N365 Surgery Medications

Question 1

What class of drugs is Nitrous Oxide?

Answer 1

Gaseous General Anesthetic

Question 2

What is the general action of Nitrous Oxide?

Answer 2

Produces narcosis, analgesia and amnesia to varying degrees by causing progressive depression of the CNA; GABA receptor agonist, opiod agonist.

Question 3

What are ADR’s for Nitrous Oxide?

Answer 3

Free of major toxicities when given WITH OXYGEN. if not mixed with enough oxygen it can cause a compromise of normal tissues. Post-op nausea and vomiting.

Question 4

What is the ideal use of Nitroud Oxide?

Answer 4

Induction agent.

Question 5

What is the minimal amount of oxygen that must be mixed with Nitrous Oxide?

Answer 5

30% at least

Question 6

What class of drugs is Isoflurane (Forane)?

Answer 6

Inhaled general anesthetic, volatile.

Question 7

What about Isoflurane (Forane) makes it’s onset slower?

Answer 7

It’s more soluble in blood, intercellular fluid, and fatty tissue and therefore causes a slower onset.

Question 8

What is the action of Isoflurane (Forane)?

Answer 8

Progressive depression of CNS (exact action unknown). GABA glutamate receptor agonist.

Question 9

What are the main ADR’s of Isoflurane (Forane)?

Answer 9

Hypotension from vasodilation, Significant respiratory depression, can trigger malignant hyperthermia.

Question 10

What is a specific action of Isoflurane (Forane) on the trachea, and why is it specific to surgery?

Answer 10

Isoflurane relaxes the tracheal area and depresses reflexes leading to simpler intubation.

Question 11

What should you look for in a patient recovering from isoflurane (Forane)

Answer 11

Shivering

Question 12

What drug, when used with isoflurane, can cause malignant hyperthermia?

Answer 12

succinycholine

Question 13

What are some advantages of using IV Anesthetics?

Answer 13

rapid pleasant induction, no explosive hazards, low incidence of post op N&V

Question 14

What are some disadvantages of IV anesthetics?

Answer 14

Laryngospasm, bronchospasm, hypotension, and respiratory arrest.

Question 15

What are the uses of IV anesthetics?

Answer 15

to induce and maintain general anesthesia, basal anesthesia, and hypnosis.

Question 16

what is the main difference between barbituates and gaseous agents is?

Answer 16

safety

Question 17

Aspects of inhalation as a method of anethesia.

Answer 17

controlled minute by minute

Question 18

Aspects of IV administered anethesia.

Answer 18

once administered the course must continue until out of system.

Question 19

What class of drugs are barbiturates?

Answer 19

IV general anesthetic, ultra short acting.

Question 20

What class of drug is propofol (diprivan)?

Answer 20

IV general anesthetic, ultra short acting.

Question 21

What is the Action of propofol (diprivan)?

Answer 21

Promotes release of GABA, short action anesthetic. Not a controlled substance.

Question 22

What are ADR’s for propofol (diprivan)?

Answer 22

Respiratory depression, hypotension from vasodilation, risk of bacterial infection in lipid based emulsion: propofol infusion syndrome, injection site pain.

Question 23

What is propofol like for the patient?

Answer 23

Smooth, easy, and pleasant for patient, has antiemetic properties.

Question 24

Who should not receive propofol (divipran)?

Answer 24

patients with respiratory difficulties or heart disease.

Question 25

what is a nickname for propofol?

Answer 25

Milk of amnesia.

Question 26

What is Etomidate (amidate)

Answer 26

hypnotic agent used for induction, especially in patients with heart problems that can't have propofol (divipram).

Question 27

What is Fentanyl/droperidol combination known as Innovar?

Answer 27

Innovar is an opiod neuroleptic combination used for neurolept analgesia.

Question 28

What classification is Fentanyl (Sublimaze)?

Answer 28

Narcotic anethetic

Question 29

What is the action of Fentanyl (Sublimaze)?

Answer 29

Opioid agonist. Morphine like action (100 x more potent).

