Name drugs that could suppress EEG activity.
- Hypnotics, volatiles, NMBDs, Opioids
- β-blockers
__________ drugs can induce CYP450’s.
Barbiturates
What is the mechanism of action of benzodiazepines?
- Enhancement of GABA binding by changing receptor affinity. Allows for greater Cl⁻ influx and thus hyperpolarization.
How many subunits are present in a GABA receptor?
Where do GABA molecules bind on said receptor?
- Five
- In-between the α1 & β2 subunits.
What subunits do Benzodiazepines bind to on the GABA receptor?
- In-between α1 & γ2
What is the preop/intraop sedation dosing for midazolam in pediatric populations?
When do effects peak and what is the consequence of this?
- 0.25 - 0.5 mg/kg PO route
- Peaks in 20-30 min (give 30 min prior to OR)
What is the preop/intraop dosing of midazolam in adult populations? When does the effect peak?
- 1-5mg IV
- Peaks in 5 minutes
What is the postoperative sedation dose of midazolam?
How long should midazolam be used for long-term sedation? Why is this?
- 1-7 mg/hr IV.
- 2-3 days due to unclear effects on T-cell response.
What is the onset of diazepam?
What is the E ½ time of diazepam?
What is the Vd of diazepam?
- Onset: 1-5 minutes
- E ½ = 20-40 hours (very protein-bound)
- Vd = 1-1.5 L/kg
What is the seizure dosing for diazepam?
What seizures is it utilized for?
- 0.1 mg/kg IV
- DT’s, status epilepticus, lidocaine toxicity seizures.
What is the induction dose of diazepam?
When would one decrease the dose by 50%?
- 0.5-1 mg/kg IV
- 50% cut with elderly, liver patients, and with concurrent opioid use.
When is peak effect seen with lorazepam?
- 20-30 min with IV dose (1-4mg)
What is the E ½ time of lorazepam?
- 14 hours
What is the dosing of flumazenil?
- 0.2mg IV titrated to consciousness (repeat 0.1mg q1min til 1mg total)
What is the sedation reversal dose range of flumazenil?
- 0.3 - 0.6 mg
What is the complete reversal dose range of flumazenil?
- 0.5 - 1 mg
