pharmacology of sedatives Flashcards
class of benzodiazepines
alprazolam
clonazepam
diazepam
lorazapam
midazolam
triazolam
barbiturates
produce dose-dependent effects
Sedation –> Sleep –> Anesthesia –> Coma
phenobarbital
methohexital - used for induction of anesthesia
binds to gaba but a different receptor
does not attach directly like benzos does
just remember that it works on different receptor of GABA
ketamine
affects NDMA receptor
usually through IV
recovery can take up to 1-2 hours
doesn’t affect the airway, relaxes diaphragm
first pass metabolism
happy drug usually, if you I’ve too much they can hallucinate and agitate patient (dissociative state)
propofol
used for SEDATION - milky substance - LIPID BASED - lipophilic
general anesthetic
affects blood pressure and heart rate
it is hepatic metabolism - metabolized through the liver
etomide
very quick non barbiturate general anesthetic (benzylimidazole)
can be used to help induce the case
etomidate –> drops in cortisol
given as a ONE time dose
metabolized through hepatic and plasma esterases
eliminated by kidneys
analgosedation
Mechanism of Action
Bind to “benzodiazepine receptors” on GABA receptors enhancing the affinity of GABA receptors for GABA, resulting in more frequent opening of the chloride channels. The increased influx of chloride causes hyperpolarization and increased inhibition
flumazenil
reverses the effect of BENZOS
benzes side effects
Medication is lipophilic and is able to cross the blood-brain barrier easier.
side effects are drowsiness, fatigue, amnesia, confusion
many benzes have long half lives
- benzodiazepines undergo various types of hepatic metabolism (type of metabolism & rates depend on the individual drug)
prolong half life
3-5 half lives for it to get out of your system
induction vs inhibition
induction speeds up metabolism
inhibition slows down metabolism
dexmedetomidine
do not have to be intubated
selective apha2-adrenoreceptor
results in inhibition of norepinephrine release
side effects –> lowers BP and causes bradycardia
