Inhaled and IV Anesthetics Flashcards
*Sevoflurane, Halothane, Isoflurane
Inhaled and IV Anesthetics Inhaled Anesthetics: Nitrous Oxide Organ System Effects • *Depress cardiac contractility • *Decrease Mean Arterial Pressure • *Bronchodilation • *Respiratory Depression ADE - *Nephrotoxicity • *Hepatotoxicity • Nausea and Vomiting - **Malignant Hyperthermia (*Dantrolene - antidote)
Thiopental and Methohexital
Inhaled and IV Anesthetics IV Anesthetics: Barbiturates Therapeutic Indication • *Induction of Anesthesia • *Neuroprotection Organ System Effects • *Depression (CNS) • *Cerebral vasoconstrictors • *Decrease in systemic blood pressure • *Respiratory Depression – transient apnea MOA - Increase duration of Cl- channel opening at GABAA receptor ADE • *Severe pain and vasoconstriction • *Postoperative nausea and vomiting
Propofol
Inhaled and IV Anesthetics IV Anesthetics: GABAA Potentiators - Most frequently administered drug for induction Therapeutic Indication • Induction & maintenance of Anesthesia • Sedation Organ System Effects • *CNS depression • *Decrease system blood pressure • *Bradycardia & Asystole • *Apnea MOA - Potentiate Action of GABAA receptor
Etomidate
Inhaled and IV Anesthetics IV Anesthetics: GABAA Potentiators Therapeutic Indication • *Induction of anesthesia • (esp. compromised myocardial contractility) Organ System Effects • *Cerebral vasoconstrictor • *Reduction CMRO2 • *Modest decrease in systemic blood pressure • *Depression on ventilation • *Adrenocortical suppression • *Not used for continuous infusion • *Postoperative nausea and vomiting MOA - Potentiate Action of GABAA receptor
Midazolam
Inhaled and IV Anesthetics IV Anesthetics: Benzodiazepines • Anxiolytic and retrograde amnesia - premedication Therapeutic Indication • *Preoperative medication • IV sedation • Suppression of seizure activity Organ System Effects • *Decrease CMRO2 • *Decrease in systemic blood pressure • *Minimal respiratory depression • *Decreased ventilation response to CO2 (esp. opioids) • *Pain during injection MOA - Increase Cl- opening frequent at GABAA receptor
Ketamine
Inhaled and IV Anesthetics
Therapeutic Indication
• *Induction of Anesthesia/adjunct
• *Premedication (mentally challenged/pediatric)
Organ System Effects
• *Vasodilator increases blood flow & CMRO2)
• *Vivid colorful dreams, hallucinations ensory distortions etc.
• *(transient) increase in systemic blood pressure, HR, CO
• *Minimal respiratory depression
MOA
- Major effect by Inhibition of NMDA receptor
Dexmedetomidine
Inhaled and IV Anesthetics
Therapeutic Indication
• *Short-term sedation intubated/ventilated patients in ICU
Organ System Effects
• *Hypnosis/analgesic
• *Decrease in cerebral blood flow
• *Decrease in HR,SVR, systemic blood pressure
• *Moderate decrease in tidal volume and minimal hange on respiratory rate
