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Neuro block 2 > ancillary anesthesia drugs > Flashcards

ancillary anesthesia drugs Flashcards

1
Q

which drugs used for sedation? when do you use them?

2 diff classes here.

1 class = 3 drugs

other class = 2 drugs

A

benzos: diazepam and lorazepam

1st gen-antihistamines: hydroxyzine, diphenylhradmine, promethazine

use for amnesci and calming effect (used night before for anxiolysis)

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2
Q

what do you use for analgesia?what ADEs do they have?

A

morphine and codeine (but they have ADEs for ortho HypoTN, constipation, N/V, respiratory depression/coma)

NSAIDs(ketorolac and ibuprofen but worry about post-sx bleeding and fracture healing

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3
Q

what do you use for aspiration pneumonitis?(2 drugs here)

A

neutralize acid w/H2 blockers: cimetidine and ranitdine = prevent new acid but you stilll have old contents in theree.

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4
Q

which two antacids are used in the context of aspiration penumonitis?

A

bicitra and polycitra

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5
Q

what do you use for prophylaxis to allergic rxn?

A

cimetidine and diphenhydramine

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6
Q

why do you use anticholinergics in anesthesia

A

to dry secretions, prevent reflex bradycardia, also sedate/amnesia

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7
Q

which three anticholinergics do you use?

A

atropine (bradycardia here)

glycopyrrolate(decreased secretions)

scopolamine( sedation/amnesia)

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8
Q

which drugs used in rapid sequence intubation?(4 FLAV)

A

lidocaine(for increased ICP and brochospasm)

fentanyl (for increased ICP,bleeding, CV dz)

vecuronium(decrease ICP increse caused by succinlycholine)

atropine (decrease bardy Cardia caused by succinlycholine)

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9
Q

which drugs used to hyopTN/what do you do for hypo tN?

A

GIVE fluids

give dopamine and phenylephrine or ephedrine

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10
Q

all the drugs used in aspiration pneumonitis

5

2H2s

2antacadis

D2 central antagonist aslo used for emesis prevention in migraines

A

cimetidine

ranitidine

bicitra

polycitra

metoclopramide

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11
Q

drugs used for N/V (3)

A

ondasestron

scopolamine

metoclopramide

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12
Q

drugs used for CV support (3)

A

dopamine

phenylephrine

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13
Q

4 drugs used in anaphylaxis prevention (HAME)

A

epinephrine

aminophylline

hydrocortisone

methylprednisolone

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14
Q

an anti-dopamine/cholinergic/histaminergic drug used to mitigate anxiety?

A

promethazine

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15
Q

2 1st gen anti histamines used to reduce anxiety with effects of bronchodilation, sedative, anxiolytic and analgesic?

A

hydroxyzine and diphenhydramine

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16
Q

what are 3 major differences btw H1 and H2 antagonists?

H1 antagonist: diphenyhydramine, promezathine, hydroxyzine

H2 antagonist: cimetidine and ranitidine

A

H1 antagonists have following action: sedative, cholinergic antagonism and anti-emetic effect

17
Q

t/f. cimetidine has slight sedative action

A

true

18
Q

3 major problems of opiate receptor agonists

ONE = OD triad

A
  1. orthostatic hyoptension, epigastric distress, antidiarrheal, and increased sphincter tone
  2. N/V via chemoreceptor trigger(dopamine antagonism) + delay of GI transit + increased GI secretion
  3. respiratory depressant + coma-inducing+miosis (OD triad)
19
Q

why are H2 receptor antagonists (cimetidine and ranititdine) use in the prophophylaxis against respiration pneumonitis?

what are their ADEs(3)?

A
  1. fewer CNS effects and they lower the gastric pH
  2. ADE: headache, confusion, seizures, agitation in old pp?
20
Q

why do pts receive bicitra and polycitra

A

b/c H2 antagonsists do not neutralize existsing stoamch contents or prevent gastric emptying

21
Q

which agent used to stimulate gastric emptying?

A

metoclopramide

NOTE: antagonized by anticholinergics and narcotics.

central effects dopamine antagonism: sedation and lowers seizure threshold.

22
Q

how much water needed to stimlate gastric stretch receptors to initate the process of natural stomach emptying?

A

150 mL

23
Q

which inhaled ansethetic is especially pro-emetic

A

nitrous oxide

24
Q

atropine - strongest effect

A

_anticholinergic _strongest: vagolytic - 3+; antisialoggoue effect; no sedation or amnesia

25
Q

scopalamine - MOA

A

anticholinergic: strongest effect: 3+ sedation and amnesia; 2+ for antisialogogue; 1+ vagolytic

26
Q

glycopyrrolate MOA

A

antichiolinergic = MOA - 3+ ANTI-sialogogue effect; 2+ vagolytic; 0 sedation and amnesia

27
Q

why use anticholinergics in pre-op?

3 reasosn

A
  1. tx of reflex bradycardia
  2. blcok muscuraic efffects of anti-cholinesterases
  3. drying of secretions
28
Q

rapid sequence intubation:

which drug described:

what: decreased intracranial and brochospasitc reponse in increased ICP or penetrating injury, reactive airway disease

A

lidocaine

29
Q

RSI

what: decreased sympathetic responses to laryngoscopy/intubation
when: increased ICP, hemorrhage, cardiovascualr disease

A

fentanyl

30
Q

RSI

what: mitigates bradycardia in response to succinlycholine in chidren under10 yrs

A

atropine

31
Q

what: defaciculates and mitigates ICP response to succinlycholne in increased intracranial pressure of penetrating injury

A

vecuroniu

32
Q

note sequence of rapid sequence intubation : IV push of sedative –> succinycholine(neuromuscular blockade)

A
33
Q

which IV anesthetic agent has antiemetic qualities?

A

propofol

34
Q

after how many drugs does the risk of polypharmacy increase dramatically?

A

10

35
Q

bone cement and radio contrast dye are well known causative agents of what?

A

anaphylacxis in anesthesia

36
Q

what are the 4 components of INITIAL anaphylaxis management?

A
  1. strop drug admin, discontinue anesthetisa
  2. give O2
  3. give Epinephrine
  4. intravascular volume expansion
37
Q

drugs used in the prophylaxis of allergic reaction

A

cimetidine and diphenydramine (they prevent consequences fo the reaction, but do not prevent it from occuring)

Neuro block 2 (9 decks)

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