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Med Procedures - Quiz 3 > Conscious Sedation > Flashcards

Conscious Sedation Flashcards

1
Q

What is the intent of procedural sedation and analgesia?

A

Depressed level of consciousness that allows patient to maintain oxygenation and airway control independently

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2
Q

Goals of conscious sedation

A
  • Minimize pain
  • Alleviate anxiety
  • Maximize amnesia
  • Control behavior
  • Maintain CV and resp status
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3
Q

Define anxiolysis

A
  • Minimal sedation
  • Response to verbal stimulation is normal
  • Cognitive function and coordination may be impaired
  • CV and resp functions unaffected
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4
Q

What drug is MC used for procedural sedation and analgesia?

A

Versed (Midazolam)

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5
Q

What is the reversal agent of Versed (Midazolam)?

A

Flumazenil

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6
Q

Cons of Versed (Midazolam)

A
  • No analgesia
  • Resp depression
  • Hypotension w/high doses
  • Disinhibition
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7
Q

What drug is MC used for mild-mod sedation?

A

Lorazepam (duration of action is longer than Midazolam)

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8
Q

Define moderate (conscious) sedation

A
  • Drug induced depression of consciousness
  • Pt responds purposefully to verbal commands
  • Airway is patent, spontaneous ventilation adequate
  • CV function usually unaffected
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9
Q

Define deep sedation

A
  • Pt responds purposely following repeated/painful stimulation
  • Independent maintenance of vent function may be impaired
  • Spontaneous ventilation may be inadequate
  • CV function usually maintained
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10
Q

Define general anesthesia

A
  • Drug induced loss of consciousness
  • Pt cannot be aroused
  • Ventilatory function is impaired
  • CV function may be impaired
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11
Q

Risks of sedation

A
  • Hypotension
  • Hypoxia
  • Bradycardia
  • Cardiac dysrhythmias
  • Respiratory depression
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12
Q

Pros of Versed (Midazolam)

A
  • Decent amnesia

- Has a reversal agent

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13
Q

How does lorazepam compare to midazolam for sedation?

A
  • Onset is slower than midazolam
  • Duration is LONGER (6-8 hrs vs. 30-60 mins)
  • Double the potency of midazolam
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14
Q

Pros of Ketamine

A
  • Analgesia/amnesia
  • Airway reflexes maintained
  • No pain perception
  • Dosing IM, IV, PO, PR
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15
Q

Cons of Ketamine

A
  • Sympathomimetic
  • Increased ICP, IOP and BP
  • Laryngospasm
  • Emesis
  • Emergence reaction
  • Increases muscle tone
  • Patient will still move
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16
Q

Describe Etomidate

A
  • Ultra short acting non-barbiturate hypnotic used for anesthesia
  • Works via GABA receptors
  • Produces rapid induction without histamine release and w/minimal CV/respiratory effects
17
Q

Pros of Etomidate

A
  • Quick on and off
  • No histamine release
  • Minimal CV/resp effects
  • Possible amnesia
18
Q

Cons of Etomidate

A
  • Myoclonus
  • NV
  • No analgesia
  • 12-48 hrs inhibition of adrenal axis
19
Q

Describe Propofol

A
  • Potent ultra short acting sedation and anesthesia
  • MOA unknown (GABA?)
  • NO analgesic properties
20
Q

What are the ultra short acting drug options for sedation?

A
  • Etomidate

- Propofol

21
Q

Pros of Propofol

A
  • Quick on and off
  • Antiemetic
  • Amnesia
  • Anticonvulsant
  • Decreases ICP and IOP
22
Q

Cons of Propofol

A
  • Burns during injectino
  • No analgesia
  • Hypotension
  • Decreased resp drive
  • Allergic reaction to soy and eggs possible
23
Q

Role of opiates in procedures?

A

Provides analgesia and sedation

24
Q

What is the usual opiate of choice in procedures/sedation?

A

Fentanyl (prompt onset and short duration w/minimal CV/resp effects)

25
Q

What is used to classify airway management?

A

Mallampati Classification (1 is patent, 4 is completely closed)

26
Q

Which drugs can be used in pediatrics for sedation?

A
  • Fentanyl
  • Ketamine
  • Propofol (data limited)
27
Q

What does Naloxone reverse?

A

Opioids

28
Q

What does Flumazenil reverse?

A

Benzodiazepines

Med Procedures - Quiz 3 (4 decks)

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