200 analgesia/anesthetics Flashcards
Opioids
MOA,s/s
MOA
opioid narcotics cause relief of pain by binding to Mu and Ka(kappa) receptors in the brain producing analgesic effects altering response to pain alterations toe resp drive suppression may last longer than analgesic effects and therefore may produce apnea principle effect are for analgesia and sedation
CONTRA
- MAOIs within 14 days
- severe hemorrhage
- head injury
- hypotension
- UDabdo pain(relative)
s/s
- resp depression
- Aloc
- bradycardia
- may potentiate with other CNS depressants
- euphoria
- n/v
- hypotension
- pupil constriction(miosis)
- decrease gi motility (constipation)
fentanyl citrate
narcotic analgesic
Name
fent-any-l citrate
SUB-LI-MAZE (subway lies about mazes)
Pain analgesic
05-1mcg/kg SIVP/IO
RSI
2-5mcg/kg (1-3mcg/kg if hypotensive)
notes
less emetic effect than morphine
50-100 times more potent but shorter-acting
Narcan(nolaxone) is a reversal agent
use cautiously with bradycardia
caution with hepatic or renal failure
morphine sulfate
opioid analgesic
Name
mor-phine sulfate
MS CONTIN or STATEX
DOSE
pain analgesic 2-4 mg SIVP/IO q 5-30min
STEMI 2-10mg followed by 2mg increments until the desired effect
notes
- contra** allergy to codeine
- UDabdo pain(relative)
- caution with RVI
- **hypotension risk higher
- Ind** cardiac chest pain refractory to nitrate
meperidine hydrochloride
opioid analgesic
name
me-peri-dine hydrochloride (me and parry dine)
DEM-ER-OL
dose
pain analgesic 25-50mg SIVP q 3-4 hours PRN
50-100 Im
notes
- has a greater affinity for kappa receptors over Mu than morphine
- same tendency for abuse
- phenytoin (Dilantin) decreases its analgesic effects
- Narcan antidote
nalbuphine
synthetic analgesic
name
nul-bu-phine (No bu fin not dolphin)
NUBAIN (the new bane)
dose
5mg SIVP
notes
faster acting and longer lasting than morphine
has Narcan like antagonistic properties that reduce the risk of abuse (risk for withdrawals)
small dose can cause resp deptession
codiene
opioid analgesic
name
codi-ene
dose 15-60mg po/Im
anesthetics
Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical purposes
drugs
ketamine (Ketalar)
nitrous oxide(Entenox)
propofol(Diprivan)
tetracaine(Pontocaine)
ketamine
KETALAR
Name
ket-a-mine
KET-AL-AR (pirate kat says L not R)
anesthetic agent, analgesic agent
dose
- sedation/pain
- 0.5-1.0mg/kg SIVP
- 2-4mg/kg Im
- RSI
- 1-2mg/kg IV/IO
MOA/notes
believed to cause disassociation between cortical and limbic systems resulting in a seemingly awake pt who is dissociated from the environment.
blocks afferent neural transmission of impulses associated with pain
short anesthetic property without muscle relaxation
derivative of PCP(phencyclidine)
Contraindications sever hypertension(relative), stroke, ICP, cardiac decompisition
s/s
- hypertension(relative)
- heart rate up
- hallucinations bad dreams******
- excessive bronchial secretions****
- n/v
- increased skeletal muscle tone
- resp depression
nitrous oxide
ENTONOX
name
nitrous oxide
EN-TO-NOX
MOA
CNS depressant with potent analgesic and weak anesthetic properties
nitrous oxide induces opioid peptide release in the brain stem leading to the activation of descending noradrenergic neurons, which results in modulation of the nociceptive process in the spinal cord
indications
- muscular-skeletal pain
- ischemic chest pain
- active labor
- burns
contraindications
- cant self admin
- aloc/intoxicated
- head injury
- UDabdo/bowel obstruction
- pneumothorax
- COPD
- scuba diving within 24 hours
propofol
DIPRIVAN
Name
pro-po-fol
DIP-RI-VAN (dipers in a van)
MOA
general anesthetic(rapid)
unknown action but causes global CNS depression presumed through GABA receptors agonist action
dose
2-2.5mg/kg IVpump less the 55 y/o
procedural sedation
0.5-1mg/kg IVpump
s/s
- hypotension
- transient apnea in induction
- bradycardia
- n/v
- headache
tetracaine
PONTOCAINE
name
tetra-caine
PON-TO-CAINE
MOA
topical ophthalmic anesthetic
reduces sodium permeability which increases the action potential of cell inhibiting nerve conduction
***for short term relief of eye irritation***
dose
1-2 drops per eye
- s/s
- burning sting sensation
- blurry vision
- photophobia
- irritation
