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5 Cards in this Set
- Front
- Back
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What are the 4 PSA regimens: (4) |
1. Sedative + Analgesic 2. Pure Sedation 3. Dissociative analgesia + sedation 4. Inhalation anestesia |
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Benzodiazepine: Midazolam * ONLY Versed (Midazolam for PSA) 1. MOA: |
1. Adult IV: 0.025mg/kg Max: 0.1mg/kg Peds IV: 0.05mg/kg Max: 0.15mg/kg 2. Bind GABA-A receptors, which potentiates the effects of GABA by increasing the frequency of chloride channel opening. 2. Protein binding: 97% bound to plasma protein, mainly albumin 3. Metabolism: primarily metabolized in the liver and gut by CYP3A4 to its pharmacologic active metabolite, alpha-hydroxymidazolam (also known as 1-hydroxy-midazolam). also undergoes N-glucuronidation via UGT1A4 after the process of hepatic oxidation by cytochrome enzymes. 4. Elimination: The α-hydroxymidazolam glucuronide conjugate of midazolam is excreted in urine. 5. Half life: - IV: healthy adults = 1.8 to 6.4 hours (mean of 3 hours). - IM: 4.2 (±1.87) hours. 6. Toxicity: LD50=215 mg/kg, in rats. |
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Opiates: Morphine |
1. Dose: 2. MOA: |
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Fentanyl: 1. Dose- Adult/peds 2. Onset 3. Duration 4. Adverse effects 5. Contraindications 6. MOA |
1. IV 1-2mcg/kg Peds: IV 1mcg/kg Nasal .7-1.5 mcg/kg Nebulizer 1-3mcg/kg 2. Onset: 2-3 min 3. Duration: 20-30 min 4. Adverse effects: Resp depression, bradycardia, EMRA is, CHEST WALL RIGIDITY 5. Contraindicaciones: allergic, <6months, current illicit drug use, coma 6. MOA: binds to opioid receptors- mu opioid receptor, which are coupled to G-proteins. Activation of opioid receptors causes GTP to be exchanged for GDP which in turn down regulates adenylate cyclase, reducing concentrations of cAMP. Reduced cAMP decreases cAMP dependant influx of calcium ions into the cell. The exchange of GTP for GDP results in hyperpolarization of the cell and inhibition of nerve activity. |
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Chest wall rigidity treatment? 1. 2. 3. |
1. BVM- assist w/ ventilation 2. Naloxone: 0.2 mg -> 0.4mg (Resp arrest give 1-2mg) Max: 10mg 3. Paralyze and intubate |
