Med Review Induction Agents Flashcards
Propofol is typically supplied as __% solution, equating to what concentration?
Propofol 1% = 10 mg/mL
____ is typically given as pretreatment for propofol administration, why?
1-2% Lidocaine to avoid pain with propofol injection
Propofol
- E1/2:
- protein binding:
- E1/2: 0.5 - 1.5 hours
- protein binding: 98%
Which induction agent causes bronchodilation and suppresses SNS response to laryngoscopy?
Propofol
What are some complications that can occur with propofol administration?
- Lipidemia
- Englarged liver
- Metabolic acidosis
- Rhabdo
- Myoglobinuria
- Propofol Infusion Syndrome
Propofol Infusion Syndrome is characterized by what symptoms?
Sudden onset of bradycardia that leads to asystole and is resistant to treatment
What is the MOA of Etomidate?
GABA modulator (does not mimic)
Which induction agent is generally considered cardiovascularly stable
Etomidate
Which induction agent is beneficial in unstable patients, trauma, elderly, and cardiovascular instable patients?
Etomidate
Which drug can cause adrenocortical suppression? How long does this effect typically last?
Etomidate
- can last about 4 - 8 hours
Which induction agent can cause PONV in 30% of patients?
Etomidate
Ketamine causes what kind of anesthesia?
Dissociative anesthesia, not a hypnotic. Also provides intense analgesic and profound amnestic effects
What is the IM dose for ketamine? What patient population is this good for?
4 - 8 mg/kg
for pediatrics
What is ketamine metabolized into?
metabolizes 20-30% into nor-ketamine (active metabolite)
What is the E1/2 of ketamine
E1/2 : 2 hours
What are contraindications for ketamine?
No MAOIs (increases epinephrine)
How does ketamine administration affect epinephrine and norepinephrine? What effect does this have?
increases Epi and inhibits reuptake of NorEpi
Causes:
- ↑SVR/PVR
- ↑ HR
- ↑ CO
- ↑ SNS
What positive airway effects does ketamine have?
- Intense Bronchodilation
- Reflexes remain intact but not protected
What negative airway effect does ketamine produce? What should be done because of this?
- increased salivary secretion (sialagogue)
- should administer Glycopyrrolate (robinul)
What psychedelic effects can ketamine cause? What does should be done because of this?
Delirium and hallucinations
- should administer with benzodiazepine, barbiturate, or propofol
What is the adult dose for methohexital (brevital)?
1.5 mg/kg
What are the main negative effects of methohexital administration?
- cause myoclonus even at low dose
- causes seizure activity even at low dose
- airway irritability
What are the main uses for methohexital?
- suppress seizures at high doses
- ECT (doesnt suppress seizures): can map seizure foci
- cardioversion
