Benzodiazapines

Question 1

Diazepam

Answer 1

1. Valium
2. Slight water solubility, highly lipid soluble
3. Each ml contains 5 mg of diazpeman compound with 40% propylene glycol, 10% ethyl alcohol, 5% sodium benzos the and benzoic acid as buffers, and 1.5% benzoyl alcholol as preservative.
4. Works on gaba A receptor- chloride influx and hyper-polarizes membrane

Question 2

Lorazepam

Answer 2

1. Ativan
2. Less lipophilic than diazepam
3. Nearly white power almost insoluble in water.
4. Each ml of sterile injection contains either 2.0 or 4.0 mg of lorazepam, 0.18 ml polyethylene glycol, 400 in propylene glycol with 2% benzoyl alcohol as preservative
   (Works on gaba A receptors)

Question 3

Midazolam

Answer 3

1. Versed
2. Water soluble benzo available as sterile, parenteral dosage form for IV or IM injection use only
3. Each ml contains midazolam hydrochloride equivalent to 1 mg midaz compound with 0.8% sodium chloride and 0.01% edetate disodium and sodium hydroxide (and/or hydrochloride acid for pH adjustment pH 2.9-3.5)

Question 4

Flumazenil

Answer 4

1. Benzo antagonist
2. Insoluble in water, but slightly soluble in aciditic aqueous solutions. Available as sterile parenteral dosage form for IV adminstration
3. Each ml contains flumazenil 0.1 mg (many other inactive ingredients)
4. Hydrochloric acid and/or sodium hydroxide to adjust pH 3.5-4.5 and water for injection

Question 5

Barbiturates

Answer 5

1. Has 5 carbons on it
2. Freely soluble in H2O (conjugate acid insoluble in H2O)
3. PH solution for injection is 9.0-10.5
4. Aqueous solution of pentobarbital sodium are unstable. Drug supplied for injection in alcohol 10% and propylene glycol 20-40%

Question 6

Methohexital Sodium

Answer 6

1. Ultra short acting barb anesthetic
2. Should be stored at room temp < 25 C
3. Solutions in sterile H2O are stable at least 6 weeks. Solutions in 5% dextrose or 0.9% NS stable for < 24 hours.
4. NOTE: incompatible with aciditic solutions (atropine, metocurine iodide, succinylcholine chloride) or those containing phenol as preservative. INcompatible with silicone
5. If given with succ= increase the pH and hydrolysis of this drug- metabolize it fast

Question 7

Thiopental

Answer 7

1. Sterile thiopental sodium is a mixture of sterilized thiopental sodium with anhydr sodium carbonate as buffer.
2. Strongly alkaline with a pH of 10.5
3. Short acting (similar to propofol in that its redistribution makes it fast acting rather than its metabolism)

Question 8

Redistribution of thiopental after IV bolus injection?

Answer 8

1. Rapid distribution into the brain and rapid redistribution to other tissues.
2. Thiopental and propofol rapidly equilibrate with the CNS due to their high lipophilicity, then rapidly redistribute to other tissues due to the same reason

Question 9

Propofol

Answer 9

1. Highly lipophilic and non-ionizable
2. Pka-11 (base form)
3. Formulated as an emulsion: Diprivan: soybean oil, glycerol, egg lecithin, adjusted to pH 7-8.5
4. Generic formulations are now available that contain sulfite of benzoyl alcholols

Question 10

Ketamine

Answer 10

1. Dissociative anesthetic, pka 6.5
2. Blocks NMDA receptor and excitatory signals
3. Package insert: ketamine hydrochloride is a non barbiturate anesthetic. It is formulated as a slightly acidic pH 3.5-5.5 sterile solution for IV or IM injection in concentrations containing the equivalent of either 10, 50, or 100 mg ketamine per milliliter.
4. The 10 mg/ml solution has been made isotonic with sodium chloride

Question 11

Phencylcidine

Answer 11

1. A dissociated anesthetic and hallucinogen

2. Pka 8.2

Question 12

Etomidate

Answer 12

1. Short acting anesthetic-hypnotic agent, undergoes hydrolysis, pka 4.2
2. STerile non pyrogens solution. Each millimeter contains 2 mg of etomidate.
3. The pH is 6.0. (Aciditic)