NU340 Dose Calculations Quiz & Critical Care
Infusions Quiz Review
1/ (x) kg
if looking for mg/kg/hr (or something similar), write equation as _____
(x) kg / 1
if looking for mL/hr (or something similar), write equation as _____
mcg / (kg x min)
if mcg/kg/min (or something similar), then write equation as mcg _____
Morphine Sulfate
which medication?
- opioid agonist, schedule II, high alert
- Onset: route-dependent (SC = 20 min; IM = 10-30 min; IV = rapid)
- Function/Mechanism of Action: analgesia (binds to opioid receptors in CNS; alters
perception & response to painful stimuli while producing generalized CNS depression)
- Administration: PO, SC, IM, IV, rectal // dilute IVP with 5 mL NS // administer over 5
min
- Adverse Effects: respiratory depression, prolonged sedation, confusion, hypotension,
n/v, constipation
- Other Considerations/Monitoring: Naloxone (Narcan) = reversal agent; use cautiously
with head trauma; monitor pain, LOC, RR, HR, BP
Fentanyl (Sublimaze)
which medication?
- opioid agonist, schedule II, high alert
- Onset: route-dependent (IM = 15 min; IV = 1-2 min)
- Function/Mechanism of Action: analgesia, supplemententation of anesthesia/sedation
(binds to opioid receptors in CNS; alters perception & response to painful stimuli while
producing generalized CNS depression)
- Administration: IM, IV, transdermal // administer over 1-3 min
- Adverse Effects: respiratory depression, apnea, laryngospasm, sedation, confusion,
hypotension, bradycardia, constipation, muscle rigidity
- Other Considerations/Monitoring: Naloxone (Narcan) = reversal agent; avoid if had
MAOIs in last 14 days; monitor pain, LOC, RR, HR, BP
Oxycodone
which medication?
- opioid agonist, schedule II, high alert
- Onset: route-dependent (PO = 10-15 min)
- Function/Mechanism of Action: analgesia (binds to opioid receptors in CNS; alters
perception & response to painful stimuli while producing generalized CNS depression)
- Administration: PO, rectal
- Adverse Effects: respiratory depression, sedation, confusion, constipation
- Other Considerations/Monitoring: Naloxone (Narcan) = reversal agent; monitor pain,
LOC, RR, HR, BP
Hydromorphone (Dilaudid)
,which medication?
- opioid agonist, schedule II, high alert
- Onset: route-dependent (PO = 30 min; IM = 15 min; IV = 10-15 min)
- Function/Mechanism of Action: analgesia (binds to opioid receptors in CNS; alters
perception & response to painful stimuli while producing generalized CNS depression),
antitussive (suppresses cough reflex via direct central action)
- Administration: PO, IM, IV
- Adverse Effects: respiratory depression, sedation, confusion, constipation,
hypotension
- Other Considerations/Monitoring: Naloxone (Narcan) = reversal agent; avoid if had
MAOIs in last 14 days; monitor pain, LOC, RR, HR, BP
Propofol (Diprivan)
which medication?
- NMDA receptor agonist, sedative
- Onset: rapid (~40-60 secs) // very short half life
- Function/Mechanism of Action: intubation, procedural sedation, continuous sedation,
antiemetic effects // no analgesic properties (not effective in helping manage pain)
- Administration: IV // titrated to patient response
- Adverse Effects: allergic reactions (soybean & egg products), respiratory depression,
apnea, hypotension; pain, burning, stinging of site
- Other Considerations/Monitoring: propofol infusion syndrome (collection of metabolic
abnormalities & organ system failures; tends to happen in patients on high doses for >
48 hrs & on vasopressors; sends patient into sudden cardiac failure (cardiogenic shock,
metabolic acidosis, hepatic failure, renal failure, rhabdomyolysis); supportive therapy is
tx); change IV tubing q 12 hrs (contains lots of lipids & calories, which increase risk of
infection); monitor RR, HR, BP, triglyceride levels; maintain patient airway & adequate
ventilation; patient must be intubated if infusion is running (causes respiratory
depression)
Dexmedetomidine (Precedex)
which medication?
