Flashcards in Basic principles of Peds Deck (81)
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1
for a adolescent arriving for elective surgery what must be done?
Stop everything and get a pregnancy test
2
the major objectives of pre-anesthetic medication are too
(1) allay anxiety
(2) block autonomic (vagal) reflexes
(3) reduce airway secretions
(4) produce amnesia
(5) provide prophylaxis against pulmonary aspiration of gastric contents
(6) facilitate the induction of anesthesia
(7) if necessary, provide analgesia.
3
premedication may also decrease the stress response to anesthesia and prevent
cardiac arrhythmia
4
factors to consider when selecting a drug or a combination of drugs for premedication include:
the child’s age,
ideal body weight,
drug history, and allergic status;
underlying medical or surgical conditions and how they might affect the response to premedication or how the premedication might alter anesthetic induction;
parent and child expectations;
the child’s emotional maturity, personality, anxiety level, cooperation, and physiologic and psychological status
5
diazepam oral
0.1-0.5mg
6
diazepam Rectal
1mg
7
midazolam oral
0.25-0.75mg
8
midazolam nasal
0.2mg
9
midazolam rectal
0.5-1mg
10
midazolam IM
0.1-0.15
11
lorazepam oral
0.025-0.05mg
12
Ketamine oral
3-6mg/kg
13
ketamine nasal
3mg/kg
14
ketamine rectal
6-10mg/kg
15
ketamine intramuscular
2-10mg/kg
16
benzodiazepines how do we prevent neurotoxicity
use preservative free for nasal administration
17
Anticholinergic agents were used
1) to prevent the undesirable bradycardia associated with some anesthetic agents (halothane and succinylcholine)
(2) to minimize the autonomic vagal reflexes manifested during surgical manipulations (e.g., laryngoscopy, strabismus repair)
(3) to reduce secretions.
18
most commonly used anticholinergics
atropine
scopolamine
glycopyrrolate
19
undesirable effects of anticholinergics
tachycardia
dry mouth
skin erythema
hyperthermia
result of inhibited sweating
20
which two anticholinergics cross the BBB
atropine and scopolamine
21
the recommended doses of anticholinergics are
atropine, 0.01 to 0.02 mg/kg
scopolamine, 0.005 to 0.010 mg/kg
22
which anticholinergic does not cross the BBB
glycopyrollate
23
which anticholinergic used to block the vagus nerve
atropine
24
which is better for sedative
scopolamine
25
infants who are at risk for or show early evidence of slowing of the heart rate should receive
atropine before the heart rate actually decreases to ensure a prompt onset of effect to maintain cardiac output.
26
which drug is twice as potent as atropine in decreasing oral secretions and the duration is three times greater
glycopyrrolate.
27
the recommended dose of glycopyyrolate
0.01mg/kg half that of atropine
or 10mcg/kg
28
the routine use of an anticholinergic for the sole purpose of drying secretions is probably unwarranted why
dry mouth can be a source of extreme discomfort for a child
29
When is glycopyolate best used for
sialorrhea associated with ketamine.
30
