Card Set Information
anesthesia drugs meds
Typical indications in a rural emergency room for intubation?
What equipment do you want for intubation?
Ambu bag (with reservoir)
Taping for tube
Monitoring system - ECG, pulse oximetry, end tidal O2 monitor
Syringe (to inflate the cuff)
Lubricant and Xylo spray
Rescue airways (LMA, etc)
Oral airway and nasal airway
Kit available for cricothyroidotomy
Physical features difficult intubation?
Short, thick muscular neck
Fracture, receding or immobile mandible
Prominent incisor teeth
Rigid cervical spine
Mallampati III or IV
What does each class of Mallampati mean?
Structures that can be seen with mouth open, seated
: soft palate, uvula, fauces and pillars visible
: soft palate, uvula, fauces visible but not pillars
: soft palate only visible
: hard palate only
What is another score for predicting laryngoscopic view?
Hussain Khan (Upper Lip bite) class
I - lower incisors can hide mucosa of upper lip
II - lower incisors partially hide mucosa of upper lip
III - unable to touch mucosa of upper lip
Dose of succhinylcholine for induction?
1 - 1.5 mg/kg
100mg in 70kg man
What kind of drug is Succinylcholine (SCH)?
Depolarizing muscle relaxant - made up of 2 ACh molecules bound together
Onset and duration of succinylcholine?
Onset 30-45s (fastest)
Duraiton - 4-5 min
Contraindications of SCH (succinylcholine)?
burns, crush injuries
open eye injuries
Dose of Thiopental (Pentothal) for induction?
Thiopental 2.5-4 mg/kg IV = 200mg in 70kg man
What is the class of Thiopental?
Properties of sodium thiopental?
barbiturate - for induction/sedation
direct myocardial depressant
peripheral vasodilation --> lowers MAP
Speed of onset and duration of thiopental?
Duration 10 minutes
What is Rocuronium?
A non-depolarizing muscle relaxant
Dose of Rocuronium for induction?
0.6 - 0.8 mg/kg as intubating dose for short-acting (30 min duration) (2-3 min onset)
1.2mg/kg for longer acting (60 min) with quicker onset (1 min)
Typical dose in 70kg man:
50 mg intubation dose, 80mg for longer action
Properties of Etomidate?
Imidazole derivative - for induction/sedation
Acts on GABA Rc
mild decrease in MAP
s/e - adrenal suppression, pain on injection, n/v
Properties of propofol?
Substituted phenol - for induction/sedation
myocardial depression, peripheral vasodilation - drop in MAP
(moreso than STP/thiopental)
Minimal effect on HR
Propofol onset and duration?
duration 10-15 min
Contraindications to propofol?
Properties of Ketamine?
Phencyclidine derivative - induction/sedation
Sympathomimetic - increased CO, MAP and HR
1 - 2.5 mg/kg IV
Onset of Ketamine and duration?
< 1 min onset
Contraindications to ketamine?
head trauma (relative)
ischemic heart disease
0.02 mg/kg (sedation range)
0.3 mg/kg (induction range)
Contraindications to Midazolam?
Disadvantage is its unpredictability
Properties of midazolam?
Benzodiazepine - induction/sedation
anxiolysis, sedation, amnesia
No effect on MAP or CO.
Properties of opioids?
vagolytic effect - bradycardia
(except meperidine - tachy)
Contraindications of thiopental (STP)?
sulfa allergy - contains sulfa
porphyria - induces porphyrin synthesis - abdo pain, weakness, autonomic dysfxn
caution in hypovolemia or poor systolic fxn
advance age, hepatic dysfxn, obesity (prolonged effects)