Box 2 Flashcards
Other name for Sufentanil?
Sufenta
Classification of Sufentanil?
Opioid Agonist
Sufentanil dose:
induction?
Epidural bolus?
Epidural infusion?
Induction: 1 to 30mcg/kg
Epidural bolus: 25-50mcg
Epidural infusion 5-30mcg/hr
MOA Sufentanil?
Opioids act as agonists at specific opioid receptors at sites in the CNS as well as the periphery. Opioids mimic the action of endogenous ligands by binding to opioid receptors, resulting in activation of pain-modulating system.
Sufentanil half life?
6 hours
Sufentanil
Onset?
Peak?
Duration?
Onset: 1-3 minute
Peak: 5.6 minutes
Duration: Dose Dependent.
Contraindications to Sufentanil use?
caution in elderly, hypovolemic, pt. taking sedatives or narcotics.
Crosses the placental barrier can cause resp. depression in neonate if used during labor.
Other name for Ketamine?
Ketalor
Ketamine classification?
Phencyclidine (PCP) derivative: Non-barbiturate dissociative anesthetic: NMDA (N-Methyl-D-Aspartate) receptor antagonist
Contraindications to Ketamine?
patients with CAD (inotropic effect increases cardiac myocardial O2 requirements)
pulmonary HTN
increased ICP
Ketamine dose:
analgesic?
Induction?
analgesic- 0.2-0.5mg/kg
Induction- 1-2mg/kg IV
Why would you give Ketamine for induction?
acts as an anesthetic (non-barbiturate anesthetic)
Ketamine MOA?
exact MOA is unknown; primarily a noncompetitive antagonist for NMDA receptors, also acts on opioid, monoaminergic, muscarinic and neuronal nicotinic Ach receptors. High lipid solubility, not significantly bound to plasma proteins therefore peak brain concentration may be 5x that of plasma concentrantion.
Ketamine IV:
Onset?
Peak?
Duration?
O: 30-60 sec. IV
P: 1 min IV
D: 10-20 min.
What patients would Ketamine be good for induction?
causes bronchodilation and may be useful in patients with ASTHMA
Does ketamine produce resp. depression?
No, does not produce significant resp. depression.
What does ketamine commonly cause?
nystagmus (also causes increased ICP)
What is ketamine known for upon emergence?
emergence delirium, can be prevented with a benzo such versed.
Patients that should not be given ketamine?
PTSD (patients who have trauma past)
What can giving a sub anesthesia dose of ketamine prevent?
opioid tolerance
Ketamine comes supplied as a vial concentration of?
500mg/10ml
Flumazenil trade name?
Romazicon
Classification of Flumazenil?
competitive benzodiazepine-receptor antagonist
Contraindications to Flumazenil?
avoided in patients who take chronic oral benzos and
those taking antiepileptic drugs chronically due to risk of having withdrawal seizure.