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Dental Nursing Sedation 2024 > Intravenous sedation > Flashcards

Intravenous sedation Flashcards

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1
Q

What is the brand name for Midazolam?

A

Hypnovel

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2
Q

What is the brand name for Propofol?

A

Diprivan

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3
Q

What is the brand name for flumazenil?

A

Annexate

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4
Q

What is the half life of midazolam?

A

1.5 - 2.5 hours

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5
Q

What is the half life of flumazenil?

A

50 minutes

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6
Q

What is the initial recommended bolus of midazolam to ASA I patients?

A

2mg over 30 seconds

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7
Q

What is the initial recommended bolus of midazolam to elderly patients?

A

1 - 1.5mg, observe for 2 minutes+

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8
Q

Name 3 side effects of midazolam

A

Respiratory depression
Coughing
Headaches & drowsiness
Nausea & vomiting

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9
Q

If midazolam is used in conjunction with an opiate, which drug should be administered first?

A

Opiate

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10
Q

What is the pH of midazolam?

A

3.4

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11
Q

Name the 3 dosages that midazolam is available in

A

10mg in 5ml
10mg in 2ml
5mg/5ml

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12
Q

When did midazolam first become available in the UK?

A

1983

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13
Q

What should NOT be administered to a patient experiencing anaphylaxis from midazolam?

A

Flumazenil - It is a benzodiazepine like midazolam, therefore it should not be used as a reversal drug if someone is allergic to benzodiazepines

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14
Q

What is the onset time of midazolam?

A

1 - 3 minutes

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15
Q

Midazolam should be titrated in ___ mg increments

A

0.5 - 1mg increments

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16
Q

What does GABA stand for?

A

Gamma Amino Butyric Acid

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17
Q

How many phases are there in intravenous sedation?

A

4 Phases

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18
Q

What drug is not licenced for use in general dental practices?

A

Propofol

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19
Q

What emulsion is propofol available in?

A

200mg/20ml

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20
Q

Midazolam is excreted by the ___ ?

A

Kidney

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21
Q

What is the maximum dose of flumazenil that can be administered in a medical emergency?

A

1mg

22
Q

When two or more drugs are used in conjunction together, what is this known as?

A

Advanced sedation

23
Q

Why is erythromycin contraindicated in midazolam use?

A

It inhibits the metabolism of midazolam, increasing it’s effect

24
Q

What is the alpha half life of midazolam?

A

4 - 18 minutes

25
Q

What is the beta half life of midazolam?

A

1 - 4 hours

26
Q

What does alpha half life relate to?

A

How the drug is redistributed throughout the body

27
Q

What does the beta half life relate to?

A

How the drug is eliminated from the body

28
Q

What is the recovery time for Propofol?

A

5 minutes

29
Q

What is the half life of flumazenil?

A

50 minutes

30
Q

What is the half life of Propofol?

A

2 - 24 minutes

31
Q

What is the reversal drug for fentanyl?

A

Naloxone Hydrochloride

32
Q

What is the dosage for ketamine?

A

1-2mg per kg IV

33
Q

If midazolam and Propofol are used together, what will you need?

A

A dedicated sedationist

34
Q

What are 3 contraindications to flumazenil?

A

Benzodiazepine dependence
Coronary heart disease - Stress of reversal places unnecessary stress on the heart
Epilepsy - most epilepsy medication belongs to the benzodiazepine family, therefore flumazenil will reverse their epilepsy medication

35
Q

What schedule controlled drug is Propofol?

A

Schedule IV (4) therefore should be under lock and key

36
Q

Name 3 contraindications for Propofol

A

Prescribed respiratory depressants
Pregnancy & nursing mothers
Allergy to eggs

37
Q

What is beta half life?

A

Metabolism and excretion - drug is broken down by the body and eliminated

37
Q

What is alpha half life?

A

Distributions and redistribution - the drug is introduced into the body and redistributed throughout

38
Q

After how long is it expected a patient will reach stage four of sedation?

A

An hour

39
Q

What is phase 1 of intravenous sedation?

A

The drug is at its maximum potency.
Co-ordination is impaired
Positive eve’s sign
Unaware of surroundings

40
Q

What is phase 2 of intravenous sedation?

A

Alpha half life begins - drug potency decreases as it is redistributed throughout the body
Awareness increases

41
Q

What is phase 3 of of intravenous sedation?

A

Anxiolytic effect is still active
Patient starts to feel more like themselves
Beta half life has not yet occured

42
Q

What is the usual dose of midazolam during IV sedation?

A

2.5mg - 7.5mg

43
Q

When two intravenous drugs are titrated together, it is known as what?

A

Polypharmacy

44
Q

What drug enhances the metabolism of midazolam?

A

St John’s wort - resulting in a reduced effect

45
Q

How many vials of flumazenil should be available when sedation is taking place?

A

minimum of two

46
Q

1mg of flumazenil equates to how many ampoules?

A

2

47
Q

How is flumazenil excreted?

A

Urine

48
Q

Which intravenous drug does not have a reversal?

A

Propofol

49
Q

What schedule drug is Propofol?

A

Schedule IV

50
Q

Which drug can be administered intravenously, but also drank as a liquid?

A

Midazolam

Dental Nursing Sedation 2024 (7 decks)

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