Pharmacology of Drugs Flashcards

1
Q

What classes of drugs are often used in sedation?

A

Benzodiazepines

Opiates

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2
Q

Give example of benzodiazepine

A

Midazolam

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3
Q

Give example of opiates used?

A

Fentanyl

Remifentanil

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4
Q

What other drugs can be used outside benzodiazpeines/ opiates?

A

Propofolol

Ketamine

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5
Q

How does midazolam work?

A

Via action on GABA receptors

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6
Q

What is midazolam?

A

Benzodiazepine

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7
Q

How give midazolam?

A

Can be given via IV for moderate sedation

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8
Q

What is onset, peak and duration of midazolam sedation?

A

Onset 1-3 minutes
Peak 5-7 minutes
Duration 20-30 minutes

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9
Q

What is dosage of midazolam?

A

Initial dose of 2.5mg given over 2 minutes
Wait 2 minutes for effects
Subsequent dose of 1mg

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10
Q

What is dose try not to exceed when giving midazolam?

A

5mg

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11
Q

What to be aware of if given pre-medication before midazolam?

A

Dose will need to be reduced by 1/3

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12
Q

Advantages of midazolam?

A

Quick onset

Minimal CV effects

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13
Q

Adverse effects of midazolam?

A

Respiratory depression

Can cause airway obstruction

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14
Q

How reverse midazolam?

A

Flumazenil

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15
Q

What dose of flumazenil to reverse midazolam?

A

200mcg every 1-2 minutes

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16
Q

What is fentanyl?

A

Man-made synthetic opiate drug that provides analgesia and sedation

17
Q

Onset, peak and duration of fentanyl?

A

Onset 1-2 mins
Peak 10-15 mins
Duration 3-60 mins

18
Q

How dose fentanyl?

A

25mcg bolus up to 200mch max

19
Q

Advantage of fentanyl?

A

Provide analgesia and sedation

Fast onset

20
Q

Adverse effects of fentanyl?

A

Hypotension and bradycardia
Respiratory depression
Nausea

21
Q

Example of ultrashort aciting opiate?

A

Remifentanil

22
Q

How is remifentanil delivered?

A

Continuous infusion via syringe driver

23
Q

Adverse effects of remifentanil?

A

Hypotnesion
Bradycardia
Resp depression

24
Q

Who can propofol be used by?

A

Trained seditionist or anaesthetic staff as can rapily progress to GA

25
Q

What are general tips for providing sedation?

A

Use single drug

Give small incremental bolus to titrate individual patient

26
Q

Benefits of polypharmacy?

A

Different drugs have diff effects (e.g sedation or analgesia), giving 2 drugs means can use less of each reducing side effects

27
Q

Risks of polypharmacy?

A

Increased risk of overdosing and overstating patients