Question 30

What are the ADR's for Fentanyl

Answer 30

euphoria, miosis, N&V puritis, constipation, hypotension, respiratory depression, bradycardia,

Question 31

What is the BLACK BOX warning for Fentanyl (sublimaze)?

Answer 31

significant abuse potential

Question 32

Special Information for Fentanyl (Sublimaze)

Answer 32

Rapid administration can cause rigidity and apnea so patient must be closely observed.

Question 33

How often so you chance topical Fentanyl Patches (duragesic)?

Answer 33

Q 72 hours

Question 34

What other forms of fentanyl (sublimaze) are there

Answer 34

Lozenge on stick, and buccal tablets.

Question 35

What classification is ketamine?

Answer 35

dissociative anethetics, induces a trans like effect characterized by analgesia, quietute, and detachment from environment.

Question 36

What classification of drugs is Midazolam (Versed)

Answer 36

IV anesthetic, benzodiazepine

Question 37

What is the action for midazolam (Versed)?

Answer 37

neuropletic effect, exact action unknown. Acts on limbic, thalmic, and hypothamic regions to cause CNS depression and skeletal muscle relaxation.

Question 38

What are the ADR's for midazolam (Versed)?

Answer 38

Respiratory depression (even arrest), decreased altertness and amnesia, hypotension, hiccups, laryngospasm, loss of dexterity, some have reported muscle tremors, tachycardia, shortness of breath.

Question 39

What is the BLACK BOX warning for midazolam (Versed)?

Answer 39

Can cause respiratory depression and arrest.

Question 40

Special Information for Midazolam (Versed).

Answer 40

produces anterograde amnesia and loss of memory about procedure, can decrease anxiety. Midazolam can also have a prolonged anesthetic recovery period than barbiturates.

Question 41

What classification is Short-duration-mepivacaine (carbocaine), lidocaine (Xylocaine), and long duration bupicacaine (Marcaine)?

Answer 41

They are local anesthetics.

Question 42

What is the action of local anesthetics?

Answer 42

Unknown but though to stabilize or elevate the threshold of excitation of nerve cells without affecting the resting potential, thus preventing depolarization and transmission of nerve impulses.

Question 43

What are the ADR's of local anesthetics?

Answer 43

overdosage into CNS from periphery causing excitement, convulsions, and then CNS depression (Bradycardia, hypotension, cardiac arrest) N&V, pallor, apprehension.

Question 44

Special information regarding local anesthetics?

Answer 44

Loss of all sensation occurs, starting with pain. if becomes systemic, has serious CNS depressive effects. Vasoconstrictors are used to decrease CNS absorption.

Question 45

What is a topical example of a local anesthetic?

Answer 45

benzocaine

Question 46

What are the two major types of skeletal muscle relaxants?

Answer 46

Non-depolarizing NMJ agents and depolarizing NMJ agents.

Question 47

What class of drug is rocuronium (Zemuron)?

Answer 47

Non-depolarizing (competitive) neuromuscular junction blocking agent

Question 48

What is the action of rocuronium (Zemuron)?

Answer 48

Prevents ACH from acting, by occupying the cholinergic receptor sites. competitive antagonist.

Question 49

What are the ADR's for rocuronium ) Zemuron?

Answer 49

Tachycardia, muscle weakness, salivation, and hypertension.

Question 50

What reverses rocuronium (Zemuron)?

Answer 50

ACH of course

Question 51

What class of drugs is Succinylcholine (anectine?)

Answer 51

Depolarizing neuromuscular blocking agent.

Question 52

What is the action of succinylcholine?

Answer 52

resembels ACH and prevents the repolarization of end plate, producing a prolonged depolarization by causing a slower inactivation by cholinesterase.

Question 53

What are the ADR's for succinylcholine?

Answer 53

Muscle weakness, bronchospasm, bradycardia, hypotension, arrhythmias, salivation, post op muscle pain, hyperthermia. low level toxicity.

Question 54

What potentiates succinylchole?

Answer 54

anticholinesterase