IV Anesthetics Flashcards
Propofol MOA
GABA(A) agonist
Propofol Infusion Sedation
25-100 mcg/kg/min
Propofol Infusion TIVA
100-300 mcg/kg/min
Propofol Induction Dose
- 5-2.5 mg/kg -Adults
2. 5-3.5 mg/kg -Peds
Etomidate MOA
GABA(A) modulation
Etomidate Induction Dose
0.2-0.4 mg/kg
Ketamine MOA
NMDA Antagonist
Ketamine Induction Dose
1-3 mg/kg IV
4-8 mg/kg IM
Ketamine as an adjunct analgesic
0.2-0.5 mg/kg
Ketamine Infusion
2-15 mcg/kg/min
Dex MOA
alpha 2 agonist
Dex premed dose
0.33-0.67 mcg/kg 15 minutes before surgery
Dex MAC dosing
1 mcg/kg over 10 minutes and then 0.7 mcg/kg/min keeps BIS 70-80
Barbituates MOA
GABA(A) agonist
Benzodiazepine MOA
GABA(A) agonist
Midazolam Dose
- 5-4 mg IV - Adults
- often 2mg bc that is what is in a vial
0.1-0.2 mg/kg IV -Peds
Diazepam dose
5-10 mg IV -Adults
0.2-0.3 mg/kg IV -Peds
Lorazepam PO pre-med dose
0.5-2.0 mg at HS and 0.5-2.0 mg PO at 0600
Thiopental induction dose
3-5 mg/kg
Methohexital induction dose
1-1.5 mg/kg
Lorazepam dosing for amnesia
50 mcg/kg (max 4 mg) amnesia for 6 hours
IV anesthetic that preserves CV function
Etomidate
Most Common IV anesthetic
Propofol
May cause R on T and Torsades
Droperidol
Antiemetics that cause sedation
Droperidol
Scopolamine
IV Anesthetics that cause pain at the injection site
Propofol
Etomidate
Cons to Ketamine
dysphoria, hallucinations, emergence delirium
increases BP, HR, ICP, CBF, CMRO2 (don’t use in neuro cases)
Amnestics
Benzos: Midazolam, Diazepam, Lorazepam
Hypnotics
Sodium Thiopental, Propofol, Etomidate
Analgesics
Opioids: Morphine, Meperidine, Fentanyl, Alfentanyl, Sufentanil, Remifentanil
Anxiolytics
Propofol Barbiturates (NaPentothal, Methohexital, Thiamylal) Etomidate Ketamine Benzos (Diazepam, Midazolam, Lorazepam) Opioids
Paralytics
Succinylcholine, Mivacurium, Rocuronium, Cisatracurium, Vecuronium, Pancuronium, Curare
Flumazenil
BZD reversal (competitive antagonist)
Propofol decreases PONV (T/F)
True
Propofol Infusion Syndrom
(PRIS) is a life-threatening condition characterized by acute refractory bradycardia progressing to asystole and one or more of: metabolic acidosis. rhabdomyolysis. hyperlipidemia. enlarged or fatty liver.
Typically with longer infusions and higher doses
Etomidate Cons
causes myoclonus
increases PONV
provides no analgesia
adrenal suppression
Barbiturates Cons
May cause hyperalgesia, can cause histamine release, Extravasation causes tissue sloughing, do not mix with succ (will make “concrete”), intraarterial injection causes severe vasoconstriction, induces the P450 system, contraindicated in patients with acute intermittent porphyria
Dex Pros
Reduces MAC of inhaled agents, reduces postoperative opioid requirements
Which of the intravenous induction agents has a direct vasoconstriction effect on cerebral blood vessels?
Sodium Pentothal
The initial recovery from intravenous induction agents is due to:
Redistribution
Increases CmRO2?
ketamine
Barbiturate activation of the GABAA Receptor does what to the Cl- channel?
increases the duration of time the Cl- channel is open
Increases CBF, CPP, and ICP
ketamine
should be avoided in patients with a phenol allergy?
propofol
