ECT drugs

Question 1

Like Mario & Luigi…

Answer 1

Bini & Cerletti! Inventors of ECT

Question 2

ECT has been used for over…

Answer 2

50 Years!

Question 3

T/F The APA considers ECT safe.

Answer 3

TRUE

Question 4

They believed that these two couldn’t coexist together, so they’d force one out:

Answer 4

Schizophrenia & Epilepsy

Question 5

What reduced the use of EXT?

Answer 5

Criticism & Psyhotropic Drugs

Question 6

ECT is still a useful treatment for:

Answer 6

Depression - when everything else is ineffective.

Question 7

ECT can also be used to help people suffering:

Answer 7

Suicidal ideation
Mania
Catatonia
& Some types of schizophrenia

Question 8

How many treatments does the patient normally receive?

Answer 8

6-12

Question 9

How long is electric current passed through the brain?

Answer 9

.5-2 seconds

Not the current that treats, but the seizure activity!

Question 10

Current desirably induces a…

Answer 10

Grand Mal Seizure lasting 30-60 seconds

Question 11

ECT patient’s shouldn’t take these drugs. Why?

Answer 11

Benzos - raise seizure threshold

Question 12

Today, ECT is administered under:

Answer 12

Short-term anesthesia, modifying seizure activity

Question 13

The five drugs used in ECT are: (msagp)

Answer 13

methohexital
succinylcholine
atropine
glycopyrolate
propofol

Question 14

Methohexital is a very…

Answer 14

Short-acting barbiturate

Question 15

Methohexital is used here to…

Answer 15

Anesthetize patient & reduce pre-treatment anxiety

Question 16

Methohexital is administered:

Answer 16

IV by anesthesiologist

Question 17

Dose for methohexital in ECT?

Answer 17

1.5mg per kg of body weight (50-120)

Question 18

Methohexital works quickly by:

Answer 18

Passing blood brain barrier and quickly depressing CNS

Question 19

Duration of the effect of methohexital?

Answer 19

5-7 minutes! ACT FAST!

Question 20

Methohexital is excreted by…half-life?

Answer 20

Urine - half life of 3-8 hours.

Question 21

Major side effects of methohexital?

Answer 21

Resp. depression
Hypotension
Myocardial depression
Anaphylactic reactions
Dyspnea
Prolonged unconsciousness

Question 22

Minor side effects?

Answer 22

N/V
Headache/restlessness
Skin rash
HICCUPS

Question 23

Methohexital interacts with..

Answer 23

Other CNS depressions

Question 24

Methohexital can cause hypotension when mixed with…

Answer 24

Furosemide - diuretic

Question 25

This next drug killed MJ!

Answer 25

Propofol

Question 26

Propofol is used as an alternative to...

Answer 26

Methohexital

Question 27

Propofol produces effects in only..

Answer 27

40 seconds

Question 28

Usual dose of propofol?

Answer 28

.75-1.5mg per kg of body weight

Question 29

Duration of effect of propofol?

Answer 29

5-10 minutes

Question 30

If we were to put someone into a drug induced coma, we would do so with:

Answer 30

Propofol

Question 31

Propofol is beneficial over methohexital because it is less likely to:

Answer 31

Produce cardiovascular & N/V effects

Question 32

Propofol is known to affect the length of seizure by:

Answer 32

Reducing it!

Question 33

Propofol also _____ _______ @ injexn site.

Answer 33

Causes pain

Question 34

Propofol, while a better symptom profile may interact with _____ ________ and produce:

Answer 34

Irreversible MAOI's hyper/hypotension

Question 35

We should wait how long between MAOI & ECT?

Answer 35

Couple of weeks

Question 36

This next drug is used because to control muscle contraction during seizure.

Answer 36

Succinylcholine

Question 37

Succinylcholine is an:

Answer 37

Ultrashort acting neuromuscular blocker

Question 38

The paralysis caused by succinylcholine is effective in:

Answer 38

Preventing or significantly reducing muscle contractions with seizure

Question 39

T/F Succinylcholine effects seizure activity in brain.

Answer 39

FALSE - no changes

Question 40

Dose for succinylcholine? (Small)

Answer 40

0.6mg per kg of body weight

Question 41

Succinylcholine is given Before or After methohexital?

Answer 41

AFTER - One minute!!!

Question 42

Succinylcholine is effective by...

Answer 42

Interfering with action of acetylcholine in muscle cells.

Question 43

Initial stimulation by succinylcholine causes.

Answer 43

Depolraizations - which then develop into paralysis as binding to receptor sites prevents further depolarization.

Question 44

Complete paralysis effect in...

Answer 44

30-60 seconds

Question 45

T/F Succinylcholine can be reversed by other drugs.

Answer 45

FALSE - Cannot be reversed

Question 46

Side effects of succinylcholine include:

Answer 46

``` Extensions of paralysis Prolonged respiratory depression & apnea Cardiac arrest & changes in rhythm Hypotension Skin rashes! ```

Question 47

These drugs can prolong paralysis with succinylcholine:

Answer 47

Lithium Promazine (Phenothiazine) Furosemide Phenelzine (Irrev MAOI)

Question 48

This drug is used to decrease production of saliva & respiratory secretions. Dry you out. Like a bone.

Answer 48

Atropine

Question 49

In addition to drying out, it is useful to decrease...

Answer 49

potential of CV depression

Question 50

Atropine is given by..and when?

Answer 50

SQ or IM 1/2 hour to 1 hour before

Question 51

Dose range is...(small)

Answer 51

.4-.6mg

Question 52

Duration of effect of atropine?

Answer 52

4 hours

Question 53

Common side effects of atropine?

Answer 53

Anticholinergic effects

Question 54

Atropine will potentiate other drugs with:

Answer 54

Anticholinergic properties (psych meds & antihistamines)

Question 55

An alternate to atropine?

Answer 55

Glycopyrolate

Question 56

In addition to drying saliva & secretions it will prevent:

Answer 56

Bradycardia

Question 57

Glycopyrolate can be given...

Answer 57

IM or IV

Question 58

IV onset is within:

Answer 58

1 minute

Question 59

IM onset is within..

Answer 59

20-40 minutes, peaking 30-35

Question 60

Dose range (sooo small)

Answer 60

.1-.4mg

Question 61

Compared to atropine, glycopyrolates action is:

Answer 61

Longer

Question 62

The benefit of being longer is:

Answer 62

Longer time frame of protection against bradycardia.

Question 63

Side effects of glycopyrolate?

Answer 63

Anticholinergic Sfx

Question 64

Glycopyrolate will also:

Answer 64

Interact and potentiate anticholinergic effects of other drugs.