Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anesthetics > IV Induction Agents > Flashcards

IV Induction Agents Flashcards

1
Q

Thiopentone - class and properties

A

Ultra-short acting barbiturate

Yellow powder mixed with 20ml water to give 2.5% solution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Thiopentone - dosage

A

IVI: 3-6mg/kg (titration)
Onset: 30-40 seconds
Duration: 10-30 minutes

PR: 30-40mg/kg (kinders)
Onset: 8-10 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Thiopentone - contraindications

A
  • asthma
  • porphyria
  • not for TIVA (accumulation d/t enzyme saturation)
  • barbiturate allergy
  • history of paradoxic excitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Thiopentone - metabolism

A

Redistribution: 2-7 minutes
Hepatic metabolism and renal excretion
Half life 3-8 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Thiopentone - physiological effects

A

CNS

  • hypnosis and anesthesia without analgesia
  • anticonvulsant
  • ↓ ICP (decreased cranial blood flow)
  • taste of onions/ garlic
  • smooth and rapid recovery

CVS

  • decreased SVR and myocardial depression (↓ BP)
  • reflex increase in heart rate

Resp

  • respiratory depression
  • increased sensitivity to laryngospasm
  • increased bronchial tone

Other

  • decreased renal and hepatic blood flow
  • histamine release
  • ↓ IOP
  • nausea and vomiting (low incidence)
  • stimulate porphyrin production
  • enzyme inducer
  • minimal muscle relaxation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Thiopentone - complications

A

Perivenous injection - tissue necrosis (treat with hyaluronidase injection)
Intra-arterial injection - pain, vasoconstriction, thrombosis and necrosis (treated with intravascular local anesthetic and heparin)
Thrombophlebitis
Laryngospasm
Hypotension
Anaphylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Propofol - class and properties

A

Non barbiturate short acting intravenous anaesthetic agent, alkyl phenol

Milky white emulsion (stabilised in fat emulsion). Comes in 20ml or 50ml vials, concentration 1% or 2%

Contains no antimicrobial preservative, therefore work aseptically and do not store once opened

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Propofol - dosage

A

Induction: 1-2.5mg/kg
Onset: 90-100 seconds
Duration: 5-10 minutes

Infusion: 50-150μg/kg/hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Propofol - contraindications

A
  • obstetrics
  • pediatrics (<3)
  • egg or soy allergy
  • hypertension or hypovolemia
  • disorders of fat metabolism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Propofol - metabolism

A

Redistribution: 2-8 minutes
Hepatic Metabolism and renal excretion
Half life: 4-24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Propofol - physiological effects

A

CNS

  • hypnosis and anesthesia without analgesia
  • ↓ ICP
  • anticonvulsant
  • quicker complete recovery

CVS

  • decreased SVR and contractility (↓ BP)
  • no change in heart rate - baroreceptor reflex inhibited

Respiratory

  • respiratory depression (apnea)
  • no histamine release
  • depresses upper airway reflexes

Other

  • decreased renal and hepatic blood flow
  • ↓ IOP
  • antiemetic
  • antipruritic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Propofol - complications

A 
Pain on local injection (prevented with 20mg lignocaine/ 200ml propofol)
Hypotension
Apnea
Expensive
Propofol Infusion Syndrome
Excitatory phenomena
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Etomidate - class and properties

A

Carboxylated imidazole

Clear liquid. 10ml amps, concentration 2mg/ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Etomidate - dosage

A

Induction: 0.2-0.6mg/kg
Onset: 1 min
Duration: 3-5 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Etomidate - contraindications

A

Not for infusion
Depressed adrenal function
Porphyria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Etomidate - metabolism

A

Redistribution: 3 min
Hepatic metabolism with renal excretion
Half-Life: 3-5 hours

17
Q

Etomidate - physiological effects

A

CNS

  • hypnotic
  • anticonvulsant
  • involuntary muscle movements during induction
  • ↓ ICP
  • rapid awakening with no hangover

CVS

  • transient ↓ SVR causes hypotension
  • generally stable wrt HR, contractility and CO

