Intravenous Anesthetics Flashcards
1
Q
What is the clinical presentation of propofol infusion syndrome?
A
- acute refractory bradycardia > systole + at least one of the following
- metabolic acidosis (base deficit > 10 mmol/L)
- rhabdomyolysis
- enlarged or fatty liver
- renal failure
- hyperlipidemia
- lipemia (cloudy plasma or blood) - early sign
2
Q
What are side effects of fospropofol?
A
- genital and anal burning
3
Q
What is the metabolite of fospropofol?
A
- propofol
4
Q
Ketamine provides analgesia for what type of pain?
A
somatic > visceral
5
Q
What is the active metabolite of ketamine?
A
norketamine
6
Q
Is ketamine a myocardial depressant or stimulant?
A
- depressant
- the CV effects of ketamine require and intact SNS
- myocardial depressant effects will be umasked in its with depleted catecholamine stores (sepsis) or sympathectomy
7
Q
How is etomidate cleared from the body?
A
- hepatic P450 enzymes + plasma esterases
- rapid awakening is d/t redistribution (NOT metabolism)
8
Q
What are drugs to avoid in the pt with acute intermittent porphyria?
A
- barbiturates
- etomidate
- glucocorticoids
- hydralazine
9
Q
What is the anesthetic management for acute intermittent porphyria?
A
- liberal hydration
- glucose supplementation (dec’s ALA synthase activity)
- heme arginate (dec’s ALA synthase activity)
- prevention of hypothermia
- it is made worse by stimulation of ALA synthase, emotional stress, prolonged NPO status, & CYP 450 induction
10
Q
What is the relative potency from greatest to least of diazepam, lorazepam, and midazolam?
A
- lorazepam > midazolam > diazepam
11
Q
Rank each benzo according to it’s half-life (shortest to longest)
A
- midazolam > lorazepam > diazepam
