Exam 2 Meds Only Flashcards
Which drug is given before and after surgery to increase gastric emptying?
(Reglan) Metocloprmide
Atropine
Pre-Op Usual Dose
0.4 mg IM 30-60 minutes before anesthesia
Atropine
Side Effects
tachycardia
fever
flushed
Atropine
Pre-Op Uses
decrease pharyngeal secretions
decreases anxiety
reduces side effects of anesthesia agents
induce amnesia
glycopyrrolate (Robinul)
similar to Atropine
decrease pharyngeal secretions, decreases anxiety, reduce side effects of anesthesia agents, induce amnesia
Scopolamine
Route
patch worn behind the ear
Scopolamine
Uses
prevents nausea
decreases oral and respiratory secretions
Sedatives, Hypnotics, & Anxiolytics
Action
CNS Depressants
Someone can get a combo of drugs from these categories but they’ll be in smaller doses b/c they have an additive effect
Sedatives, Hypnotics, & Anxiolytics
Subclasses
Benzodiazepines
Barbituates
Non-benzodiazepine/non-barbituate
Benzodiazepines
Action
Potentiate GABA (gamaamniobutyric acid) - an inhibitory neurotransmitter that results in CNS depression
Benzodiazepines
Uses
decrease anxiety
induce sedation
amnesic effects
Benzodiazepines
Examples
midazolam (Versed)
lorazepam (Ativan)
**benzos end in “lam” or “pam”
What anti-emetic drug is commonly given before, during and after surgery? Side effects?
(Zofran) ondansetron
Respiratory depression and lethargy
Common drug name for proton pump inhibitor. Prevents nausea and vomiting and gastric reflux. Reduces acidity.
(Prilosec) omeprazole
What drugs potentiate GABA, decrease anxiety, induce sedation, have amnesic effects and create CNS depression.
Used for MAC induce neuromuscular relaxation and decrease muscle spasms.
(Versed) midazolam
(Ativan) lorazepam
-Both Benzodiazepines
If these drugs are used you decrease the amount of anasthesia needed, decrease anxiety, increase pain control and cause sedation.
Opioids
Common mentioned in ppt
Morphine, fentanl (sublimaze) and hydromorphone (dilaudid)
Mainly used to decrease pharyngeal secretions.
Atropine - An anticholinergic
Also decreases anxiety and reduces the effects of anasthetic agents.
Side effects are flushed, fever and tacycardia
Drug similar to atropine?
(Robinul) glycopyrrolate- an anticholinergic
Anticholinergic that prevents nausea and decreases respiratory secretions. Often a patch.
Scopolamine
metoclopramide (Reglan)
Uses
increases gastric emptying
Neuromuscular Blocking agents
facilitate intibation and promote paralysis during general anasthesia
(Anectine)- succinylcholine
(Norcuron) - vecuronium
(Zemuron) - rocuronium
Antibiotics
Use
decrease risk of post-op wound infection
must monitor for allergic reaction
General anesthesia Inhalation meds
Volatile liquids
(Forane)-isoflurane
(Suprane)-desflurane
(Ultane)-sevoflurane
IV general anesthesia meds
barbituate with fast acting rapid induction
(Pentothal)-thiopental
IV general anesthesia meds
non-barbituate hypnotic
(diprivan)- propofol Michael Jackson :(
(Amidate) - etomidate
Most common meds used for MAC
Fentanol and versed
treatment for malignant hyperthermia
Dantrolene
Opiod antagonist
Narcan
Narcotic analgesics
Examples
morphine
fentanyl (Sublimaze)
hydromorphone hydrochloride (Dilaudid)
Narcotic analgesics
Uses
relieves pain
decreases anxiety
sedation
Opioids
Uses
relieve anxiety
diminish the amount of anesthesia needed
Proton Pump Inhibitors (PPIs)
Example
omeprazole (Prilosec)
General Anesthesia
Step#4
Emergence
either let meds wear off or give anecdote to cause pt to wake up
Antiemetics
Examples
ondasetron (Zofran)
metoclopramide (Reglan)
ondasetron (Zofran)
Side Effects
respiratory depression
lethargy
ondasetron (Zofran)
Administered when?
given before, during, and after surgery
metoclopramide (Reglan)
Uses
increases gastric emptying
Name an adjuvant agent that decreases inflammation
Corticosteroids
Name an adjuvant agent that relieves muscle spasms
Anxiolytics - Inhibits anxiety
Name an adjuvant agent that is used for chronic pain
(Elavil) - a tricyclic antidepressant
Types of Regional Anesthesia
Spinal Epidural Caudal Peripheral nerve block IV regional extremity block
Meds used to treat somrthing else and found to be useful in in treating other ailments as well.
