Miscellaneous
The situation when you would use atropine.
Symptomatic bradycardia
The first line vasopressor for septic shock.
Levophed.
Dobutamine: primarily chronotrope or inotrope?
inotrope
Which drug has the longest half life? Fentany or hydromorphone?
Hydromorphone
The percentage to decrease insulin gtt when pt is NPO
50%
The reason a ketamine gtt is used (other than for sedation).
Bronchospasms
The amount of fluid you give a patient in septic shock.
30 mL/kg
The vasopressor that can be infused through a PIV.
Phenylephrine
The number a patient's QTc should not be above to receive Haldol.
500
The appropriate PPE for chemotherapy administration.
Yellow gown, double gloves, and mask with shield.
The two conditions that warrant caution in using beta blockers.
Acute asthma and cocaine usage
You have zosyn and vancomycin ordered at the same time for your patient in septic shock. Which one do you administer first?
Zosyn
DAILY DOUBLE!
Your patient is hypotensive and has tachycardia > 130. Which agent would you select and why?
Phenylephrine because it's primary effect is vasoconstriction. It has no effect on beta receptors and therefore heart rate.
Side effects of opioids. Name at least 3.
- respiratory depression
- over-sedation
- pruritus
- decreased GI motility
- addiction (very rare)
Drugs (that are not antipsychotics) that can prolong QTc. Name at least 3.
- Zofran
- Phenergan
- Azithro
- Amio
- Benadryl
- Methadone
Side effects of albuterol. Name at least 3.
Increased heart rate.
Pupil dilation.
Dried mucous membranes.
Decreased lacrimation.
Urinary retention.
Constipation.
Adverse effects of Levophed. Name at least 3.
- Compromised organ perfusion and damage
- tissue necrosis
- metabolic acidosis
- worsening ventricular failure due to afterload
- tachycardia
- shunting of oxygen leading to hypoxemia
IV gtts used for hypertensive emergency. Name at least 3.
- Nitroprusside (Nitropress)
- Labetalol
- Nicardipine (Cardene)
- Clevidipine
Antipsychotics cause this life-threatening emergency.
Neuroleptic Malignant Syndrome
The rate at which IV potassium should run through a PIV.
10 mEq/hr (or 100 mL/hr)
Per the UMMC guideline, how do you wean fentanyl gtt?
50 mcg/hr every 2 hours to maintain pain level < 4
Adverse effect of vasopressin. Name at least 3.
- MI
- Decrease in cardiac index
- Decrease in mesenteric mucosal perfusion (GI ischemia)
- ischemic skin changes
- hyponatremia
The maximum percentage to lower blood pressure by in a hypertensive emergency.
25%
Symptoms of propofol infusion syndrome. Name at least 3.
- metabolic acidosis
- hepatomegaly
- liver toxicity
- cardiomyopathy with acute cardiac failure
Onset of action of insulin aspart.
5-15 minutes.