Iv Anesthetics

Front 1

Barbiturate - long acting

Back 1

phenobarbital, pentobarbital, secobarbital

Front 2

Barbiturate - short acting

Back 2

thiopental

Front 3

Barbiturate - ultra short acting

Back 3

Methohexital

Front 4

Barbiturate mechanism of action

Back 4

depress reticular activating system, facilitate GABA transmitters, decrease sympathetic nerve transmission

Front 5

Barbiturate: CV effects

Back 5

decrease BP, reflex increase in HR, peripheral vasodilation (contraindicated in hypovolemic patients)

Front 6

Barbiturate: Respiratory effects

Back 6

depress medullary ventilatory centers = apnea

laryngeal and cough reflexes are minimally depressed

Front 7

Barbiturate: CNS effects

Back 7

cerebral vasoconstriction, decrease cerebral BF, blood volume, and ICP

decr. EEG activity = antiseizure effect (except methohexital)

Front 8

Barbiturate: Clinical Uses

Back 8

Induce anesthesia, "brain protection", rectal administration for uncooperative patients

Front 9

Benzodiazepines: Drugs

Back 9

Midazolam (Versed), Lorazepam (Ativan), Diazepam (Valium)

Front 10

Benzodiazepines: Effects

Back 10

sedation, anterograde amnesia, anticonvulsant

CV and respiratory: minimal depression

Front 11

Benzodiazepine antagonist

Back 11

Flumazenil

Front 12

Benzodiazepine mechanism of action

Back 12

enhance chloride gating function of GABA

greatest density of post-synaptic receptors in the cerebral cortex

Front 13

Benzodiazepine: pharmacokinetics

Back 13

diazepam has active metabolites (prolonged effects), midazolam has no active metabolites

Front 14

Benzodiazepine: Clinical Uses

Back 14

Preop medication, IV sedation, Induce anesthesia, anticonvulsant

Front 15

Propofol facts

Back 15

allergic potential due to soybean oil, glycerol, egg lecithin

pain on injection (treat with lidocaine)

bacterial growth possible

Front 16

Propofol: CV effects

Back 16

antiemetic

CV: decrease BP with minimal HR increase, peripheral vasodilation (contraindicated for hypovolemic patients)

Front 17

Propofol: Respiratory effects

Back 17

depress medullary ventilatory centers producing apnea

minimally depressed laryngeal reflexes

Front 18

Propofol: Clinical Uses

Back 18

induce anesthesia, maintain anesthesia, IV sedation

Front 19

Etomidate facts

Back 19

carboxilated imidazole with pharmacologically inactive metabolites

Front 20

Etomidate effects

Back 20

CV stability, produce apnea with minimal effects on laryngeal reflexes

CNS: decrease cerebral BF, CMRO2, and ICP; can activate seizure foci

Front 21

Etomidate clinical uses

Back 21

Induce anesthesia, especially patients with limited cardiac reserve

Front 22

Etomidate disadvantages

Back 22

pain on injection, involuntary skeletal muscle movements, increased incidence of post-op N/V, adrenocortical suppression

Front 23

Ketamine facts

Back 23

phencyclidine derivative

produce dissociative anesthesia b/n thalamus and limbic system

Front 24

Ketamine effects

Back 24

direct stimulation of sympathetic nervous system

HR, BP, and CO maintained even in hypovolemic patients

Front 25

Ketamine clinical uses

Back 25

Induce anesthesia (IV or IM), dissociative anesthesia for burn patients

patients w/ multiple trauma and/or severe hemorrhage

analgesia greater for somatic pain than visceral pain

Front 26

Ketamine disadvantages

Back 26

emergence delirium 30%

vivid hallucinations (lessen with benzos)

develop tolerance

increased airway secretions

myoclonic activity