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Sedation Flashcards

1
Q

At what level of sedation may airway intervention be required?

A

deep sedation

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2
Q

What class of drug is midazolam (versed)?

A

benzodiazepine

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3
Q

What is the MOA of benzodiazepines?

A

GABA-A receptor agonists

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4
Q

What is the dosage for oral midazolam (Versed)?

A

0.5-1mg/kg up to 15mg

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5
Q

What is the dosage for nasal midazolam (Versed)?

A

0.2-0.3mg/kg up to 10mg

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6
Q

What is the approximate onset of oral midazolam (Versed)?

A

15-30min

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7
Q

What is the approximate onset of nasal midazolam (Versed)?

A

5min

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8
Q

What is the approximate working time of midazolam (Versed)?

A

30-40min

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9
Q

What are potential side effects of midazolam (Versed)?

A

hiccups, paradoxical reactions, hypotension

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10
Q

What drug concentration is used for oral midazolam (Versed)?

A

2mg/1mL

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11
Q

What drug concentration is used for nasal midazolam (Versed)?

A

5mg/1mL

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12
Q

What is the drug class of diazepam (Valium)?

A

benzodiazepine

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13
Q

What is the dosage for oral diazepam (Valium)?

A

0.2-0.3mg/kg up to 10mg

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14
Q

What is the onset of oral diazepam (Valium)?

A

45min

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15
Q

How long is the working time with oral diazepam (Valium)?

A

60-90min, peak at 60min

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16
Q

What is the active metabolite of diazepam (Valium)?

A

desmethyldiazepam - causes a “hangover” period with feelings of re-sedation

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17
Q

What are common side effects of diazepam (Valium)?

A

ataxia and prolonged drowsiness

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18
Q

What medical condition is contraindicated for use of diazepam (Valium)?

A

narrow angle glaucoma - can cause pupil dilation which can lead to a glaucomic attack

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19
Q

What drug class is hydroxyzine (Vistaril)?

A

antihistamine/antiemetic

20
Q

What is the MOA of hydroxyzine as an antihistamine/antiemetic?

A

H1 receptor competitive antagonist

21
Q

What is the concentration of oral hydroxyzine (Vistaril)?

22
Q

What is the dosage of oral hydroxyzine (Vistaril)?

A

0.5-1.0mg/kg up to 25mg

23
Q

What is the duration of onset for hydroxyzine (Vistaril)?

24
Q

What is the working time for hydroxyzine (Vistaril)?

25
Q

What are side effects of hydroxyzine (Vistaril)?

A

dry mouth, constipation, confusion, headache, dizziness, skin rash

26
Q

What are contraindications for use of hydroxyzine (Vistaril)?

A

pregnancy, long QT syndrome

27
Q

What is the MOA of flumazenil (Romazicon)?

A

competitive antagonist of GABA-A

28
Q

What is the concentration of IM flumazenil (Romazicon)?

29
Q

What is the recommended dose of IM flumazenil (Romazicon)?

A

0.01mg/kg up to 0.3mg, repeating every 5min PRN

30
Q

What is the MOA of nitrous oxide?

A

GABA-A receptor agonism and NMDA receptor antagonism

31
Q

What are significant clinical actions of nitrous oxide?

A

amnesia, analgesia, CNS depression and euphoria, minor depression of CO

32
Q

What are contraindications to use of nitrous oxide?

A

COPD, current URTI, recurrent middle ear disturbances, first trimester of pregnancy, vitamin B12 deficiency, cancer tx with bleomycin sulfate

33
Q

What occurs during a laryngospasm?

A

forceful, involuntary spasm of the laryngeal musculature caused by stimulation of the superior laryngeal nerve

34
Q

What is the first line of treatment for laryngospasm?

A

positive pressure ventilation with chin tilt and jaw thrust

35
Q

What drug is used as the second line of treatment for laryngospasm?

A

succinylcholine

36
Q

How does a pulse oximeter measure oxygenation?

A

2 wavelengths of light to compare oxyhemoglobin and deoxyhemoglobin

37
Q

What is health oxygen saturation?

38
Q

What can affect the accuracy of a pulse oximeter?

A

nail polish, skin pigmentation, cold skin with inadequate blood flow

39
Q

What data is captured by capnography?

A

expired CO2

40
Q

Around what oxygen saturation does low oxygen start to affect the brain?

41
Q

What oxygen saturation is considered cyanosis?

42
Q

What range is considered normal for capnography peaks?

43
Q

T/F: you should give more meds if a patient does not seem sufficiently sedated when you wish to begin treatment

A

False: you don’t know exactly when peak onset will occur and giving more medication could compound the effects and lead to overdose

44
Q

What is the minimum fasting period for clear liquids before sedation?

45
Q

What is the minimum fasting period for breast milk before sedation?

46
Q

What is the minimum fasting period for light foods before sedation?

47
Q

What is the minimum fasting period for heavy fried/fatty foods before sedation?

Board Exam Flashcards (4 decks)

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