Other

  • mild respiratory depression
  • ↓ IOP
  • postoperative nausea and vomiting (frequent)
  • no histamine release
  • depress 11B-hydroxylase
18
Q

Etomidate - complications

A

Pain on local injection
Superficial thrombophlebitis
Excitatory phenomena (spontaneous movements, myoclonus, dystonia, tremors)
Transient adrenal suppression

19
Q

Ketamine - class and properties

A

Non-barbiturate; phencyclidine derivative

10/50/100mg/ml vials

20
Q

Ketamine - dosage

A

IV induction: 0.5-2mg/kg
Onset: 30-40 seconds
Duration: 10-15 minutes

IM induction: 4-6mg/kg
Onset: 2 minutes

TIVA: 30-90μg/kg/min

Analgesia: 0.1-0.25mg/kg IV

21
Q

Ketamine - contraindications

A

Hypertension, IHD
↑ ICP
Psychiatric patients
Open eye injury

22
Q

Ketamine - metabolism

A

Redistribution: 11-16 minutes
Hepatic metabolism and renal excretion
Half-Life: 2-3 hours

23
Q

Ketamine - physiological effects

A

CNS

  • hypnosis and anesthesia with analgesia amnd amnesia
  • dissociative state
  • hallucinations
  • ↑ ICP
  • tonic-clonic movements may occur
  • anticonvulsant

CVS

  • hypertension
  • tachycardia

Respiratory

  • potent bronchodilator
  • apnea in high doses
  • salivation (treat with anticholinergic)

Other

  • nystagmus
  • ↑ IOP
  • nausea and vomiting (so-so)
24
Q

Ketamine - complications

A

Hypertension
↑ ICP
Abnormal movements
Emergence delerium

25
Q

Midazolam - class and properties

A

Short-acting imidazo-benzodiazepine

Clear solution concentration 0.1% and 0.5%

26
Q

Midazolam - dosage

A

Induction: 0.1-0.4mg/kg IV
Onset: 2-3 min

Sedation: 0.01-0.1mg/kg IV

27
Q

Midazolam - contraindications

A

Myasthenia gravis

Acute narrow angle glaucoma

28
Q

Midazolam - metabolism

A

Hepatic metabolism and renal excretion

Half-life: 2-3 hours

29
Q

Midazolam - physiological effects

A

CNS

  • sedation
  • anxiolysis
  • hypnosis
  • anticonvulsant
  • muscle relaxant
  • anterograde amnesia
  • ↓ ICP

CVS

  • slight hypotension
  • slight tachycardia

Other

  • apnea (increased risk with alcohol, and high dose)
  • nausea and vomiting (meh)
30
Q

Midazolam - complications

A

Excellent local tolerance

Prolonged awakening

31
Q

Propofol infusion syndrome

A

Risk factors:

  • poor oxygen delivery
  • sepisi
  • serious cerebral injury
  • high dose (>4mg/kg/hour)

Features

  • acute refractory bradycardia to asystole
  • metabolic acidosis, hyperkalemia
  • rhabdomyolysis, skeletal myopathy
  • hepatomegaly
  • lipaemia
  • cardiomyopathy w/ acute cardiac failure
  • hepatomegaly
32
Q

Thiopentone - mechanism of action

A
  • reduces dissociation of GABA from GABAA receptors
  • direct activation of GABAA receptors
  • acts on glutamate, adenosine, and nicotinic receptors
  • inhibit calcium-dependent release of NT
33
Q

Propofol - mechanism of action

A
  • prolongation of GABA action on GABAA receptors
  • inhibition of NMDA receptors
  • raised dopamine in nucleus accumbens (pleasure)
  • decrease serotonin in area postrema (antiemetic)
  • depressed SC activity (antipruritic)
34
Q

Etomidate - mechanism of action

A

Binds GABAA receptors and enhances affinity for GABA

35
Q

Ketamine - mechanism of action

A
  • competitive NMDA antagonist
  • opioid receptor agonist
  • activate descending monoaminergic pain pathways
  • acts on muscarinic receptors
36
Q

Midazolam - mechanism of action

A

Enhance chloride ion conduction through GABAA receptors

Anesthetics (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions