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Nursing 353 > N365 Surgery Medications > Flashcards

N365 Surgery Medications Flashcards

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1
Q

What class of drugs is Nitrous Oxide?

A

Gaseous General Anesthetic

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2
Q

What is the general action of Nitrous Oxide?

A

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

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3
Q

What are ADR’s for Nitrous Oxide?

A

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.

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4
Q

What is the ideal use of Nitroud Oxide?

A

Induction agent.

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5
Q

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

A

30% at least

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6
Q

What class of drugs is Isoflurane (Forane)?

A

Inhaled general anesthetic, volatile.

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7
Q

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

A

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

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8
Q

What is the action of Isoflurane (Forane)?

A

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

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9
Q

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

A

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

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10
Q

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

A

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

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11
Q

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

A

Shivering

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12
Q

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

A

succinycholine

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13
Q

What are some advantages of using IV Anesthetics?

A

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

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14
Q

What are some disadvantages of IV anesthetics?

A

Laryngospasm, bronchospasm, hypotension, and respiratory arrest.

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15
Q

What are the uses of IV anesthetics?

A

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

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16
Q

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

A

safety

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17
Q

Aspects of inhalation as a method of anethesia.

A

controlled minute by minute

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18
Q

Aspects of IV administered anethesia.

A

once administered the course must continue until out of system.

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19
Q

What class of drugs are barbiturates?

A

IV general anesthetic, ultra short acting.

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20
Q

What class of drug is propofol (diprivan)?

A

IV general anesthetic, ultra short acting.

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21
Q

What is the Action of propofol (diprivan)?

A

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

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22
Q

What are ADR’s for propofol (diprivan)?

A

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

23
Q

What is propofol like for the patient?

A

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

24
Q

Who should not receive propofol (divipran)?

A

patients with respiratory difficulties or heart disease.

25
Q

what is a nickname for propofol?

A

Milk of amnesia.

26
Q

What is Etomidate (amidate)

A

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

27
Q

What is Fentanyl/droperidol combination known as Innovar?

A

Innovar is an opiod neuroleptic combination used for neurolept analgesia.

28
Q

What classification is Fentanyl (Sublimaze)?

A

Narcotic anethetic

29
Q

What is the action of Fentanyl (Sublimaze)?

A

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

30
Q

What are the ADR’s for Fentanyl

A

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

31
Q

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

A

significant abuse potential

32
Q

Special Information for Fentanyl (Sublimaze)

A

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

33
Q

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

A

Q 72 hours

34
Q

What other forms of fentanyl (sublimaze) are there

A

Lozenge on stick, and buccal tablets.

35
Q

What classification is ketamine?

A

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

36
Q

What classification of drugs is Midazolam (Versed)

A

IV anesthetic, benzodiazepine

37
Q

What is the action for midazolam (Versed)?

A

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

38
Q

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

A

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

39
Q

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

A

Can cause respiratory depression and arrest.

40
Q

Special Information for Midazolam (Versed).

A

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

41
Q

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

A

They are local anesthetics.

42
Q

What is the action of local anesthetics?

A

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.

43
Q

What are the ADR’s of local anesthetics?

A

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

44
Q

Special information regarding local anesthetics?

A

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

45
Q

What is a topical example of a local anesthetic?

A

benzocaine

46
Q

What are the two major types of skeletal muscle relaxants?

A

Non-depolarizing NMJ agents and depolarizing NMJ agents.

47
Q

What class of drug is rocuronium (Zemuron)?

A

Non-depolarizing (competitive) neuromuscular junction blocking agent

48
Q

What is the action of rocuronium (Zemuron)?

A

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

49
Q

What are the ADR’s for rocuronium ) Zemuron?

A

Tachycardia, muscle weakness, salivation, and hypertension.

50
Q

What reverses rocuronium (Zemuron)?

A

ACH of course

51
Q

What class of drugs is Succinylcholine (anectine?)

A

Depolarizing neuromuscular blocking agent.

52
Q

What is the action of succinylcholine?

A

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

53
Q

What are the ADR’s for succinylcholine?

A

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

54
Q

What potentiates succinylchole?

A

anticholinesterase

Nursing 353 (13 decks)

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