sedation

Question 1

What 3 classes of drugs used for sedation?

Answer 1

1. muscle relaxant - relax vocal chords to prevent spasms
2. Opiod pain mx
3. Induction agent

Question 2

Thiopental - induction

Answer 2

1. Extremely rapid onset of action making it the agent of choice for rapid sequence of induction

Question 3

What side effects

Answer 3

1. Marked myocardial depression may occur
2. Metabolites build up quickly
3. Unsuitable for maintenance infusion
4. Little analgesic effects

Question 4

Propofol - induction

Answer 4

1. fast onset

2. Widely used especially for maintaining sedation on ITU, total IV anaesthesia and for daycase surgery

Question 5

Propofol - SE

Answer 5

1. Rapidly metabolised with little accumulation of metabolites
2. Proven anti emetic properties
3. Moderate myocardial depression

Question 6

Ketamine - induction

Answer 6

1. NMDA receptor antagonist

2. May be used for induction of anaesthesia

Question 7

Ketamine - SE

Answer 7

1. Has moderate to strong analgesic properties
2. Produces little myocardial depression making it a suitable agent for anaesthesia in those who are haemodynamically unstable
3. May induce state of dissociative anaesthesia resulting in nightmares

Question 8

Etomidate - SE

Answer 8

1. Has favorable cardiac safety profile with very little haemodynamic instability
2. No analgesic properties
3. Unsuitable for maintaining sedation as prolonged (and even brief) use may result in adrenal suppression
4. Post operative vomiting is common

Question 9

What is an induction agent?

Answer 9

a drug used to get a patient to sleep

Question 10

What side effects are caused by both Thiopentone and Propofol

Answer 10

1. Airway - reduced airway reflexes
2. Breathing - respiratory depression
3. Cardiovascular - vasodilation
4. Disability - unconsciousness

Question 11

What are main side effects of Thiopentone?

Answer 11

1. reduced cardiac output / marked myocardial depression my occur
2. Risk of severe anaphylaxis

Question 12

What are the main side effects of Propofol?

Answer 12

1. Antiemetic effects

2. Hyperlipidaemia

Question 13

what are inhalation anaesthetic agents used for?

Answer 13

used following induction to maintain anaesthesia

Question 14

Name 2 commonly used inhalation agents?

Answer 14

1. Sevoflurane

2. Nitrous oxide

Question 15

What is nitrous oxide used for?

Answer 15

analgesia properties are more potent than anaesthetic properties

Question 16

What are the main contraindications to nitrous oxide use?

Answer 16

nitrous oxide can escape the blood and accumulate in potential air sacs in the body

1. pneumothorax
2. air embolus
3. Skull fracture - air filled pocked could increase ICP
4. Intestinal obstruction

Question 17

why is nitrous oxide use contraindicated in pregnancy?

Answer 17

inactivates vitamin B12 which is an important co factor of DNA synthesis