Drug Descriptions Flashcards
What are the two main effects of versed?
sedation and amnesia
most common pain medication given to patients undergoing surgery
fentanyl
what does the anesthetist use to guide narcotic dosing of fentanyl?
respiratory rate
Fast RR= pain
Slow RR= comfort
This drug is commonly dosed in the PACU
morphine sulfate
NSAID that causes pain relief without causing respiratory depression
ketorolac
most common drug to induce general anesthesia
propofol
induces general anesthesia without causing a drop in blood pressure
etomidate
associated with adrenal suppression and PONV
etomidate
causes a drop in blood pressure and profound respiratory depressant and bag masking a patient should be readily available with this drug
propofol
what are the two types of acetylcholine receptors?
nicotinic and muscarinic
Where are nicotinic receptors found?
skeletal muscle
Which drugs affect nicotinic receptors?
succinylcholine, rocuronium, neostigmine, and sugammadex
Ach can bind muscarinic receptors on which organs?
heart, lungs, GI tract, eyes, salivary glands
what is/are the neurotransmitter(s) for the sympathetic nervous system?
epinephrine and norepinephrine
What effect does Ach have on the heart and lungs?
bradycardia and bronchoconstriction
Describe how a muscle contracts.
when a presynaptic nerve is stimulated it releases Ach into the neuromuscular junction and the muscle contracts when Ach binds to the postjunctional nicotinic Ach receptors on the muscle
which drug(s) bind(s) to nicotinic receptors and block them from binding Ach?
rocuronium/ nondepolarizing muscle relaxants
Acetylcholinesterase breaks down Ach into what?
choline and acetic acid
this drug prevents acetylcholinesterase from doing its job and floods the neuromuscular junction with Ach
neostigmine
This drug encapsulates nondepolarizing muscle relaxants so it can’t bind postjunctional receptors
sugammadex
Which drug(s) block muscarinic receptors?
glycopyrrolate (Robinul) and atropine
Which drug(s) block the parasympathetic input from the body and cause sympathetic effects?
robinul and atropine
This drug is usually administered with Neostigmine
Robinul
This drug is a much better reversal agent than Neostigmine and is typically used where top notch reversal is essential.
sugammadex
Binds to postjunctional receptors and is shaped like Ach and causes intense muscle contraction leading to muscle fatigue and reaches a state of “maximum contraction” and therefore cannot contract anymore
succinylcholine
True/False. There is nothing an anesthetist can do to reverse the effects of succinylcholine other than to just wait.
True
What is the main use of succinylcholine?
paralyze, relax, the vocal cords prior to intubation .
It is used for full stomach patients and ideal for situations where a breathing tube needs to be inserted as fast as possible. It is short acting so it is not used to keep a patient paralyzed during surgery
What is a popular drug for maintaining muscle paralysis throughout surgeries that require muscle paralysis?
rocuronium; has a longer onset and longer duration of action than succinylchoine. still have to bag mask the patient for a minute or two after drug is given
What are the two main effects of antimuscarinic drugs?
- ) increase heart rate in bradycardic patients (block muscarinic receptors)
- ) block parasympathetic effects of neostigmine
more commonly used to treat profound, emergent, bradycardia
atropine
treats nausea by blocking serotonin 5HT3 receptors
ondansetron
antiemetic, upper Gi stimulant. indicated for full stomach patients
metoclopramide
antiemetic steroid. can be used to treat swelling after intubation trauma
dexamethasone
alpha 1 agonist
causes vasconstriction, increases blood pressure, and cause “reflex bradycardia”
phenylephrine
treats patients with low blood pressure and adequate heart rate and avoided for bradycardic patients
phenylephrine
causes an increase in blood pressure and increase in heart rate
ephedrine
given to patients who have hypotension and bradycardic
ephedrine
drug that displays an effect on epinephrine
adrenergic
sedative
anxiolytic
decrease pain
analgesic
any chemical produced in the adrenal medulla, usually refers to epinephrine or norepinephrine
catecholamine
drug that works on the acetylcholine receptor
cholinergic
drug that infuses slowly over a period of time at a constant rate
infusion
drug that increases cardiac contractility
inotrope
injection into the subarachnoid space, “spinal” anesthesia
intrathecal injection
larger dose given prior to an infusion (in an effort to speed up the onset)
loading dose
provides analgesia only to the area of injection (not to the entire body)
local anesthetic
dose required to achieve a given effect in 50% of the population. the “MAC” value for IV drugs
median effective dose (ED50)
dose that causes death in 50% of the population
median lethal dose (LD50)
addictive substance that decreases pain, induces sedation, and decreases respiratory drive
narcotic
synthetic narcotic resembling naturally occurring opiates
opioid
a narcotic that contains opium and any substance that binds to opiate receptors
opiate
a narcotic substance extracted from leaves
opium
increases HR, BP or both
sympathomimetic
What are the three steps for titration?
- ) start with a lower initial dose
- ) the dose is increased until the desired effect is achieved
- ) the dose is reduced if the drug goes beyond the desired effect
compares the amount of a drug that causes a therapeutic effect to the amount that causes toxicity
therapeutic index
true/false: a drug with a small therapeutic index has a “narrow therapeutic range”
true
true/false: a drug with a higher therapeutic dose is considered dangerous
false; higher TI=safer
antimuscarinic
vagolytic
dilates blood vessels and decreases BP
vasodilator
constricts blood vessels and increases BP
vasopressor
Name all 6 things activation of sympathetic nervous system leads to.
- ) increased heart rate
- ) increased BP
- ) bronchodilation
- ) pupil dilation (mydriasis)
- ) gastroparesis (inhibition of peristalsis)
- ) dry mouth
Name all 5 things activation of parasympathetic nervous system leads to.
- ) decreased HR
- ) bronchoconstriction
- ) pupil constriction (miosis)
- ) peristalsis
- ) airway secretions/saliva
what are the three main uses of lidocaine?
- ) to reduce the burning sensation caused by the IV from propofol
- ) decrease in the cough reflex associated with intubation
- ) it is antiarrhythmic, which can be used to treat certain irregular heart beats/rhythms
