Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anesthesia and Prescribing > Emergency drugs > Flashcards

Emergency drugs Flashcards

1
Q

INTRODUCTION

A

•Emergency anesthetic drugs are life-saving drugs

considered necessary preparation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Advantages of emergency drugs

A
  • Ability to save time in the case of an emergency
  • Easy to work in unfamiliar place
  • Reduce the stress of the anesthetist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Disadvantages

A
  • Drug admission errors
  • Drug contamination errors
  • Drug wastage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

List of emergency drugs

A 
•Atropine
•Ephedrine
•Phenylephrine
•Adrenaline
Suxamethonium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
  1. Adrenaline Mechanism of action
A

Sympathomimetic amine which is a potent stimulant of alpha- & beta-adrenergic receptors. It has strong vasoconstrictor action.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Adrenaline indications

A
  1. Anaphylactic shock
  2. Cardiac arrest
  3. Bronchospasm
  4. Cardiopulmonary resuscitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Adrenaline contraindications

A
  1. Hypersensitivity to the active ingredient or any of its excipients
    Hypersensitivity to sodium metabisulfite (should not necessarily deter use when indicated for serious allergic reactions or emergency situations)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Adrenaline Side effects

A
  1. Angina
  2. Hypertension( cerebral hemorrhage)
  3. Cardiac dysrhythmia 4. Ventricular arrhythmia
  4. Dyspnea
  5. Stress cardiomyopathy
  6. Pulmonary oedema
  7. Nervousness and restless
  8. Nausea and vomiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Adrenaline Doses

A
  1. Bronchodilation:

• IM/SC: 0.2-0.5mg (0.2-0.5ml of 1:1000 (one:one thousand)), repeat every 20min if needed; Max: 1mg/dose.

  1. Anaphylaxis:

•IM/SC: 0.2-0.5mg (0.2-0.5ml of 1:1000 (one:one thousand)), repeat every 5-15min if needed.

NB. Doses may be repeated at 5-15min intervals according to blood pressure, pulse and respiratory function

The intramuscular route is the preferred choice for most individuals who have to be given adrenaline for the management of an anaphylactic reaction

SC admin. results in slower absorption and is less reliable.

IM admin. in the anterolateral aspect of the middle third of the thigh is preferred

3. Cardiac stimulant
Cardiopulmonary resuscitation (CPR):

•Intracardial/IV: 1mg, repeat every 3-5min if needed.

NB. IV route to be used with extreme caution; reserved for specialists familiar with IV use of epinephrine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ephedrine mechanism of action

A

Ephedrine is a sympathomimetic amine that acts directly on alpha and beta receptors and indirectly by increasing the release of noradrenaline at the sympathetic nerve endings.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ephedrine Indications

A

Hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ephedrine contraindications

A

Hypersensitivity to the active ingredient or any of its excipients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ephedrine Side effects

A
  1. Cerebral hemorrhage
  2. Headache
  3. Restlessness
  4. Anxiety
  5. Tremor
  6. Dizziness
  7. Confusion
  8. Delirium hallucination
  9. Palpitations
  10. Hypertension
  11. Tachycardia
  12. Pallor
  13. Respiratory difficulty
  14. Palpitations
  15. Nausea & vomiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Ephedrine Doses

A
  1. Hypotension
    - Anesthesia-induced
  • IV: 5-10mg, bolus given as a slow injection; Max: 50mg/24hrs
  • IM/SC: 25-50mg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

PHENYLEPHRINE Mechanism of action

A

•Phenylephrine is a potent vasoconstrictor that acts almost exclusively by stimulation of alpha-1-adrenergic receptors. •Arterial vasoconstriction is accompanied by venous vasoconstriction which gives an increase in blood pressure and reflex bradycardia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Phenylephrine Indications

A
  1. Hypotension (spinal anesthesia, sympathectomy, overdose of antihypertensive)
  2. Shock
  3. Paroxysmal atrial tachycardia
17
Q

