8. Parenteral II

Question 1

Patients above ASA class _ should be sedated in a hospital setting

Answer 1

II

Question 2

Pre-anesthetic preparation to avoidemesis and aspiration

Answer 2

• NPO 6-8 hrs prior to procedure
• May need to take meds with sipds of water
• Adjustments in oral hypoglycemic and or insulin regimen for diabetics

Question 3

Anesthesia should be postponed if the pateint has what kind of infection

Answer 3

upper/lower respiratory infection

Question 4

What is the difference between Hypertensive urgency and emergency

Answer 4

Both have high BP readings

• Urgency- patient feels fine
• Emergency- feels like they have the flu and chest is tight

Question 5

Profound respiratory depression can lead to

Answer 5

hypoxia

Question 6

Adverse drug reactions can occur in patients that

Answer 6

• Substance abusers

- Hepatic or renal insufficiency

Question 7

What is the biggest risk of IV sedation

Answer 7

respiratory depression (you stop breathing)

Question 8

What types of monitors are meeded during sedation

Answer 8

• BP
• Pulse
• Heart rate (pulse)
• Heart rhythm (ECG)
• Oxygenation/ventilation (pulse oximeter, pre-cordial stethoscope)
• Temperature

Question 9

What is the easiest and least accurate way to obtain patient temperature

Answer 9

skin temp

Question 10

Discharge criteria for sedated pateints is

Answer 10

Aldrete score (must be 10 or more for discharge)

Question 11

Primary reason we give opiods is

Answer 11

analgesia

Question 12

Sequelae of OD on opiods is

Answer 12

respiratory depression 9Chest-wall rigidity)

Question 13

Opiods leads to decrease in (sympathetic/parasympathetic stimulation

Answer 13

sympathetic

Question 14

Naloxone can lead to

Answer 14

dysrhythmia, myocardial failure and pulmonary edema

Question 15

What is the most potent opiod

Answer 15

sufentanyl (more then fentanyl)

Question 16

Locaiton of the GABA receptors acted on by benzons

Answer 16

cerebral cortex and limbic system

Question 17

Uses of benzos are

Answer 17

anxiolysis
anterograde amnesia
sedation

Question 18

What is the most commonly used benzo and why

Answer 18

midazolam- no active metabolites and fast on fast off

Question 19

Contraindications of benzons

Answer 19

• Allergy
• Narrow angle gluacoma
• Extremes of age (use anti-histamines)

Question 20

MOA of ketamine

Answer 20

-Blocks CNS NDMA receptors (excitatory receptors0 resulting in sedation

Question 21

Advantages of ketamine

Answer 21

not much depression in heart and respiratory function like opiods

Question 22

Disadvantages of ketamine

Answer 22

extreme psychological effects on people (emergence phenomena- unpleasant visuals, auidtory or proprioceptive phenomena)

Question 23

MOA of propofol

Answer 23

Bites a site associated with GABA

Question 24

Effects of propofol

Answer 24

sedation (little analgesia) - can stop patient from breathing rapid bolus dose administration shouldn’t be used for ASA III, and IV patients

Question 25

Effect of Benzos

Answer 25

• Anxiolysis
• Sedation
• Anterograde amnesia

Question 26

Effect of opiods

Answer 26

• Analgesia

- Sedation

Question 27

Effects of ketamine

Answer 27

• Analgesia
• Dissociation
• Sedation

Question 28

What is the most common mixture of sedation agents

Answer 28

opiod and benzo

Question 29

Agents used in Jorgenson

Answer 29

pentobarbital, meperidine, scopolamine

Question 30

Agents in Foreman

Answer 30

Diazepam methohexital

Question 31

Agents in Berns

Answer 31

secobarbital, meperidine, and methohexitol

Question 32

Agents that can be used alone for sedation

Answer 32

• propofol
• Benzo
• Opioid
• Ketamine

Question 33

Continuous infusion of single agent analgesic is done with

Answer 33

propofol

Question 34

What happens to the doss of anesthetic agents when multiple types are used

Answer 34

dose of all of them declines

Question 35

T/F N2O reduces need for higher conc. levels of benzos and opiods

Answer 35

t