Tag: pharmacokinetics

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Clinical Tips Human Physiology and Pathophysiology Opioid Free Anesthesia Pharmacology Preparing for Grad School/Residency Regional Anesthesia

#49 – Local Anesthetics with Skyler Rouhselang, BSN, SRNA

This episode was originally published in April 2019 on From the Head of the Bed… a podcast for the anesthesia community. In this podcast, Skyler provides a thorough overview of local anesthetics including relevant anatomy and physiology (i.e. nerve fibers, sodium channels, pKa, etc), types of local anesthetics and factors that effect onset, potency, duration of action and absorption. We touch on methemoglobinemia, Local Anesthetic Systemic Toxicity (LAST) and common dosing and max dosing for local anesthetics. This is a great run down for anyone wanting to brush up on local anesthetics!

At the time of this recording, Skyler Rouhselang was a second-year SRNA at Marian University in Indianapolis, IN. She attended Ball State University for her undergraduate education where she earned her BSN in 2013. Skyler went on to work in the medical ICU at a level 1 trauma center in downtown Indianapolis for 5 years before returning to school to complete her Doctor of Nursing Practice degree. Skyler has married and changed her name to Skyler Williams, DNP, CRNA. As of September 2021, Dr Williams practices anesthesia as a CRNA at IU Health Arnett Hospital in Lafayette, IN.

Resources

Butterworth, J. F., Mackey, D. C., & Wasnick, J. D. (2018). Morgan and Mikhail’s clinical anesthesiology. McGraw-Hill Education.

Miller, R. D. (2014). Miller’s anesthesia. Philadelphia, PA: Elsevier. 

Nagelhout, J. J., Elisha, S., & Plaus, K. (2017). Nurse anesthesia. Elsevier Health Sciences.

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Clinical Tips Pharmacology Preparing for Grad School/Residency

#48 – IV Induction Agents with Ashley Scheil, BSN, SRNA

This episode was originally published in April 2019 on From the Head of the Bed… a podcast for the anesthesia community. In this podcast, Ashley walks us through an overview of the most common IV anesthesia induction agents. We cover propofol, ketamine, etomidate, barbiturates (e.g. methohexital), dexmedetomidine and benzodiazepines (e.g. midazolam). A run down of the mechanism of action, dosing, onset, metabolism and physiologic effects are provided. This is an excellent introduction to these common medications and how to utilize them as part of a routine IV induction of anesthesia.

Ashley Scheil earned her BSN from Purdue University in 2012. She worked as a critical care Registered Nurse in the surgical ICU at the Roudebush VA Medical Center in Indianapolis for 6 years before going back to anesthesia school to earn her DNP at Marian University in May of 2020. Dr Scheil, DNP, CRNA practices anesthesia at IU Health Arnett Hospital as of September 2021.

Resources

Butterworth, J. F., Mackey, D. C., & Wasnick, J. D. (2018). Morgan and Mikhail’s clinical anesthesiology. McGraw-Hill Education.

Cohen, L., Athaide, V., Wickham, M. E., Doyle-Waters, M. M., Rose, N. G., & Hohl, C. M. (2015). The effect of ketamine on intracranial and cerebral perfusion pressure and health outcomes: a systematic review. Annals of emergency medicine, 65(1), 43-51.

Miller, R. D. (2014). Miller’s anesthesia. Philadelphia, PA: Elsevier. 

Morris, C., Perris, A., Klein, J., & Mahoney, P. (2009). Anaesthesia in haemodynamically compromised emergency patients: does ketamine represent the best choice of induction agent?. Anaesthesia, 64(5), 532-539.

Nagelhout, J. J., Elisha, S., & Plaus, K. (2017). Nurse anesthesia. Elsevier Health Sciences.Audio Player

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Clinical Tips Human Physiology and Pathophysiology Pharmacology Preparing for Grad School/Residency

#46 – Pharmacokinetics of Volatile Anesthetics with Skyler Rouhselang, BSN, SRNA

This episode was originally released in April 2019 on From the Head of the Bed… a podcast for the anesthesia community. In this podcast, Skyler gives a succinct run down on the pharmacokinetics of volatile anesthetics. We talk about uptake, distribution, elimination and metabolism and unpack concepts such as blood gas solubility, oil gas solubility, Fa/Fi curves and more. You don’t want to miss this excellent overview of core anesthesia concepts!

At the time of this recording, Skyler Rouhselang was a second-year SRNA at Marian University in Indianapolis, IN. She attended Ball State University for her undergraduate education where she earned her BSN in 2013. Skyler went on to work in the medical ICU at a level 1 trauma center in downtown Indianapolis for 5 years before returning to school to complete her Doctor of Nursing Practice degree. Skyler has married and changed her name to Skyler Williams, DNP, CRNA. As of September 2021, Dr Williams practices anesthesia as a CRNA at IU Health Arnett Hospital in Lafayette, IN.

References

Butterworth, J. F., Mackey, D. C., & Wasnick, J. D. (2018). Morgan and Mikhail’s clinical anesthesiology. McGraw-Hill Education.

Miller, R. D. (2014). Miller’s anesthesia. Philadelphia, PA: Elsevier. 

Nagelhout, J. J., Elisha, S., & Plaus, K. (2017). Nurse anesthesia. Elsevier Health Sciences

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Anesthesia Education Clinical Tips Pharmacology Preparing for Grad School/Residency

#19 – Anesthesia Top Drawer Run Down – Part 3

The Top Drawer Run Down is a 3-part series covering the 39 most commonly administered intravenous medications in anesthesia. These medications are often found in the top drawer of anesthesia carts in the United States. The Top Drawer Run Down was originally posted on From the Head of the Bed… a podcast for the anesthesia community in September of 2019.

Michael Mielniczek, MSN, CRNA joins me to deliver the run down on these medications. Michael has a deep interest in pharmacology and completed his anesthesia training with a Master’s in Nursing from the University of Scranton in 2018. He joined me on Episode 3 of Anesthesia Guidebook for a deep dive into succinylcholine, a medication that was the focus of his graduate degree research. He has spoken at state CRNA conferences on succinylcholine, as well as at the national AANA Annual Congress.

We cover the following medications in this series:

Part 1:

  • Propofol
  • Etomidate
  • Ketamine
  • Lidocaine
  • Fentanyl
  • Morphine
  • Hydromorphone
  • Remifentanil
  • Sufentanil
  • Alfentanil
  • Succinylcholine
  • Rocuronium
  • Vecuronium
  • Cisatracurium

Part 2:

  • Atropine
  • Glycopyrrolate
  • Neostigmine
  • Sugammadex
  • Metoprolol
  • Labetalol
  • Esmolol
  • Hydralazine
  • Phenylephrine
  • Ephedrine
  • Epinephrine
  • Calcium Chloride

Part 3:

  • Heparin
  • Naloxone
  • Albuterol
  • Dexamethasone
  • Famotidine
  • Ondansetron
  • Haloperidol
  • Furosemide
  • Metoclopramide
  • Ketorolac
  • Oxytocin
  • Methylergonovine
  • Carboprost

Here is the Anesthesia Guidebook Top Drawer Run Down Study Guide:

Anesthesia-Guidebooks-Top-Drawer-Run-Down-Study-GuideDownload

The information provided in this series is as accurate as possible but mistakes can happen. It is your responsibility to consult experienced healthcare providers, up-to-date published text books and peer reviewed literature before making decisions to implement information you hear in podcasts, blogs and social media posts, including Anesthesia Guidebook. Dig deep, do your homework and own your practice. Your practice is your responsibility.

Resources:

Assante, J., Collins, S., & Hewer, I. (2015). Infection Associated With Single-Dose Dexamethasone for Prevention of Postoperative Nausea and Vomiting: A Literature Review. AANA journal, 83(4).

Katzung, B. G. (2017). Basic and clinical pharmacology. McGraw-Hill Education.

Miller, R. D., et. al. (2014). Miller’s Anesthesia. Elsevier Health Sciences.

Nagelhout, J. J., Elisha, S., & Plaus, K. (2013). Nurse anesthesia. Elsevier Health Sciences.

Ouellette, R., & Joyce, J. (Eds.). (2010). Pharmacology for nurse anesthesiology. Jones & Bartlett Publishers.

Rezai, S., Hughes, A. C., Larsen, T. B., Fuller, P. N., & Henderson, C. E. (2017). Atypical amniotic fluid embolism managed with a novel therapeutic regimen. Case reports in obstetrics and gynecology, 2017.

Tubog, T. D., Kane, T. D., & Pugh, M. A. (2017). Effects of ondansetron on attenuating spinal anesthesia-induced hypotension and bradycardia in obstetric and nonobstetric subjects: a systematic review and meta-analysis. AANA Journal, 85(2), 113-122.

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Categories
Anesthesia Education Clinical Tips Pharmacology Preparing for Grad School/Residency

#18 – Anesthesia Top Drawer Run Down – Part 2

The Top Drawer Run Down is a 3-part series covering the 39 most commonly administered intravenous medications in anesthesia. These medications are often found in the top drawer of anesthesia carts in the United States. The Top Drawer Run Down was originally posted on From the Head of the Bed… a podcast for the anesthesia community in September of 2019.

Michael Mielniczek, MSN, CRNA joins me to deliver the run down on these medications. Michael has a deep interest in pharmacology and completed his anesthesia training with a Master’s in Nursing from the University of Scranton in 2018. He joined me on Episode 3 of Anesthesia Guidebook for a deep dive into succinylcholine, a medication that was the focus of his graduate degree research. He has spoken at state CRNA conferences on succinylcholine, as well as at the national AANA Annual Congress.