Phenylephrine contraindications

A
  1. Hypersensitivity to the active ingredient or any of its excipients
  2. Severe hypertension
  3. Hyperthyroidism
  4. Partial heart block
  5. Bradycardia
18
Q

Phenylephrine Side effects

A
  1. Severe reflex bradycardia- (asystole).
  2. Severe hypertension.
  3. Acute cardiac failure- ( If afterload increase excessively, or poor left ventricular contractility) .
  4. Extravasation can cause local skin necrosis.
19
Q

Phenylephrine Doses

A
  1. Intraoperative hypotension:
  • SC/IM: Initial: 2-5mg; Titrate by 1-10mg depending on patient response.
  • IV: 0.1-0.5mg, bolus given by slow IV injection, every 15mins.
  • IV: 10mg in 500ml 0.9% sodium chloride or 5% dextrose to run at 180μg/min, as an infusion; Titrate down by 30-60μg/min according to patient response.
20
Q

Suxamethonium mechanism of action

A
  • Suxamethonium chloride causes a persistent depolarization of the neuromuscular junction. This depolarization is caused by suxamethonium mimicking the effect of acetylcholine but without being rapidly hydrolysed by acetylcholinesterase.
  • This depolarization leads to desensitization.
  • Rapid, complete and short duration
21
Q

Suxamethonium Chloride indications

A
  1. Endotracheal incubations

2. Muscle relaxation

22
Q

Suxamethonium Chloride contraindications

A
  1. Hx of malignant hyperthermia
  2. Pre- existing hyperkalemia
  3. Known hypersensitivity
  4. Avoid 24 hr – 6 mo after major burn injury or para/ tetraplegia
23
Q

Suxamethonium Chloride Side effects

A
  1. Post operative muscle pain of varying degree
    Vagal stimulation ( Salivation, hypotension, bradycardia)
  2. Hypersensitivity reactions have reported
  3. Associated with malignant hyperthermia.
24
Q

Suxamethonium Chloride Dose

A
  1. IV: 1-2mg/kg, as a single dose.

NB. Subsequent doses must be individualized according to the patients needs

25
Q

ATROPINE Mechanism of action

A
  • Atropine is an antimuscarinic agent which competitively antagonizes acetylcholine at postganglionic nerve endings, thus affecting receptors of the exocrine glands, smooth muscle, cardiac muscle and the central nervous system.
  • Atropine increases sinus rate and sinoatrial and AV conduction. Usually, heart rate is increased but there may be initial bradycardia. Atropine inhibits secretions throughout the respiratory tract and relaxes bronchial smooth muscle producing bronchodilatation.
26
Q

Atropine indications

A
  1. Pre-operatively, to counteract the vagal effects that may frequently occur during anesthesia
  2. Muscarinic toxicity or poisoning by organophosphate cholinesterase inhibitors or cholinomimetic alkaloid muscarine
27
Q

Atropine contraindications

A
  1. Hypersensitivity to the active ingredient or any of its excipients.
  2. AV block with wide QSR complex.
  3. Urinary retention
  4. Closed – angle glaucoma
  5. Fever
  6. Atony of GIT
28
Q

Atropine side effects

A
  1. Dry mouth
  2. Blurred vision
  3. Photophobia
  4. Increased intraocular pressure
  5. Anhidrosis
  6. Flushing
  7. Cardiac arrhythmia
  8. Urinary retention&/ constipation
29
Q

Atropine Dose

A
  1. Pre-operative:
    • IV: 0.3-0.6mg, immediately before anesthesia
    • IM/SC: 0.3-0.6mg, 60min. before anesthesia
  2. Post-operative:
    In combination with neostigmine used to reverse the effects of non-depolarising muscle relaxants

• IV: 0.6-1.2mg, given as a slow injection

NB. Atropine should be administered before neostigmine

Anesthesia and Prescribing (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions