Sedation Flashcards
midazolam preparation
5mg/5ml
midazolam is metabolised in….
the liver
midazolam half life
90-150 mins
how to treat midazolam over sedation
Flumanezil
500mcg in 5ml
flumazenil dose
200mcg then 100mcg increments every 60 seconds until a response is seen
fumazenil downsides
shorter half life than midazolam
- 50 mins
risk of re-sedation
over sedation - signs and symptoms
loss of responsiveness
respiratory depression
loss of ability to maintain airway
respiratory arrest
management of respiratory depression
check oximeter
stimulate patient
- ask them to breathe
supplemental oxygen
- nasal cannula 2 litres per minute
reverse with flumazenil
Effects of benzodiazepines
respiratory depression
- CNS depression and muscle relaxation
reduced blood pressure by muscle relaxation decreasing vascular resistance
- increase heart rate due to baroreceptor reflex
benzodiazepines side effects
drug interactions
- other CNS depressants
- erythromycin
- antihistamines
tolerance
dependence
sexual fantasies
IV sedation procedure
cannulation
pulse oximeter
BP monitoring
drug administration
- 2mg bolus
- 1mg increments every 60 seconds
- until suitable level of sedation
iv sedation - signs patient is adequately sedated
slurring and slowing of speech
relaxed
delayed response to commands
willingness to accept treatment