/kg. | | | | | | | | Some of | | | | | | | | our | | | | | | | | docs | | | | | | | | are | | | | | | | | startin | | | | | | | | g | | | | | | | | demoniz | | | | | | | | e | | | | | | | | routine | | | | | | | | Precede | | | | | | | | x | | | | | | | | use.** | | | | | | | | | | | | | | | | \*side | | | | | | | | effects | | | | | | | | : | | | | | | | | | | | | | | | | Brady, | | | | | | | | hypoten | | | | | | | | sion, | | | | | | | | dry | | | | | | | | mouth | | | | | | | | | | | | | | | | Awake | | | | | | | | intubat | | | | | | | | ion | | | | | | | | | | | | | | | | 1 | | | | | | | | mcg/kg | | | | | | | | IV | | | | | | | | (then | | | | | | | | can | | | | | | | | start | | | | | | | | drip | | | | | | | | for | | | | | | | | mainten | | | | | | | | ance) | | | | +---------+---------+---------+---------+---------+---------+---------+ | Atropin | Inhibit | Anticho | Adult | N/A | 2-5 | N/A | | e | s | linergi | dose | | hours | | | | postgan | c | for | | | Sometim | | Concent | glionic | | symptom | | | es | | ration: | muscari | (antimu | atic | | | given | | | nic | scarini | brady: | | | with | | 1mg/10m | recepto | c) | 0.5mg | | | neostig | | l | rs, | | IV | | | mine | | | thus | | | | | | | 0.1mg/m | compete | | Repeate | | | | | l | s | | d | | | | | | with | | every | | | | | | acetylc | | 3-5 | | | | | | holine | | minutes | | | | | | at the | | up to | | | | | | muscari | | 3mg or | | | | | | nic | | 6 doses | | | | | | recepto | | | | | | | | r | | Pediatr | | | | | | sites | | ic | | | | | | as an | | doses: | | | | | | antagon | | | | | | | | ist. | | 0.02mg/ | | | | | | A | | kg | | | | | | competi | | **IV** | | | | | | tive | | | | | | | | antagon | | 0.02-0. | | | | | | ist, | | 04mg/kg | | | | | | thus | | **IM** | | | | | | its | | | | | | | | effects | | Maximum | | | | | | can | | single | | | | | | eventua | | dose | | | | | | lly | | for | | | | | | be | | child: | | | | | | overcom | | 0.5mg | | | | | | e | | | | | | | | by an | | Maximum | | | | | | increas | | single | | | | | | ing | | dose | | | | | | concent | | for | | | | | | ration | | adolesc | | | | | | of | | ent: | | | | | | acetylc | | 1.0mg | | | | | | holine. | | | | | | +---------+---------+---------+---------+---------+---------+---------+ PIMPED +-----------------------+-----------------------+-----------------------+ | Question | Answer | Comments | +=======================+=======================+=======================+ | Treatments for | 1. Calcium (e.g. | Signs of | | hyperkalemia | Calcium | hyperkalemia: | | | gluconate) | | | | | Mild: peaked T waves; | | | 2. Insulin (e.g. | shortened QRS | | | Regular) (may | | | | need to also give | | | | glucose) | | | | | | | | 3. Beta 2 agonist | | | | (e.g. albuterol) | | | | | | | | 4. Sodium | | | | Bicarbonate | | | | | | | | 5. Diuretics (e.g. | | | | Lasix) | | | | | | | | 6. Dialysis | | | | | | | | 7. Kayexalate | | +-----------------------+-----------------------+-----------------------+ | Change in cm = change | Change in 15 cm | Especially important | | in mmHg (MAP) | height \--\> change | for patients that you | | | 10 mmHg in MAP | worry about cerebral | | | | perfusion (MAP --ICP) | +-----------------------+-----------------------+-----------------------+ | Size of ETT for | (age/4) +4 | Formula for uncuffed | | pediatrics | | | | | | If cuffed \--\> use | | | | 0.5 size smaller | +-----------------------+-----------------------+-----------------------+ | When you release | Evil humors \--\> | Open up the roller | | surgery tourniquet, | vasodilation | clamp and allow | | what are you worried | | fluids to run freely | | about? | | right before | | | | tourniquet removal | +-----------------------+-----------------------+-----------------------+ | Curare Clefts | Dips in the plateaus | Might mean you need | | | on the CO2 waveform | more NMB | | | indicating | | | | spontaneous | | | | respiratory effort | | | | during mechanical | | | | ventilation | | +-----------------------+-----------------------+-----------------------+ | Dose of Pitocin to be | Typically 40 mg; St | Ask the surgeon when | | given to a patient | Francis CRNAs put 20 | they're ready for you | | undergoing C-section | mg in a bag of LR if | to give Pitocin | | after delivery of | it has at least 500 | | | baby? | mLs and then the | | | | other 20 mg in a new | | | | bag of LR | | +-----------------------+-----------------------+-----------------------+ | Why are we hesitant | It can cause | | | on giving a second | bradycardia. | | | dose of Sux? | | | +-----------------------+-----------------------+-----------------------+ | What happens if you | Laryngospasm | | | extubate in stage 2? | | | +-----------------------+-----------------------+-----------------------+ | How to treat | Positive pressure- if | | | laryngospasm? | not working then | | | | succs (20mg) | | +-----------------------+-----------------------+-----------------------+ | How does your body | Sensed in | | | sense changes in BP? | baroreceptors and | | | | then sent to medulla | | +-----------------------+-----------------------+-----------------------+ | Respiratory response | Shallow tidal volumes | | | to volatile | and rapid respiratory | | | anesthetics? | rate | | +-----------------------+-----------------------+-----------------------+ | Quick way to figure | Cardiac output times | | | out PaO2 for a | FiO2 | | | healthy person? | | | +-----------------------+-----------------------+-----------------------+ | Random seizure | Postanesthetic | | | activity that can | opisthotonos | | | happen after the | | | | administration of | | | | propofol? | | | +-----------------------+-----------------------+-----------------------+ | A big factor that is | Seizure medication | | | fairly common that | | | | causes NMB's duration | | | | of action to be | | | | shortened? | | | +-----------------------+-----------------------+-----------------------+ | Why would you not | Because their | Slides 13-20 from | | want to give Sux to a | receptors are | Ron's NMB lecture is | | patient with Cerebral | upregulated and they | good for all of this. | | Palsy? | have lots of immature | | | | receptors that could | | | | cause a massive K | | | | efflux which equals | | | | your patient | | | | potentially going | | | | night night forever | | +-----------------------+-----------------------+-----------------------+ | Which NMB are | Sux sensitive to | | | sensitive to | upregulation and | | | upregulation and | resistant to | | | which are sensitive | downregulation and | | | to downregulation? | the NDMB are | | | | sensitive to | | | | downregulation and | | | | resistant to | | | | upregulation | | +-----------------------+-----------------------+-----------------------+ | What causes a left to | Increased afterload | | | right shunt? | compared to pulmonary | | | | pressure | | +-----------------------+-----------------------+-----------------------+ | Which reflex can be | Bezold-Jarisch reflex | | | ablated by giving | | | | Zofran in patients | | | | under spinal | | | | anesthesia for | | | | C-section? | | | +-----------------------+-----------------------+-----------------------+ | Which patient | Pregnancy-induced | Methergine contracts | | population do you | hypertension; | vascular smooth | | want to avoid giving | asthmatics. | muscle and can | | methergine to during | | markedly increase | | a C-section? In which | | blood pressure in | | do you avoid | | those predisposed. | | carboprost | | Hemabate can cause | | (Hemabate)? | | bronchospasm as well | | | | as HTN. | +-----------------------+-----------------------+-----------------------+ | Which glycoprotein is | Antithrombin III | If resistant to | | required in order for | | heparin (as indicated | | heparin to function | | by much lower than | | adequately? | | expected ACT), | | | | administer FFP. | +-----------------------+-----------------------+-----------------------+