Pharm Midterm Flashcards
What is halothane used for?
anesthesia maintenance - it is an inhalant. dose measured by minimum alveolar concentration
Describe the idea of balanced anesthesia?
The use of a variety of medication with different routes of administration to achieve desired effects. It includes induction, muscle relaxation, and analgesia
What is thiopental?
a barbiturate used as an IV anesthetic that is no longer available in the US because it’s used for lethal injection
What is Diazepam? How quickly does it work?
A Benzo used as an IV anesthetic. Pt is unconscious within a minute
What is medazolam? How quickly does it act?
It is a benzo used as an IV anesthetic. Pt is out within 80 seconds
What are the new NPO guidelines for pre-op?
Adults: solids: 6-8hrs clears: 2-3hrs
Children: solids: 6hrs clears: 2-3hrs
< 6mo: solids (breastmilk) 4-6hrs clears: 2hrs
How do local/regional anesthetics work?
By decreasing the amount of sodium that enters a neuron, preventing conduction of pain impulse/action potential
What is Novocaine?
An ester type local/regional anesthetic.
Ester types have higher incidence of allergic reactions than amide types
What is Lidocaine?
An Amide-type local/regional anesthetic.
Most widely used, not very long lasting
Can be used for CV dysrhythmias
What can be added to local/regional anesthetics and why would you do it?
Epinephrine because it’s a strong vasoconstrictor which would keep blood flow from the area allowing the anesthetic to act more quickly and for a longer period of time
What can the nurse administer that requires FULL attention and is their ONLY responsibility during administration?
Monitored Anesthesia Care (MAC)
Moderate/ Conscious sedation
How does Ritalin work and what are some key factors to it’s use?
It promotes the release and prevents reuptake of norepi and dopa from the neurons.
Doesnt directly suppress - behavior, but allows for + behavior to be learned.
May require drug holiday for growth & reevaluation of need
What is the difference in sedative hypnotics used for anxiety vs insomnia
Anxiety is a smaller dose
insomnia is a larger dose
What is ativan used for and what are some key nursing considerations?
it is a benzo used for short term use of anxiety/insomnia
Amplifies GABA effects
Some have active metabolites
Seizures are a serious withdrawal reaction!
What is the treatment for a Benzo overdose?
PO - emetic w activated charcoal
IV - Flumazenil: works within 30 seconds but can cause seizures!!
What is the MOA of barbiturates used for anxiety/insomnia
Stimulate the synthesis of P450: This causes RAPID and incredibly strong tolerance to drug but NOT the adverse effects
What is the treatment for a barbiturate overdose?
There is none!
Why are barbiturates not used much anymore?
There is no limit to their degree of CNS depression #1 drug for suicide
What is Thorazine?
It is a low potency FGA that can cause SERIOUS movement disorders: EPS (if overdose occurs)
Other s/e include lactation and seizures
What is Haldol?
It is a high potency FGA
Which type of symptoms are more responsive to FGA treatment?
Positive, as opposed to negative
What is Clozapine?
An antipsychotic that is more effective than others but really dangerous.
agranulocytosis occurs so you MUST get WBC count before each administration.
Which cholinesterace inhibitor is approved for severe symptoms of dementia?
Aricept
What is the issue with dementia pts and how would you treat this?
They have about 90% less ACh than they should. You would treat w a cholinesterace inhibitors that would prevent the break down of ACh.
“Start low go slow”
Can cause bronchoconstriction!
