Day 2 Revised

Question 1

methohexital

Answer 1

barbiturate anesthetic

i: induct/maintain anesthesia, induct hypnotic state
ta: depress CNS to produce hypnosis and anesthesia w/o analgesia = pain relief /rapid anesthesia 10-30 sec

ci no silicone, preg/lact

c: x
ae: CNS dep (N/V, apnea, dec HR/BP, GI/GU)
di: CNS dep, narcotic; dec OAC, b-blocker, steroid, contraceptives, theophylline
ni: physician/CRNA bedside, intubated

Question 2

midazolam

Answer 2

Nonbarbiturate Anesthetic

i: induce amnesia/anesthesia, contd sedation for procedure, pre-procedure anxiety
ta: potentiate GABA effect - amnesia

ci resp dep - arrest/apnea; propofol - egg/soy allergy; ketamine - mental hx

c: same; midazolam - vomiting compromise risk
ae: CNS/resp dep, skin breakdown; propofol - severe bradycardia, hypoT; ketamine - bizarre mental state, psychosis, slow recovery

di ketamine w/ NMJ blocker - paralysis; midazolam w/ CNS dep - inc toxicity, recovery duration.

ni: resp equipment bedside, contd cardiac monitor, ketamine not dec HR/BP, propofol - frequent tubing change, no driving, antidote flumanezil