2. Intravenous anesthetics. Neurolept analgesia. Perioperative medication .3. Benzodiazepines Flashcards
Intravenous anesthetics
Propofol Etomidate Ketamine Barbiturates Benzodiazepines Opioids α2 adrenergic agonists
Propofol
sedative / hypnotic (no analgesia) for: induction and maintenance acts on GABAA receptors fast onset liver metabolism short half life antiemetic AE: Vasodilation, can have excitatory phenomena, pain at site of injection
Etomidate
hypnotic (no analgesia)
induction due to rapid onset and short duration
Cardiovascular stability
AE: myoclonic movements
Ketamine
NMDA antagonist (PCP site) Anesthetic and analgesic! “dissociative anesthesia” increases sympathetic activity good for hypovolemic / cardiogenic shock patients clinical indication: strok, hypertension No muscle relaxation effect AE: risk of convulsions
Barbiturates for intravenous anesthesia
Thiopental
Methohexital
Benzodiazepines for intravenous anesthesia
Midazolam
Lorazepam
Diazepam
Opioids for intravenous anesthesia
Analgesic | choice based on duration
IV / Intrathecal injection
AE: hypotension, respiratory depression, muscle rigidity opioid “hangover” - nausea and vomiting
suffix - entanil
druges ... Fentanyl Alfentanil Remifentanil Sufentanil
α2 adrenergic agonists for intravenous anesthesia
Clonidine
Dexmedetomidin
dissociative anesthesia
characterized by catalepsy, catatonia, analgesia, and amnesia
not always involve loss of consciousness so it is not a state of general anesthesia
Fentanyl
longest duration than other opiod
Naloxone
antagonize opioids effect
Dexmedetomidin
α2 adrenergic agonists
Sedative (without respiratory depression), analgesic, sympatholytic, anxiolytic effects
Benzodiazepines
lipophilic
act on GABA.A
druges .. Midazolam Triazolam Lorazepam Oxazepam Alprazolam Nitrazepam Chlordiazepoxide Diazepam Flurazepam Clonazepam Temazepam
very short acting Benzodiazepines
Midazolam
Triazolam
short acting Benzodiazepines
Lorazepam
Oxazepam
medium acting Benzodiazepines
Alprazolam
Nitrazepam
long acting Benzodiazepines
Chlordiazepoxide
Diazepam
Flurazepam
Midazolam
Hypnotic, induction of general anesthesia (retrograde amnesia)
Triazolam
Hypnotic
for difficulties falling asleep
Lorazepam
Anxiolytic, Hypnotic, Antiepileptic , induction of general anesthesia (retrograde amnesia)
Oxazepam
Anxiolytic
dont have active metabolite
Alprazolam
Anxiolytic, used in Panic attack and mental depression as well
Nitrazepam
Hypnotics
Chlordiazepoxide
Anxiolytic
Diazepam
Centrally muscle relaxant, Antiepileptic, premedication before general anesthesia
Flurazepam
Hypnotic
Clonazepam
prolonged treatment of anxiety disorders, panic, Antiepileptic (adjunctive therapy)
First line drug in absence seizure and Lennox-Gastaut syndrome
disadvantageous Sedation and tolerance
Temazepam
intermediate acting
for patients experiencing frequent wakening
Flumazenil
not benzodiazepine used as an antidot for BZN
GABA receptor antagonist
IV only
Anxiolytic Benzodiazepines
Chlordiazepoxide
Oxazepam
Clonazepam
Alprazolam
hypnotic Benzodiazepines
Nitrazepam Flurazepam Midazolam Triazolam Lorazepam
Benzodiazepines for panic attaks & mental depression
Alprazolam
Clonazepam
Benzodiazepines for centrally acting skelatal muscel relaxants
Diazepam
antiepileptic Benzodiazepines
Diazepam
Lorazepam
Clonazepam
premedication before general anesthesia
Diazepam
induction of general anesthesia
Midazolam
lorazepam
metabolizem of bezodiazepinse
3 types
diazepam type - active metabolite withe long half life
triazolam type - active metabolite with short half life
oxazepam type no active metabolite
