GENERAL INTRAVENOUS

Question 1

what are the drugs?

Answer 1

barbiturates

• thiopental
• methohexital

propofol
etomidate
ketamine

Question 2

name this barbiturate?

not used in the USA
used for induction due to rapid onset of action
not good for maintenance sine it has zero order kinetics and builds up in fat stores
cardiac:
-decrease BP
-induces tachycardia
-decreased CO

resp decreased and decreased ICP

Answer 2

thiopental

Question 3

barbiturate that is an induction agent used for patients undergoing electroconvulsive therapy (ECT)

activates seizure foci and lowers seizure threshold, facilitating ECT

Answer 3

methohexital

Question 4

1st line used
MOA is GABA potentiation
used for induction, maintenance and ICU sedation

neutral on HR because of the blunted baroreceptor reflex

good: rapid onset/offset, less hangover, antiemetic and anticonvulsant properties
bad: hypotension, injection site pain, propofol related infusion syndrome

Answer 4

propofol (1st line)

Question 5

back up to propofol, when it cant be used, contraindicated

GABA potentiation MOA
used for induction

good: excellent hemodynamic stability, rapid onset/offset, anticonvulsant properties
bad: high propensity for post op N/V, injection site pain, myoclonic movements

Answer 5

etomidate

Question 6

inhibits NMDA receptors
used for induction, maintenance, supplement to general anesthesia to reduce opioid needs

increases bronchodilation, decreases resp drive

cerebral analgesia, dreams, increased ICP

good: quick onset/offset, analgesic effects, minimal resp depression
bad: psychomimetic effect, increased ICP

Answer 6

ketamine

Question 7

advantageous for procedures where rapid return to a peroperative mental status is desirable

Answer 7

propofol

Question 8

usually reserved for patients at risk for hypotension or MI

Answer 8

etomidate

Question 9

best suited for patients w/ asthma or for children undergoing short, painful procedures

Answer 9

ketamine