N365 Surgery Medications Flashcards
What class of drugs is Nitrous Oxide?
Gaseous General Anesthetic
What is the general action of Nitrous Oxide?
Produces narcosis, analgesia and amnesia to varying degrees by causing progressive depression of the CNA; GABA receptor agonist, opiod agonist.
What are ADR’s for Nitrous Oxide?
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.
What is the ideal use of Nitroud Oxide?
Induction agent.
What is the minimal amount of oxygen that must be mixed with Nitrous Oxide?
30% at least
What class of drugs is Isoflurane (Forane)?
Inhaled general anesthetic, volatile.
What about Isoflurane (Forane) makes it’s onset slower?
It’s more soluble in blood, intercellular fluid, and fatty tissue and therefore causes a slower onset.
What is the action of Isoflurane (Forane)?
Progressive depression of CNS (exact action unknown). GABA glutamate receptor agonist.
What are the main ADR’s of Isoflurane (Forane)?
Hypotension from vasodilation, Significant respiratory depression, can trigger malignant hyperthermia.
What is a specific action of Isoflurane (Forane) on the trachea, and why is it specific to surgery?
Isoflurane relaxes the tracheal area and depresses reflexes leading to simpler intubation.
What should you look for in a patient recovering from isoflurane (Forane)
Shivering
What drug, when used with isoflurane, can cause malignant hyperthermia?
succinycholine
What are some advantages of using IV Anesthetics?
rapid pleasant induction, no explosive hazards, low incidence of post op N&V
What are some disadvantages of IV anesthetics?
Laryngospasm, bronchospasm, hypotension, and respiratory arrest.
What are the uses of IV anesthetics?
to induce and maintain general anesthesia, basal anesthesia, and hypnosis.
what is the main difference between barbituates and gaseous agents is?
safety
Aspects of inhalation as a method of anethesia.
controlled minute by minute
Aspects of IV administered anethesia.
once administered the course must continue until out of system.
What class of drugs are barbiturates?
IV general anesthetic, ultra short acting.
What class of drug is propofol (diprivan)?
IV general anesthetic, ultra short acting.
What is the Action of propofol (diprivan)?
Promotes release of GABA, short action anesthetic. Not a controlled substance.
What are ADR’s for propofol (diprivan)?
Respiratory depression, hypotension from vasodilation, risk of bacterial infection in lipid based emulsion: propofol infusion syndrome, injection site pain.
What is propofol like for the patient?
Smooth, easy, and pleasant for patient, has antiemetic properties.
Who should not receive propofol (divipran)?
patients with respiratory difficulties or heart disease.
what is a nickname for propofol?
Milk of amnesia.
What is Etomidate (amidate)
hypnotic agent used for induction, especially in patients with heart problems that can’t have propofol (divipram).
What is Fentanyl/droperidol combination known as Innovar?
Innovar is an opiod neuroleptic combination used for neurolept analgesia.
What classification is Fentanyl (Sublimaze)?
Narcotic anethetic
What is the action of Fentanyl (Sublimaze)?
Opioid agonist. Morphine like action (100 x more potent).
What are the ADR’s for Fentanyl
euphoria, miosis, N&V puritis, constipation, hypotension, respiratory depression, bradycardia,
What is the BLACK BOX warning for Fentanyl (sublimaze)?
significant abuse potential
Special Information for Fentanyl (Sublimaze)
Rapid administration can cause rigidity and apnea so patient must be closely observed.
How often so you chance topical Fentanyl Patches (duragesic)?
Q 72 hours
What other forms of fentanyl (sublimaze) are there
Lozenge on stick, and buccal tablets.
What classification is ketamine?
dissociative anethetics, induces a trans like effect characterized by analgesia, quietute, and detachment from environment.
What classification of drugs is Midazolam (Versed)
IV anesthetic, benzodiazepine
What is the action for midazolam (Versed)?
neuropletic effect, exact action unknown. Acts on limbic, thalmic, and hypothamic regions to cause CNS depression and skeletal muscle relaxation.
What are the ADR’s for midazolam (Versed)?
Respiratory depression (even arrest), decreased altertness and amnesia, hypotension, hiccups, laryngospasm, loss of dexterity, some have reported muscle tremors, tachycardia, shortness of breath.
What is the BLACK BOX warning for midazolam (Versed)?
Can cause respiratory depression and arrest.
Special Information for Midazolam (Versed).
produces anterograde amnesia and loss of memory about procedure, can decrease anxiety. Midazolam can also have a prolonged anesthetic recovery period than barbiturates.
What classification is Short-duration-mepivacaine (carbocaine), lidocaine (Xylocaine), and long duration bupicacaine (Marcaine)?
They are local anesthetics.
What is the action of local anesthetics?
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.
What are the ADR’s of local anesthetics?
overdosage into CNS from periphery causing excitement, convulsions, and then CNS depression (Bradycardia, hypotension, cardiac arrest) N&V, pallor, apprehension.
Special information regarding local anesthetics?
Loss of all sensation occurs, starting with pain.
if becomes systemic, has serious CNS depressive effects.
Vasoconstrictors are used to decrease CNS absorption.
What is a topical example of a local anesthetic?
benzocaine
What are the two major types of skeletal muscle relaxants?
Non-depolarizing NMJ agents and depolarizing NMJ agents.
What class of drug is rocuronium (Zemuron)?
Non-depolarizing (competitive) neuromuscular junction blocking agent
What is the action of rocuronium (Zemuron)?
Prevents ACH from acting, by occupying the cholinergic receptor sites. competitive antagonist.
What are the ADR’s for rocuronium ) Zemuron?
Tachycardia, muscle weakness, salivation, and hypertension.
What reverses rocuronium (Zemuron)?
ACH of course
What class of drugs is Succinylcholine (anectine?)
Depolarizing neuromuscular blocking agent.
What is the action of succinylcholine?
resembels ACH and prevents the repolarization of end plate, producing a prolonged depolarization by causing a slower inactivation by cholinesterase.
What are the ADR’s for succinylcholine?
Muscle weakness, bronchospasm, bradycardia, hypotension, arrhythmias, salivation, post op muscle pain, hyperthermia. low level toxicity.
What potentiates succinylchole?
anticholinesterase
