Pharm Unit 2 Flashcards
What can be given for pre-eclampsia?
Magnesium sulfate
What are the 5 components of anesthesia?
Hypnosis, analgesia, muscle relaxation, sympatholysis and amnesia
How do barbiturates exert their effect?
Potentiating GABA-a channels, also act on glutamate/adenosine/neuronal nicotinic ACh receptors
What do barbiturates do the CBF/CRMO?
Act as a cerebral vasoconstrictor, reduce CBF and CRMO by about 55%
Why do you want to avoid infusions of barbiturates?
Prolonged context-sensitive half time. They also rapidly redistribute into other tissues.
Dose of Thiopental?
4 mg/kg IV
Dose of methohexital?
1.5 mg/kg IV
How does methohexital affect seizures?
Lowers seizure threshold = easier to have one, making it an ideal drug for ECTs
Basic effects of barbiturate’s on ventilation?
Dose dependent depression with slower frequency and lower tidal volume, similar to narcotics
What happens during intra-arterial injection of a barbiturate?
Immediate intense vasoconstriction and pain. Treat with vasodilators: lidocaine or papaverine
List the induction, conscious sedation and maintenance doses of propofol
Induction = 1.5 - 2.5 mg/kg IV
CS = 25 - 100 mcg/kg/min
Main = 100 - 300 mcg/kg/min
Describe Ampofol and Aquavan relative to Propofol
Ampofol = low-lipid emulsion with no preservative, higher incidence of pain on injection (good d/t less effect on triglycerides)
Aquavan = prodrug that converts into active form, no pain on injection, by has unpleasant sensation related side effects
Describe Propofol MOA
Selective modulator of GABA-a = increased Cl conductance and hyperpolarized cell
Describe the BP/HR changes with propofol, etomidate and ketamine
P = decreased BP and HR
E = no change to BP and HR
K = increased BP and HR
T/F: Propofol is safe for alcoholic patients?
T: awakening time does not change with healthy vs ETOH patients
How does the dose of Propofol change with children vs elderly?
Children = increased dose, elderly = decreased dose (by 25-50%)
Why is Propofol advantageous as a sedative?
Prompt recovery, low PONV, anti-convulsant, amnestic, anti-oxidant. Does not provide analgesia however
What is the sub-hypnotic dose of Propofol?
10-15 mg IV followed by 10 mcg/kg/min
Anti-pruritic dose of Propofol?
10 mg IV
What effect does Propofol have on the airway?
Bronchodilation
Anti-convulsant dose of Propofol?
1 mg/kg IV
Effects on CRMO with Propofol?
Decreases CRMO, CBF and ICP. D/t autoregulation, CBF and PaCO2 are maintained
Black box warning for Propofol?
Profound bradycardia leading to asystole in healthy patients
Describe Propofol infusion syndrome including dose
Greater than 75 mcg/kg/min longer than 24 hours. Can cause severe refractory bradycardia in children, lactic acidosis, brady-dysrhythmias and lactic acidosis. Green urine.