- sedative, hypnotic, anxiolytic, anesthesia
- Onset: rapid
- Function/Mechanism of Action: selective alpha adrenergic agonist with sedative
properties; sedates initially-intubated & mechanically ventilated
- Administration: IV
- Adverse Effects: hypotension, bradycardia, sinus arrest, AV blocks, ventricular
dysfunction // doesn't cause respiratory depression (patients don't need to be on
ventilator)
- Other Considerations/Monitoring: contraindicated with chemotherapy; monitor HR, BP,
ECG
Midazolam (Versed)
which medication?
- antianxiety, anticonvulsant, sedative/hypnotic, high alert
- Onset: route-dependent (IN = 5 min, IM = 15 min, IV = 1.5-5 min)
- Function/Mechanism of Action: produces generalized CNS depression (such as short-
term sedation, postoperative amnesia, termination of seizure activity); effects can be
, mediated by GABA (inhibitory neurotransmitter)
- Administration: PO, IN, IM, IV // titrate carefully
- Adverse Effects: respiratory depression, apnea, laryngospasm, cardiac arrest, suicidal
thoughts, phelbitis
- Other Considerations/Monitoring: monitor RR, HR, BP
Lorazepam (Ativan)
which medication?
- antianxiety, sedative/hypnotic, anesthesia adjunct
- Onset: route-dependent (PO = 15-60 min; IM = 30-60 min; IV = 15-30 min)
- Function/Mechanism of Action: depresses CNS; treats n/v, seizure disorders
- Administration: PO, IM, IV, IVP (dilute in at least same volume; don't exceed 2 mg/min)
- Adverse Effects: respiratory depression, apnea, cardiac arrest (rapid IV infusion),
dizziness, drowsiness, lethargy
- Other Considerations/Monitoring: cautions driving/operating machinery; cautions in
elderly (fall risk; delirium risk); Flumazenil (Romazicon) = reversal agent; monitor
anxiety, RR, HR, BP
Furosemide (Lasix)
which medication?
- loop diuretic
- Onset: route-dependent (PO = 30-60 min; IV = 5 min)
- Function/Mechanism of Action: inhibits reabsorption of sodium & chloride; increases
renal excretion of water & electrolytes; treats fluid overload, heart failure
- Administration: PO, IV // administer 20 mg/min
- Adverse Effects: hypokalemia, hyponatremia, hypomagnesemia, hypochloremia,
hypovolemia, hypotension, dehydration, metabolic acidosis, ototoxicity
- Other Considerations/Monitoring: risk of ototoxicity if administered too fast; monitor K+
level, HR, BP, fluid status, & continence status
Insulin Lispro (Humalog), Insulin Aspart (Novolog), Insulin Glulisine (Apidra)
which medications? (3)
- rapid-acting insulins, high alert
- Onset: 15-30 min // Peak: 1 hr // Duration: 3-5 hrs
- Function/Mechanism of Action: rapid-acting; lowers blood glucose
- Administration: SC, IV (Humalog only) // administer 15 min before eating
- Adverse Effects: hypoglycemia (blood glucose < 70 mg/dL; anxiety, confusion,
headache, hunger, pallor, shaking, sweating, tachycardia, weakness), hypokalemia
- Other Considerations/Monitoring: rotate injection sites; monitor blood glucose levels
Regular Insulin
which medication?
- Onset: 30 min - 1 hr // Peak: 3 hrs // Duration: 5-7 hrs
- Function/Mechanism of Action: short-acting; lowers blood glucose (by promoting entry
of glucose into cells)
- Administration: SC, IV // administer 30 min before eating
- Adverse Effects: hypoglycemia (blood glucose < 70 mg/dL; anxiety, confusion,
headache, hunger, pallor, shaking, sweating, tachycardia, weakness)
- Other Considerations/Monitoring: rotate injection sites; monitor blood glucose levels
NPH (Isophane)
Infusions Quiz Review
1/ (x) kg
if looking for mg/kg/hr (or something similar), write equation as _____
(x) kg / 1
if looking for mL/hr (or something similar), write equation as _____
mcg / (kg x min)
if mcg/kg/min (or something similar), then write equation as mcg _____
Morphine Sulfate
which medication?
- opioid agonist, schedule II, high alert
- Onset: route-dependent (SC = 20 min; IM = 10-30 min; IV = rapid)
- Function/Mechanism of Action: analgesia (binds to opioid receptors in CNS; alters
perception & response to painful stimuli while producing generalized CNS depression)
- Administration: PO, SC, IM, IV, rectal // dilute IVP with 5 mL NS // administer over 5
min
- Adverse Effects: respiratory depression, prolonged sedation, confusion, hypotension,
n/v, constipation
- Other Considerations/Monitoring: Naloxone (Narcan) = reversal agent; use cautiously
with head trauma; monitor pain, LOC, RR, HR, BP
Fentanyl (Sublimaze)
which medication?
- opioid agonist, schedule II, high alert
- Onset: route-dependent (IM = 15 min; IV = 1-2 min)
- Function/Mechanism of Action: analgesia, supplemententation of anesthesia/sedation
(binds to opioid receptors in CNS; alters perception & response to painful stimuli while
producing generalized CNS depression)
- Administration: IM, IV, transdermal // administer over 1-3 min
- Adverse Effects: respiratory depression, apnea, laryngospasm, sedation, confusion,
hypotension, bradycardia, constipation, muscle rigidity
- Other Considerations/Monitoring: Naloxone (Narcan) = reversal agent; avoid if had
MAOIs in last 14 days; monitor pain, LOC, RR, HR, BP
Oxycodone
which medication?
- opioid agonist, schedule II, high alert
- Onset: route-dependent (PO = 10-15 min)
- Function/Mechanism of Action: analgesia (binds to opioid receptors in CNS; alters
perception & response to painful stimuli while producing generalized CNS depression)
- Administration: PO, rectal
- Adverse Effects: respiratory depression, sedation, confusion, constipation
- Other Considerations/Monitoring: Naloxone (Narcan) = reversal agent; monitor pain,
LOC, RR, HR, BP
Hydromorphone (Dilaudid)
,which medication?
- opioid agonist, schedule II, high alert
- Onset: route-dependent (PO = 30 min; IM = 15 min; IV = 10-15 min)
- Function/Mechanism of Action: analgesia (binds to opioid receptors in CNS; alters
perception & response to painful stimuli while producing generalized CNS depression),
antitussive (suppresses cough reflex via direct central action)
- Administration: PO, IM, IV
- Adverse Effects: respiratory depression, sedation, confusion, constipation,
hypotension
- Other Considerations/Monitoring: Naloxone (Narcan) = reversal agent; avoid if had
MAOIs in last 14 days; monitor pain, LOC, RR, HR, BP
Propofol (Diprivan)
which medication?
- NMDA receptor agonist, sedative
- Onset: rapid (~40-60 secs) // very short half life
- Function/Mechanism of Action: intubation, procedural sedation, continuous sedation,
antiemetic effects // no analgesic properties (not effective in helping manage pain)
- Administration: IV // titrated to patient response
- Adverse Effects: allergic reactions (soybean & egg products), respiratory depression,
apnea, hypotension; pain, burning, stinging of site
- Other Considerations/Monitoring: propofol infusion syndrome (collection of metabolic
abnormalities & organ system failures; tends to happen in patients on high doses for >
48 hrs & on vasopressors; sends patient into sudden cardiac failure (cardiogenic shock,
metabolic acidosis, hepatic failure, renal failure, rhabdomyolysis); supportive therapy is
tx); change IV tubing q 12 hrs (contains lots of lipids & calories, which increase risk of
infection); monitor RR, HR, BP, triglyceride levels; maintain patient airway & adequate
ventilation; patient must be intubated if infusion is running (causes respiratory
depression)
Dexmedetomidine (Precedex)
which medication?
