IV Anesthetic Medications

Question 1

Etomidate

1. Induction Dose
2. Duration of Action
3. Mechanism of Action

Answer 1

1. .2-.3 mg/kg
2. 3-8 minutes
3. Assumed to enhance the effects of GABAa at the B3 subunits -> rapid onset of sleep 30-60 seconds
   * *Beware adrenal suppression

Question 2

Ketamine

1. Induction Dose
2. Duration of Action
3. Mechanism of Action

Answer 2

1. 1-2 mg/kg
2. 5-10 minutes
3. Does NOT work at GABA sites
   Has action inhibiting glutamate at NMDA, at Opioid receptor agonism, monoaminergic, muscarinic, and voltage gated Ca++ channels

Question 3

Lorazepam

1. Induction Dose
2. Duration of Action
3. Mechanism of Action

Answer 3

1. .03-.1 mg/kg
2. 60-120 minutes
3. Facilitates the action of GABA a the a subunit (1a and 2B) → enhancing the opening of chloride channels → hyper polarization of post synaptic membrane (resistant to excitation)

Question 4

Midazolam

1. Induction Dose
2. Duration of Action
3. Mechanism of Action

Answer 4

1. .1-.3mg/kg
2. 15-20 minutes
3. Facilitates the action of GABA a the a subunit (1a and 2B) → enhancing the opening of chloride channels → hyper polarization of post synaptic membrane (resistant to excitation)

Question 5

Methohexital

1. Induction Dose
2. Duration of Action
3. Mechanism of Action

Answer 5

1. 1-1.5 mg/kg
2. 4-7 minutes
3. Interact with GABAa (a subunit) receptor to directly activate the chloride ion channels, increasing their duration of opening

Question 6

Thiopental

1. Induction Dose
2. Duration of Action
3. Mechanism of Action

Answer 6

1. 3-5 mg/kg
2. 5-10 minutes
3. Interact with GABAa (a subunit) receptor to directly activate the chloride ion channels, increasing their duration of opening

Question 7

Propofol

1. Induction Dose
2. Duration of Action
3. Mechanism of Action

Answer 7

1. 1.5-2.5 mg/kg
2. 3-8 minutes
3. Delays dissociate of GABA from receptors -> increases GABA activated opening of chloride ion channels
   * some activity at glycine receptors, NO spinal cord depression, CENTRAL only

Question 8

Dexmedetomidine

1. Premedication Dose
2. Mechanism of Action

Answer 8

1. .33-.67 mcg/kg 15 minutes before surgery
2. Selective a2 agonist -> inhibit adenylate cyclase and modulate ion channels in the brain and spinal cord and leads to sympatholysis, sedation, and antinociception