Adjuvant agents
metoclopramide (Reglan)
Administered when?
before and after surgery
Antibiotics
Use
decrease risk of post-op wound infection
Antibiotics
Timed administration
given within 1 hour of first incision and may be continued for 24 hours post-op
Antibiotics
Type
broad spectrum
General Anesthetics
Action
produce state of unconsciousness and whole body anesthesia by depressing CNS and blocking pain stimuli in cerebral cortex
(pt must be intubated)
TIVA
total intravenous anesthesia
Regional Anesthesia
Disadvantages
nerve damage urinary retention spinal headache difficult to position patients if they have arthritis patient may twitch during surgery
General Anesthesia
Advantages
no movement, no twitches
General Anesthesia
Disadvantages
severe hemodynamic changes
must monitor cardiovascular and respiratory systems
CNS depression
Depresses all vital centers of the body
General Anesthesia
Step #1
Pre-induction
versed or ativan = to help pt relax and helps with induction phase of anesthesia
General Anesthesia
Step #2
Induction
short acting med (ex: nitrous oxide) to produce unconsciousness and neuro blocking to cause paralysis
General Anesthesia
Step #3
Maintenance
may have meds changed depending on length of surgery, keep client anesthetized
General Anesthesia
Step#4
Emergence
either let meds wear off or give anecdote to cause pt to wake up
Barbiturate IV General Anesthesia Med
thiopental (Pentothal)
rapid induction
Nonbarbiturate Hypnotic IV General Anesthesia Meds
etomidate (Amidate)
proprfol (Dipravan)
Inhalation (volatile liquids) General Anesthesia Meds
isoflurane (Forane)
desflurane (Suprane)
sevoflurane (Ultane)
**all end in -ane
nitrous oxide
uses
potentiate volatile agents which speeds induction
reduces total dose of general anesthesia
good analgesic potency
Neuromuscular Blocking Agents
Uses
facilitate intubation
promote neuromuscular relaxation (paralysis)
Neuromuscular Blocking Agents
Examples
succinylcholine (Anectine)
vecuronium (Norcuron)
rocuronium (Zemuron)
Reversal-anticholinesterase agents
neostigmine
pyridostigmine
**end in -stigmine
Types of Regional Anesthesia
Spinal Epidural Caudal Peripheral nerve block IV regional extremity block
Spinal Regional Anesthesia
local anesthetic injected into subarachnoid space
involves lower half of body
does not affect consciousness
Risks of Spinal Anesthesia
CNS depression if anesthetic reaches higher levels
infection
nerve damage
Epidural Anesthesia
local anesthetic injected into epidural space a T, L, or S level
can become spinal block if the doc goes in too far
Caudal Anesthesia
injected into the epidural space but into the sacral canal
Peripheral Nerve Block
anesthetizes individual nerves or nerve plexuses
IV Regional Extremity Block
injected into vein to anesthetize limb
Regional Anesthesia
Advantages
no CNS depression
doesn’t impact respiratory or cardiovascular systems
Regional Anesthesia
Disadvantages
nerve damage urinary retention spinal headache difficult to position patients if they have arthritis patient may twitch during surgery
Topical Anesthesia
applied directly to the area to be desensitized
Infiltration Anesthesia
injection of local anesthetic into skin or subcutaneous tissue
(similar to Novocaine at the dentist)
Field Block Anesthesia
injection of anesthetic into area around incision. a deeper injection than infiltration, have to go layer by layer
On-q Pump
needle is placed just under skin and delivers anesthesia for 24 hours
Local Anesthetic
Disadvantages
skin irritation
may not work or be as effective
patient can still feel the pressure
Monitored Anesthesia Care (MAC)
provides anxiolysis, amnesia, and analgesia while avoiding a depth of sedation that would require respiratory support. speeds up post-op recovery and lessens anesthetic risks. physician supervision is always required. resuscitative equipment nearby.
versed and fentanyl are the most common.
acupuncture
ancient Chinese technique using insertion of needles into meridians of the body. may be related to gate control theory by stimulating larger sensory nerve fibers or triggering endorphins.
crythermia
use of cold to induce anesthesia
Elavil (tricyclic antidepressants) - adjuvant use
adjuvant agent used for chronic pain
anxiolytics - adjuvant use
adjuvant agent used for muscle spasm
corticosteroids - adjuvant use
adjuvant agent used to decrease inflammation
anticonvulsant - adjuvant use
gabapentin (Neurontin)
pregabalin (Lyrica)
adjuvant agents used for neuropathic pain