- sedative, hypnotic, anxiolytic, anesthesia
- Onset: rapid
- Function/Mechanism of Action: selective alpha adrenergic agonist with sedative
properties; sedates initially-intubated & mechanically ventilated
- Administration: IV
- Adverse Effects: hypotension, bradycardia, sinus arrest, AV blocks, ventricular
dysfunction // doesn't cause respiratory depression (patients don't need to be on
ventilator)
- Other Considerations/Monitoring: contraindicated with chemotherapy; monitor HR, BP,
ECG
Midazolam (Versed)
which medication?
- antianxiety, anticonvulsant, sedative/hypnotic, high alert
- Onset: route-dependent (IN = 5 min, IM = 15 min, IV = 1.5-5 min)
- Function/Mechanism of Action: produces generalized CNS depression (such as short-
term sedation, postoperative amnesia, termination of seizure activity); effects can be
, mediated by GABA (inhibitory neurotransmitter)
- Administration: PO, IN, IM, IV // titrate carefully
- Adverse Effects: respiratory depression, apnea, laryngospasm, cardiac arrest, suicidal
thoughts, phelbitis
- Other Considerations/Monitoring: monitor RR, HR, BP
Lorazepam (Ativan)
which medication?
- antianxiety, sedative/hypnotic, anesthesia adjunct
- Onset: route-dependent (PO = 15-60 min; IM = 30-60 min; IV = 15-30 min)
- Function/Mechanism of Action: depresses CNS; treats n/v, seizure disorders
- Administration: PO, IM, IV, IVP (dilute in at least same volume; don't exceed 2 mg/min)
- Adverse Effects: respiratory depression, apnea, cardiac arrest (rapid IV infusion),
dizziness, drowsiness, lethargy
- Other Considerations/Monitoring: cautions driving/operating machinery; cautions in
elderly (fall risk; delirium risk); Flumazenil (Romazicon) = reversal agent; monitor
anxiety, RR, HR, BP
Furosemide (Lasix)
which medication?
- loop diuretic
- Onset: route-dependent (PO = 30-60 min; IV = 5 min)
- Function/Mechanism of Action: inhibits reabsorption of sodium & chloride; increases
renal excretion of water & electrolytes; treats fluid overload, heart failure
- Administration: PO, IV // administer 20 mg/min
- Adverse Effects: hypokalemia, hyponatremia, hypomagnesemia, hypochloremia,
hypovolemia, hypotension, dehydration, metabolic acidosis, ototoxicity
- Other Considerations/Monitoring: risk of ototoxicity if administered too fast; monitor K+
level, HR, BP, fluid status, & continence status
Insulin Lispro (Humalog), Insulin Aspart (Novolog), Insulin Glulisine (Apidra)
which medications? (3)
- rapid-acting insulins, high alert
- Onset: 15-30 min // Peak: 1 hr // Duration: 3-5 hrs
- Function/Mechanism of Action: rapid-acting; lowers blood glucose
- Administration: SC, IV (Humalog only) // administer 15 min before eating
- Adverse Effects: hypoglycemia (blood glucose < 70 mg/dL; anxiety, confusion,
headache, hunger, pallor, shaking, sweating, tachycardia, weakness), hypokalemia
- Other Considerations/Monitoring: rotate injection sites; monitor blood glucose levels
Regular Insulin
which medication?
- Onset: 30 min - 1 hr // Peak: 3 hrs // Duration: 5-7 hrs
- Function/Mechanism of Action: short-acting; lowers blood glucose (by promoting entry
of glucose into cells)
- Administration: SC, IV // administer 30 min before eating
- Adverse Effects: hypoglycemia (blood glucose < 70 mg/dL; anxiety, confusion,
headache, hunger, pallor, shaking, sweating, tachycardia, weakness)
- Other Considerations/Monitoring: rotate injection sites; monitor blood glucose levels
NPH (Isophane)
