Anesthesia - Sedatives And Hypnotics Flashcards
Not having pain
Analgesia
Not feeling
Anesthesia
Blunting of consciousness
Sedation
What drugs do anesthesia providers abuse? Psychiatrists?
Opiods; benzodiazepines
How drugs get to the effect site; what body does to drug
Pharmacokinetics
Drug effect as a result of receptor binding;
What drug does to the body
Pharmacodynamics
Some things to consider when thinking about pharmacokinetics
Route of administration
Metabolism
Distribution
Elimination
Some things to consider when thinking about pharmacodynamics
Receptor agonist, antagonist
Genetic variability in receptor density
Dose response
Efficacy, potency, toxicity
When ppl talk about half life of an anesthetic are they talking about distribution or elimination half life?
Distribution half life; only care about elimination half life for drugs you are giving longer
What are contraindications for propofol?
Allergy to EGG and propofol
What are cardiovascular effects of propofol?
Hypotension - decreased sympathetic tone, decreased vascular tone, myocardial depression(?)
Variable heart rate
What are respiratory effects of propofol?
Hypopnea or apnea - Decreased tidal volume
Decreased response to hypocarbia and hypoxia
Bronchodilation
“milk of amnesia” refers to which drug?
Propofol
Major clinical use of propofol?
Induction of general anesthesia
Does propofol affect pain levels?
NO effect on pain!
List 4 receptors that propofol binds?
Beta subunit of GABAa
Alpha2 adrenoreceptors
NMDA glutamate receptors
Glycine receptors
What is propofol related infusion syndrome?
Life threatening metabolic acidosis, do not infuse propofol for more than 72 hours
Etomidate cardiovascular effects?
Moderate hypotension, few neg effects
Etomidate respiratory effects?
Minimal to moderate
Etomidate absolute contraindications?
Allergy to etomidate
Etomidate neurological effects?
Decreased cerebral metabolic rate, burst suppression
Decreased cerebral blood flow
Can cause seizures
Etomidate adverse effects?
Adrenal suppression in critically ill patients
Increased post-operative nausea and vomiting relative to propofol
Etomidate general use?
Induction of general anesthesia, mostly for known or anticipated hemodynamic instability, also for critically ill, cardiac anesthesia
Does etomidate affect pain?
No
Which is more important for anesthetics: redistribution or elimination?
Redistribution!
