Anesthetics, Analgesics, Sedative-Hypnotics, Neuromuscular Blockers Flashcards
Acetaminophen MOA
- Inhibits prostaglandin synthesis in the CNS and to a lesser extent block pain impulse through peripheral action.
- Acts centrally on hypothalamic heat regulating center, producing peripheral vasodilation (more heat loss at skin)
Acetaminophen Indications
- Relief of mild to moderate pain
- Relief of fever
Acetaminophen Contraindications
- Hypersensitivity to the drug
- Hypersensitivity to alcohol, aspartame, saccharin, sugar, tartrazine (yellow #5 food dye)
- Severe hepatic impairment or active liver disease
Acetaminophen Adult Dose
- 325-1000mg PO q4-6h total daily max of 4g/24h or (2g/24h with hepatic / renal impairment)
- 325-65omg PR q4-6h total daily max of 4g/24h or (2g/24h with hepatic / renal impairment)
Acetaminophen Pediatric Dose
10-15mg/kg PO/PR q4-6h total daily max of 75mg/kg/day or 4g whichever is less
Buprenorphine Trade Name
Sublocade
Buprenorphine Class
Opioid Agonist-antagonist
Buprenorphine MOA
Partial agonist at the mu receptors and an antagonist at the kappa receptors
Buprenorphine Indications
Pain control for severe chronic pain when patients need continuous long term pain management when alternative t/x options are inadequate
Buprenorphine Contraindications
- Hypersensitivity
- Peds
- Acute pain
- Cor pulmonale
- Liver impairment
- Renal Failure
- Alcoholism
- increased ICP
- Pregnancy / breastfeeding
- Myasthenia gravis
- GI obstruction
- Respiratory Depression
- MOA inhibitors within 14 days
- QT prolongation
- Seizures
- Electrical imbalances
Buprenorphine Dose
Buccal soluble film: 75mg daily or q 12h
Diazepam Trade Name
Valium
Diazepam Class
Benzodiazepine
Diazepam MOA
- Anxiolytic and sedative-hypnotic: depresses the CNS of the brain. Produces an anti-anxiety affect by potentiating the effect of GABBA
- Anticonvulsant: Suppresses the spread of seizure activity due to enhanced pre-synaptic inhibition.
- Skeletal muscle relaxant: involves inhibiting polysynaptic afferent pathways
- Amnesic: Exact mechanism unknown
Diazepam indiciations
- Seizures / Status
- Skeletal muscle relaxation
- Severely anxious or agitated
- Acute alcohol withdrawal delirium
Diazepam Contraindications
- Hypersensitivity to drug or other benzodiazepine
- Myasthenia gravis
- Severe hepatic dysfunction
- Narrow angle glaucoma
- Pregnancy / breastfeeding
Diazepam Adult Dose
Seizure: 5-10mg SIVP q 10-15min prn total max dose of 30mg
Acute Alcohol Withdrawal: 5-10mg SIVP q 2-4h
Anxiety/Sedation/Muscle relaxant: 2-10mg SIVP over 3-5min no repeats
Diazepam Pediatric Dose
Infants less than 1 month old - 0.1 - 0.3mg/kg SIVP q 15-30min total max 2mg
1 month - 5 yrs - 0.05 - 0.3mg/kg SIVP q 15-30min total max 2mg
Over 5 yrs - 0.05 - 0.3mg/kg SIVP (single max 1mg) q 15-30min total max 10mg
Fentanyl Citrate Trade Name
Sublimaze
Fentanyl Class
Opioid agonist, analgesic
Fentanyl MOA
Binds to opiate receptors in the CNS, altering the response to and perception of pain
Fentanyl Indications
- Moderate to severe pain
- Adult procedural sedation
- MFI maintenance
- Medicated Facilitated Intubation
Fentanyl Contraindications
- Hypersensitivity
- MAO inhibitors within 14 days (may produce unpredictable reactions)
- BP under 90 systolic
Fentanyl Adult Dose
Analgesia: 0.5 - 1 mcg/kg single max 100mcg q 5min total max 250mcg
ACS: 25mcg SIVP q 5-10min total max 250mcg
MFI: 1 - 2 mcg/kg IVP single max dose 100mcg
MFI maintenance: 0.5 - 1 mcg/kg single max 100mcg q 5-10min
0r
Infusion: 1 - 2 mcg/kg/hr (usual dose is 50 - 200 mcg/hr) mix 500mcg in 100ml NS (5mcg/ml)
Procedural: 0.5 - 1 mcg/kg max 100mcg q 10min to desired effect
