Sketchy Pharm: Propofol, Etomidate, Ketamine

Question 1

What is the useful difference between propofol, ketamine, and etomidate?

Answer 1

All three can be used as induction anesthetics (that is, for inducing sedation), but only propofol can be used to maintain anesthesia.

Question 2

What is the mechanism of propofol and etomidate?

Answer 2

They –like benzodiazepines, barbiturates, alcohol, and the non-sedative hypnotics –activate the GABA-A receptor. (Think of the old-fashioned Caba cab.)

Question 3

The most important side effect of propofol is ____________.

Answer 3

“profound” vasodilation (think of the hypnotist’s sleeves); this can induce tachycardia

Question 4

The main benefit of etomidate is _____________.

Answer 4

absence of cardiac side effects – specifically, etomidate does not cause vasodilation (think of the Intimidator balancing the hypnotized person)

Question 5

What are the side effects of ketamine?

Answer 5

Dissociative state (eyes open, but unconscious); unpleasant hallucinations; increased cardiac output (the heart-shaped cobra hood)