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Anesthesia > Parenteral Conscious Sedation II > Flashcards

Parenteral Conscious Sedation II Flashcards

1
Q

Patients with these ASA classifications should not be treated with in-office sedation.

A

ASA 3 or 4

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2
Q

Before parenteral sedation, NPO for how many hours?

A

6-8 hours

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3
Q

Can people underoing sedation take needed meds only with water?

A

Yes!

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4
Q

T/F:

Adjustments in oral hypoglycemic or insulin regimen is needed for diabetics undergoing sedation.

A

True

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5
Q

How to prevent hypoxia, bronchospasm, and respiratory failure.

A
  • Supplemental O2
  • ASA I/II patients only for in-office sedation.
  • Avoid deep levels of anesthesia.
  • Postpone the case if the patient has an active upper or lower respiratory infection.
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6
Q

Someone with a BP of 210/something (HTN) feels ok and there’s no evidence of organ damage, this is a hypertensive ______.

A

Urgency.

Don’t treat them.
Tell them to go to the doctor immediately.

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7
Q

If someone with BP of 210/something feels like they’re coming down with the flu and their chest is tight, this is a hypertensive _______.

A

Emergency.

Call 911 and give oxygen while paramedics are coming.

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8
Q

Tx for a hypertensive emergency.

A

Call 911, and give oxygen in the meantime.

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9
Q

Many asthmatics tend to have these.

A

Multiple drug allergies.

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10
Q

You need another informed consent sheet for this in addition to one for the operative procedure.

A

Sedation/Anesthetic

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11
Q

What’s the one risk the dentist always talks to the patient about for IV sedation?

A

Death

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12
Q

Must have this in addition to the practitioner performing the surgical/operative procedure.

A

Properly trained individual who knows sedation.

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13
Q

Monitors heart rate and rhythm

A

ECG

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14
Q

A really bad sign that someone is crashing.

A

Temperature drop

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15
Q

This way of measuring temperature is the easiest, but least accurate.

A

Skin temp

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16
Q

Measure ocygenation

A

Pulse oximeter

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17
Q

Measures ventilation (CO2 levels).

A

Capnometer

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18
Q

Used to listen to breathing in their throat.

A

Pre-cordial stethoscope.

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19
Q

Capnography tells you that the patient has stopped _______ as opposed to stopped oxygenating.

A

breathing

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20
Q

This person’s signature should go on the anesthetic record.

A

Practitioner’s

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21
Q

This score is based on discharge criteria.

A

Aldrete Score

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22
Q

Opioids cause cerebral vasoconstriction or dilation?

A

Constriction

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23
Q

Opioids effect on blood flow in the brain.

A

Decreased (due to vasoconstriction).

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24
Q

Opioid effect on pupils.

A

Pupillary miosis (constriction).

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25
Q

How do opioids effect Histamines?

A

Cause Histamine release, so you can break out in a rash from taking opioids.

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26
Q

Histamine release from opioids can elicit what (besides a rash)?

A

Bronchospasm

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27
Q

Opioids cause peripheral vasoconstriction or dilation?

A

Dilation

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28
Q

Effect of opioids on the chest wall.

A

Chest wall rigidity.

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29
Q

Most potent street opioid.

A

Fentanyl

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30
Q

Has the highest potency of all the opioids, and it’s used in a hospital, in a slow drip infusion.

A

Sufentanyl

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31
Q

Reversal agent for opioids.

A

Naloxone

32
Q

Naloxone MOA

A

Competitive inhibitor at opioid receptors.

33
Q

What can Naloxone precipitate?

A
  • Dysrhythmia
  • Myocardial failure
  • Pulmonary edema
34
Q

Benzodiazepine MOA

A

Bind to BDZ receptors linked with CNS GABA receptors on postsynaptic nerve endings located in the cerebral cortex and limbic system.

35
Q

Benzos cause what kind of amnesia?

A

Anterograde (they remember everything from before the anesthesia).

36
Q

CNS properties of benzos.

A
  • Anxiety reduction
  • Sedation
  • Anterograde amnesia
  • EEG changes awake alpha to beta rhythm.
  • Reduce cerebral blood flow and metabolic oxygen requirements.
37
Q

How do benzos affect cerebral blood flow?

A

Decrease (like opioids).

38
Q

Benzos affect on metbolic oxygen requirements.

A

Decrease

39
Q

Benzos can decrease the body’s response to this.

A

Increased arterial CO2

40
Q

Diazepam with propylene glycol and sodium benzoate can cause this.

A

Phlebitis- irritating to the veins.

41
Q

Benzos’ affect on tidal volume.

A

Decreased

42
Q

Benzos’ affect on respiratory rate.

A

Increased

43
Q

Drugs that are not broken down into active metabolites are ______ from the body quickly.

A

eliminated

44
Q

Midazolam active metabolites

A

NONE!

45
Q

Do not use benzos with this kind of glaucoma.

A

Acute narrow angle

46
Q

BDZ reversal agent.

A

Flumazenil

47
Q

This sedative agent causes serious dissociative events (hallucinations).

A

Ketamine

48
Q

This sedative is NOT given to soldiers, ppl with PTSD, rape victims, etc.

A

Ketamine

49
Q

This sedative blocks CNS N-methy-D-aspartate (NMDA) receptors to cause sedation.

A

Ketamine

50
Q

This sedative agent does NOT cause respiratory or cardiac depression.

A

Ketamine

51
Q

This sedative increases airway secretions and salivary flow.

A

Ketamine

52
Q

Sedative that increases cerebral blood flow, and therefore, intracranial pressure.

A

Ketamine

53
Q

Causes cerebral vasodilation.

A

Ketamine

54
Q

Emergence phenomena are associated with this sedative.

A

Ketamine

55
Q

Ketamine causes this in old people.

A

Long-term cognitive impairment

56
Q

Receptors blocked by ketamine

A

NMDA receptors

57
Q

Sedative that binds to GABA receptors.

A

Propofol

58
Q

Sedative and Analgesic effect of Propofol

A

No analgesic affect, just sedative (Michael Jackson was given this bc he couldn’t sleep at night).

59
Q

Propofol efffect on BP.

A

Reduces it

60
Q

Propofol side effects.

A

Vivid dreams with sexual content.

61
Q

Died of propofol overdose.

A

Michael Jackson

62
Q

Sedatives contraindicated for extremes in age.

A

Ketamine and Propofol

63
Q

Verrill’s Sign

A

Ptosis (droopy eyelids).

64
Q

What does Verrill’s sign indicate?

A

Sedation

65
Q

Most popular combination of intermittent incremental doses of multiple agents.

A

Opioid + Benzo

Ex: Fentanyl + Midazolam

66
Q

Causes sedation and analgesia.

A

Opioid

67
Q

Provides anxiolyis, anterograde amnesia, sedation.

A

BDZ

68
Q

How is Narcotic + BDZ + Propofol administered?

A

Intermittent incremental doses

69
Q

Sedative given via continuous infusion.

A

Propofol (via IV)

70
Q

Exam Q:

Must do this when combining sedative agents.

A

Use LESS of each agent.

71
Q

This reduces anesthetic requirements for individual agents, esp BZD’s and narcotics.

A

Nitrous

72
Q

Midazolam is AKA what?

A

Versed

73
Q

This drug should be avoided in people with prostate hyperplasia.

A

Diphenhydramine

74
Q

This drug causes fetal abnormalities.

A

Hydroxyzine

75
Q

This benzo is used in the pediatric population.

A

Midazolam

Anesthesia (11 decks)

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