Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
38 Cards in this Set
- Front
- Back
|
Thiopental (Pentothal)
|
ultra-short acting barbiturate (induction 10-15 sec.)
highly lipid soluble |
|
|
distribution of thiopental
|
initially distributes into brain well (high blood flow), then redistributes into fatty tissues (accounts for it's rapid but short effects)
|
|
|
use of thiopental
|
used mainly for induction, or very short procedures
|
|
|
thiopental metabolized by what?
|
by P-450 system in the liver
|
|
|
half-life of thiopental
|
6 hrs
|
|
|
repeated administration of thiopental will cause?
|
will fill the body's storage sites (fats) and can lead to long duration of action
|
|
|
thiopental : pain threshold
|
thiopental lowers pain threshold, thus increasing sensitivity to pain
|
|
|
Does thiopental have good skeletal muscle relaxtant effects?
|
NO! very poor skeletal muscle relaxant effects
|
|
|
effects of thiopental
|
1) potent resp. depressant - lead to a period of apnea during induction
2) depresses myocardium 3) relaxes vascular smooth muscle - cause hypotension |
|
|
Methohexital (Brevital)
|
similar to thiopental, but 3 times as potent
|
|
|
metabolism of Methohexital
|
metabolized faster (due to less lipid solubility) mainly via P-450 oxidation
|
|
|
Methohexital
|
1) loss of effect still mainly due to redistribution
2) recovery is faster than thiopental with multiple doses |
|
|
Propofol (Diprivan) acts by?
|
acts by interaction with GABA receptor, decreasing the rate of GABA dissociation from the receptor
|
|
|
other actions of propofol
|
1) antiemetic
2) antipruritic 3) anticonvulsant |
|
|
distribution of propofol
|
1) rapidly distributes to brain
2) induction in 15-30 sec. - give slowly due to vessel irritation |
|
|
termination of anesthesia of propofol is due to?
|
redistribution to fatty tissues
|
|
|
duration of propofol
|
5-10 min.
|
|
|
metabolization of propofol
|
highly metabolized in liver
half life 2-3 hrs (does not accumulate as much as Thiopental) |
|
|
propofol
|
1) does not increase pain sensitivity
2) decrease BP due to < CO and < vascular resistance 3) does not trigger malignant hyperthermic crisis |
|
|
Etomidate (Amidate)
|
1) structure unlike any other anesthetics
2) large Vd (tissue distribution) |
|
|
mechanism of etomidate
|
via GABA interaction like barbs and benzos
|
|
|
etomidate mixed with?
|
propylene glycol for injection
|
|
|
etomidate is metabolized via?
|
via hydroxylation by plasma esterases and HMES
|
|
|
induction of etomidate
|
induction as rapid as Thiopental, with emergence in 5-10 min.
|
|
|
effects of etomidate
|
1) minimal CV effects
2) resp. depression 3) depresses steroid synthesis in adrenals (not used long term) |
|
|
Dexmedetomidine (Precedex)
|
1) a novel agent for the control of stress, anxiety, and pain
2) alpha-2 agonist |
|
|
Dexmedetomidine used with?
|
used in combination with agents such as propofol, opioids, and benzo.
|
|
|
when used Dexmedetomidine alone, it produces what?
|
sedation with the ability to rouse the pt
|
|
|
Dexmedetomidine
Vd, t1/2, Cl? |
1) Vd = ~118 L
2) t1/2 = ~2hrs 3) Cl = ~39L/hr administer via continuous IV infusion |
|
|
metabolism of Dexmedetomidine via
|
1) glucuronidation
2) P450 hydroxylation (dosage adjustment in hepatic dz) |
|
|
Midazolam (Versed)
|
1) a benzodiazepine with strong hypnotic properties
2) good amnesic 3) minimal CV effects |
|
|
duration of effects of Midazolam
|
15 min.
|
|
|
use of Midazolam
|
1) usally used as an adjunct, but it can be used for induction (60 sec.) and maintenance
2) usually used with opioid for longer duration |
|
|
Ketamine (Ketaject)
|
1) similar to PCP
2) IV or IM 3) rapid induction with IV dudration of ~15 min. |
|
|
Ketamine stimulates?
|
the CV system: increase HR, CO, and BP
2) good analgesic and amnesic |
|
|
Ketamine blocks?
|
glutamate excitatory NMDA receptors in CNS
|
|
|
Ketamine triggers?
|
catalepsy (dissociation anesthesia), which is the appearance of being awake, even though they do not respond
|
|
|
recovery from Ketamine
|
recovery phase characterized by CNS stimulation, so keep pt. in quiet area
|
