IV anesthetics

Question 1

IV anesthetics

Answer 1

*climbing IV everywhere
propofol (introducing prosperpo the hypnotist)
etomidate (introducing the intimidator)
ketamine (introducing snake taming nomad)
barbituates (introducing the barber)
benzodiazepines (bens diner)

Question 2

IV anesthetics uses

Answer 2

mainly for the induction of anesthesia and minor sedation and patients in the ICU

Question 3

propofol uses

Answer 3

anesthesia induction b/c lipophilic preferentially enter the brain and SC for rapid action (introducing)
maintainenece of anesthesia by itself or combo with others (maintain your sanity)

Question 4

propofol how it works

Answer 4

potentiates Cl current through GABA-A receptor complex (Cab-A behind the hypnotist)

Question 5

propofol side effects

Answer 5

most profound vasodilation in arterioles and veins = decreased pre and after load = hypotension (dilated sleeves and pants)

Question 6

etomidate how it works

Answer 6

potentiates Cl current through GABA-A receptor complex (Cab-A behind the hypnotist)

Question 7

etomidate feature

Answer 7

preservation of cardiac stability after bolous injection, minimal changes to BP, HR, CO useful for patients with compromised cardiac contractility (stabilizing person above head)

Question 8

ketamine how it works

Answer 8

inhibition of the NMDA receptor complex (nomad on sign and inhibited camel)

Question 9

ketamine characteristic state

Answer 9

dissociative anesthesia - eyes remain open with a slow nystagmic gaze (hypnotic cobra)

Question 10

ketamine side effectc

Answer 10

emergence reactions: vivid dreams, hallucinations out of body experiences (colored smoke)
cardiovascular stimulation, increased BP, HR, CO (stimulated heart cobra)
analgesia, bronchodilation, less resp depression, convenient administration = good for uncooperative peds patients

Question 11

benzodiazepines for anesthesia induction

Answer 11

midazolam, lorazepam

used for conscious sedation for minor procedures - they can maintain their airway and follow commands (colonoscopy)

Question 12

barbituates for anesthesia induction

Answer 12

least used b/c replaced by propofol
thipental (the ol quick shave, and weeny pental)
ultra short acting (5-10 minutes) used for rapid sequence intubation, highly lipid soluble and immediately enters the CNS