Pharm of IV Anesthetics Flashcards
Sedation means you’re ____, but hypnosis is actually putting you to ____
tired, sleep
The central compartment are the
brain, heart, and kidneys
What is the rapidly equilibrating compartment?
Muscle
What is the slowly equilibrating compartment?
Fat
The _____ phenomenon is responsible for terminating the actions of IV anesthetics
redistribution
The elimination halftime is longer depending on the _______ of infusion
rate/time
Propofol’s main use is what?
induction of anesthesia
What is the redistribution time for propofol?
2-8 minutes
What is propofol contraindicated for?
Egg allergy
What three organs help metabolize propofol?
Liver, Kidney, Lung
Kids have a larger ______ ______ so they need a higher dose per kilo of propofol
central compartment
Propofol has no effect on ____
pain
Propofol potentiates the effect of ____ by acting on the_ subunit
GABA; beta
Cardiac effects of propofol include _____ and change in ___ ____ due to vasodilation (as well as myocardial ______ )
hypotension; heart rate: depression
Respiratory effects of propofol include decreased _____ ___ (hypopnea), decreased response to _____ and ______ , and bronchodilated
tidal volume; hypercarbia, hypoxia
Neurological effects of propofol include decreased ____ rate and _______ cerebral blood flow
metabolic rate; decreased
Name the four side effects of propofol
PPHD Pain on injection Propofol related infusion syndrome (mostly in kids, acidosis) Hypertriglyceridemia Decreased PMN chemotaxis
Two absolute contraindications of propofol
Allergy to the drug itself or eggs
Three relative contraindications of propofol
Hemodynamic instability, awareness under anesthesia, home use
Propofol as a drug of abuse causes increased _____ in the nucleus accumbens and causes feelings of ____-____
dopamine; well-being
When should you use etomidate instead of propofol as your drug of induction and why?
Critical illness or cardiac surgery because it does not affect hemodynamics
Etomidate and Propofol have the same _____ time and effects- they have potentiate ____ and cause no ____ relief
redistribution; GABA; pain
What is the major side effect of etomidate and what hormone does it increase?
Adrenal insufficiency; cortisol
Etomidate has no cardiac or respiratory symptoms, and it has the same neurological symptoms as propofol with the addition of what?
Seizures
Etomidate also causes serious _____ and _____ (one symptom) as well as _____
nausea and vomiting; myoclonus
What is the redistribution time for ketamine?
11-16 minutes
Where is ketamine metabolized and what is the clinically relevant metabolite?
Kidney, norketamine
What is the primary receptor ketamine acts on and what does this cause?
NMDA, sympathetic stimulation
Where is etomidate metabolized?
Liver
What are some of the positive effects of ketamine?
Many ways to administrate, hyponic, amnesic, and good lung effects
Negative side effects of ketamine
Dysphoria, increased ICP, increased salivation,
What is the reversal agent for benzos?
Flumazenil
What is the reversal agent for opiates?
Naloxone, naltrexone
Dexmedetomidine and clonidine act on which receptor and have what effect?
Alpha 2 adrenoceptor, and they provide a natural sleep
Droperidol and Haloperidol are what?
dopamine antagonists
diphenhydramine and chlorpheniramine are what?
Antihistamines
The z-drugs (zaleplon, zolpidem) are what?
Sleep Aids
Ketamine does not require what for administration?
IV access