We cover the following medications in this series:

Part 1:

  • Propofol
  • Etomidate
  • Ketamine
  • Lidocaine
  • Fentanyl
  • Morphine
  • Hydromorphone
  • Remifentanil
  • Sufentanil
  • Alfentanil
  • Succinylcholine
  • Rocuronium
  • Vecuronium
  • Cisatracurium

Part 2:

  • Atropine
  • Glycopyrrolate
  • Neostigmine
  • Sugammadex
  • Metoprolol
  • Labetalol
  • Esmolol
  • Hydralazine
  • Phenylephrine
  • Ephedrine
  • Epinephrine
  • Calcium Chloride

Part 3:

  • Heparin
  • Naloxone
  • Albuterol
  • Dexamethasone
  • Famotidine
  • Ondansetron
  • Haloperidol
  • Furosemide
  • Metoclopramide
  • Ketorolac
  • Oxytocin
  • Methylergonovine
  • Carboprost

Here is the Anesthesia Guidebook Top Drawer Run Down Study Guide:

Anesthesia-Guidebook’s-Top-Drawer-Run-Down-Study-GuideDownload

The information provided in this series is as accurate as possible but mistakes can happen. It is your responsibility to consult experienced healthcare providers, up-to-date published text books and peer reviewed literature before making decisions to implement information you hear in podcasts, blogs and social media posts, including Anesthesia Guidebook. Dig deep, do your homework and own your practice. Your practice is your responsibility.

Resources:

Brull, S. J., & Kopman, A. F. (2017). Current Status of Neuromuscular Reversal and Monitoring Challenges and Opportunities. Anesthesiology: The Journal of the American Society of Anesthesiologists, 126(1), 173-190.

Katzung, B. G. (2017). Basic and clinical pharmacology. McGraw-Hill Education.

Lauria, M.  (2018)  Emergency reflex action drills.  EmCrit RACC. Retrieved from https://emcrit.org/emcrit/emergency-reflex-action-drills/

Miller, R. D., et. al. (2014). Miller’s Anesthesia. Elsevier Health Sciences.

Nagelhout, J. J., Elisha, S., & Plaus, K. (2013). Nurse anesthesia. Elsevier Health Sciences.

Ouellette, R., & Joyce, J. (Eds.). (2010). Pharmacology for nurse anesthesiology. Jones & Bartlett Publishers.

Podcast: Play in new window | Download

Categories
Anesthesia Education Clinical Tips Pharmacology Preparing for Grad School/Residency

#17 – Anesthesia Top Drawer Run Down – Part 1

The Top Drawer Run Down is a 3-part series covering the 39 most commonly administered intravenous medications in anesthesia. These medications are often found in the top drawer of anesthesia carts in the United States. The Top Drawer Run Down was originally posted on From the Head of the Bed… a podcast for the anesthesia community in September of 2019.

Michael Mielniczek, MSN, CRNA joins me to deliver the run down on these medications. Michael has a deep interest in pharmacology and completed his anesthesia training with a Master’s in Nursing from the University of Scranton in 2018. He joined me on Episode 3 of Anesthesia Guidebook for a deep dive into succinylcholine, a medication that was the focus of his graduate degree research. He has spoken at state CRNA conferences on succinylcholine, as well as at the national AANA Annual Congress.

We cover the following medications in this series:

Part 1:

  • Propofol
  • Etomidate
  • Ketamine
  • Lidocaine
  • Fentanyl
  • Morphine
  • Hydromorphone
  • Remifentanil
  • Sufentanil
  • Alfentanil
  • Succinylcholine
  • Rocuronium
  • Vecuronium
  • Cisatracurium

Part 2

  • Atropine
  • Glycopyrrolate
  • Neostigmine
  • Sugammadex
  • Metoprolol
  • Labetalol
  • Esmolol
  • Hydralazine
  • Phenylephrine
  • Ephedrine
  • Epinephrine
  • Calcium Chloride

Part 3

  • Heparin
  • Naloxone
  • Albuterol
  • Dexamethasone
  • Famotidine
  • Ondansetron
  • Haloperidol
  • Furosemide
  • Metoclopramide
  • Ketorolac
  • Oxytocin
  • Methylergonovine
  • Carboprost

Here is the Anesthesia Guidebook Top Drawer Run Down Study Guide:

Anesthesia-Guidebook’s-Top-Drawer-Run-Down-Study-GuideDownload

The information provided in this series is as accurate as possible but mistakes can happen. It is your responsibility to consult experienced healthcare providers, up-to-date published text books and peer reviewed literature before making decisions to implement information you hear in podcasts, blogs and social media posts, including Anesthesia Guidebook. Dig deep, do your homework and own your practice. Your practice is your responsibility.

Resources:

Çoruh, B., Tonelli, M. R., & Park, D. R. (2013). Fentanyl-induced chest wall rigidity. Chest, 143(4), 1145-1146.

Katzung, B. G. (2017). Basic and clinical pharmacology. McGraw-Hill Education.

Miller, R. D., et. al. (2014). Miller’s Anesthesia. Elsevier Health Sciences.

Nagelhout, J. J., Elisha, S., & Plaus, K. (2013). Nurse anesthesia. Elsevier Health Sciences.

Ouellette, R., & Joyce, J. (Eds.). (2010). Pharmacology for nurse anesthesiology. Jones & Bartlett Publishers.

Panchal, A. R., et. al. (2018).  2018 American Heart Association focused update on advanced cardiovascular life support use of antiarrhythmic drugs during and immediately after cardiac arrest.  Circulation, 138(23), e740-e749.    Retrieved from https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000613. 

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