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45 Cards in this Set
- Front
- Back
- 3rd side (hint)
What are the 3 goals in anaesthesia? |
1. Sedation 2. Analgesia 3. Paralysis |
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Name some Benzodiazepines and their functions in anaesthesia |
1. Midazolam (Versed) 2. Diazepam (Valium) 3. Lorezapam (Ativan) Function: anxiolysis, sedation, amnesia |
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What is the dosage, clinical effect timing and half life of midazolam? |
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What is the dosage, clinical effect timing and half life of diazepam? |
Dosage: 2.5-10 mg Half life: 20 hr |
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What is the dosage, clinical effect timing and half life of lorezapam? |
Dosage: 1-4 mg |
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What is the antidote and dosage for the reversal of benzodiazepam effects? What is it's duration of clinical effect? |
Flumezanil 0.1mg , every 5 mins Duration of clinical effect: 1 hour |
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What are the functions of opioids in anaesthesia? |
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What are the common opioids used in anaesthesia? |
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How do opioids work? |
agonists to mu, delta and kappa receptors |
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What is the dosage, clinical effect timing and time to peak concentrations of Fentanyl? |
Dosage: 1 mcg/kg Clinical effect: 0.5 - 1 hour Time to peak: 3-5 mins |
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What is the dosage, clinical effect timing and time to peak concentrations of Alfentanil? |
Dosage: 10mcg/kg Clinical effect: 12-18 mins Time to peak: 1.5-2 mins |
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What is the dosage, clinical effect timing and time to peak concentrations of Sulfentanil? |
Dosage: 0.01mg Clinical effect: 0.5 - 1 hr Time to peak: 3-5 mins |
***5-10x more potent than fentanyl |
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What is the dosage, clinical effect timing and time to peak concentrations of morphine? |
Dosage: 0.1mg/kg Clinical effect: 3-4 hr Time to peak: 20-30 mins |
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Side effects of opioids |
- Respiratory depression (due to low hypoxic drive, increase in apneic threshold) - Bradycardia - Urinary retention, constipation - Muscle rigidity - Nausea and Vomiting |
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What is the antidote and dosage for opioid overdose? What is the mechanism? |
Naloxone, 0.04-0.4 mg every 2 mins Antagonizes mu receptors |
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What is the antidote to reduce peripheral symptoms of opioids? |
Methynaltrexone; this does not affect analgesia |
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Name two benefits of using opioids as an anaesthetic |
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Good for haemodynamically unstable patients |
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Name 4 common induction agents |
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What is the dosage, clinical effect timing and half life of Propofol? |
Dosage: 2-2.5mg/kg (induction), 0.025-0.2 mg/kg/min (infusion) Half life: 2-8 mins |
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What are the side effects of propofol? |
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What are the benefits of using propofol as an induction agent? |
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What can be added with propofol to reduce pain during bolus infusion? |
1% Lidocaine |
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What is the dosage of thiopental? |
Dose: 3-5 mg/kg |
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Why can't paralytic agents be mixed with thiopental infusion? |
Thiopental, being very alkaline, may react with paralytic agents (acidic) and lead to IV catheter occlusion |
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What are the side effects of thiopental? |
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What are the advantages of thiopental as an induction agent? |
It is cerebroprotective, thus recommended in brain surgery cases |
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What is the dosage of Etomidate? |
0.2-0.5 mg/kg |
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What are the side effects of etomidate? |
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What are the advantages of etomidate as an induction agent? |
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What is the dosage of ketamine? |
1-2 mg/kg (IV induction) 3-4 mg/kg (IM induction) 1-2mg/kg/hr (IV infusion) |
a dissociative anaesthetic agent |
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What are the side effects of ketamine? |
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What are the advantages of ketamine as an induction agent? |
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what types of neuromuscular blocking agents are there? |
Depolarizing vs Non-depolarizing |
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what is the mechanism, onset and duration of succinylcholine?(depolarizing NMB) |
onset = 30-45 s duration = 5 mins Mechanism: agonist to acetylcholine receptors at the NMJ, prevents NMJ repolarization |
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what is phase 2 blockade? |
prolonged end plate depolarization will lead to conformational changes within the acetylcholine receptor, and slow down recovery Hence, avoid giving too much! |
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How is succinylcholine removed? |
It is removed physiologically by pseudocholinsterase. There's currently no commercially available antidote |
dont use acetylcholinesterase inhibitors as it will worsen the NMJ blockade |
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side effects of succinycholine? |
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contraindications for succinycholine? |
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what is the mechanism of non-depolarizing NMB? |
competitive antagonism of acetycholine at NMJ receptors, do not cause depolarization of NMJ, unlike succinycholine |
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Rocuronium dosage, onset, duration, indications? |
Dosage: 0.6mg/kg Onset: 1-2 mins Duration: 30-40 mins Indications: can replace succinylcholine for RSI, as second line |
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Pancuronium onset, duration, indications? |
Onset: 4-6 mins Duration: 120-180 mins SE: tachycardia and HTN |
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Cisatracurium and Vecuronium indications? Cisatracurium SE? |
Onset: 2-4 mins Duration: 30-40 mins SE: Hypotension |
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What are the antidote for NMBs? |
acetylcholinsterase inhibitors + anticholinergic drug Neostigmine 50 mg/kg + Glycopyrrolate 10 mcg/kg Edrophonium 500 mcg/kg + Atropine 20 mcg/kg |
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What can cause cholinergic crisis in anaesthesia? what is the antidote? |
excess neostigmine/edrophonium Antidote= glycopyrrolate/atropine |
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What can cause central anticholinergic crisis in anaesthesia? what is the antidote? |
excess glycopyrrolate/atropine Antidote = physostigmine |
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