Ch. 10 Flashcards
Unpleasant state of inner turmoil, often accompanied by nervous behavior
Anxiety
Sudden, unexpected, intense attack of apprehension sometimes accompanied by physical symptoms
list the symptoms
panic disorder
- Agitation
- Tachycardia
- Hypertension
- SOB
Psychological condition that consists of irrational fear, leading to avoidance
List symptoms:
Phobia
Nervousness
Fear
Palpitations
Choking \
*most common form =Claustrophobia
fear of tight and enclosed spaces
*most common form of Phobia
Claustrophobia-
List Basic physiologic responses in anxious or agitated patients
Tachycardia
Palpitations
Chest pain
GI distress
True or false conscious sedation requires intubation (mechanical ventilation)
False: only general anesthesia
What is the difference between sedation and anesthesia
Dose of the sedative:
It is the same drug however conscious sedation is a lower dose in which the patient is relaxed and can tolerate the procedure where as general anesthesia is a higher dose that requires mechanical ventilation
Why is mechanical ventilators used with general anesthis
because all sedatives can make a patient stop breathing if the dose is too high
Where does General anesthesia take place
In OR setting and anesthesiologist has to be present
Before considering conscious sedation what pt. information is needed
- HX, physical exam, height, weight
- List of current medications (including herbal)
- Any allergies
- Last oral intake
Why must one be NPO prior to surgery
In the case that a mechanical ventilation is needed patient could vomit and then possibly asperate
What is needed before administering conscious sedation
- oxygen and pulse oximeter
- Airway equipment
- IV equipment
- Cardiac monitor
- Crash cart
- drug reversal agent
Name the 2 pharmacological reversal agents
- Flumazenil
2. Naloxone
What agents are used for conscious sedation
- Antianxiety:
- Barbituate
- Benzodiazepine - Analgesics
- Opiate Analgesics
- Morphine
- fentanyl
- Meperedine
Drug of choise to reverse antianxiety drug effects
Flumazenil ( IV)
_____ are frequently used in combination with antianxiety drugs
analgesics
*by combining the 2, synergistic actions take place to relieve the painful anxiety
_____ Stimulates CNS opiod receptors and cause a decrease in perception of pain
Opiate analgesics
- dangerous because of synergistic effects
- respiratory depression can occur
Drug of choice that reverses the effects of Opiates
Naloxone
IV, IM, or entotrachially
What is the difference between Nalaxone and Flumazenil
Naloxone is the drug of choice to reverse the effects of opiates where as
Flumazenil reverse the effects of antianxiety drugs
____ is another name for nalaxone
narcan
What does GABA stand for
Gamma-aminobutyric acid
What is the mechanism of action of barbituates
Decreases cortical brain activity by facilitating GABA and depressing cerebral cortex activity
_____ is used mostly in surgery and induces full anesthisa
- list 2 major adverse effects
Thiopental
- Low blood pressure
- Apena
____ is used mostly for brief procedures, and has extremely rapid onset
*given prior to surgery
methohexital
ex:
*cardioversions
____ may be given to patients orally the night before and the morning of the procedure to keep them calm
Phenobarbitol
- has less side effects and less adverse effects
____ Facilitates GABA
Benzodiazepines
Most widely used benzodiazepine for conscious sedation
midazolam
____ mg of madazolam can not be exceeded for conscious sedation
10 mg
list 3 adverse effects of benzodiazepines
- Hiccups
- GI upset
- Headache
What are the main opiates
- Fentanyl
- Morphine
- Meperdine
What are adverse effects of opiate analgesics
- Constipation
- Dizziness
- Excessice drowsiness
