Sedation and Hypnotics Flashcards
Can benzos be used for chronic Management?
No
What is an antagonist for benzos?
Flumazenil
What hypnotic should be used for pts having difficulty falling asleep?
Ramelteon
What can’t be used with Ramelteon?
- CYP1A2 inhibitors (cipro, fluvoxamine, tacrine, zileuton)
- CYP2C9 (fluconazole)
- Pts w/liver dysfunction
Side effects of Ramelteon
Dizziness, decr testosterone, incr prolactin
What does Buspirone do?
alleviates anxiety without causing significant sedative, hypnotic, or euphoric effects
Does Buspirone have anticonvulsant or muscle relaxant properties?
No
What receptors does Buspirone deal with?
acts as a partial agonist at brain 5-HT1A receptors, and has affinity for brain dopamine D2 receptors
Does buspirone pts show rebound anxiety or withdrawals of abrupt discontinuance?
No
How do local anesthetics work?
They bind reversibly to specific receptors site within the pore of the Na+ channels in nerves and block ion movement through this pore. This prevents the generation and the conduction of nerve impulses.
What does cIncreasing the dose by administering a high concentration do?
Shortens onset
What are the four factors affecting potency and onset of local anesthetics?
- Lipid solubility- Increase lipophilicity, increase potency and onset
- Inflammation - Decreases PH and slow onset
- Site of administration
- Epinephrine co-administration: Increase lipophilicity and PH
What is Lidocaine good for?
for individuals sensitive to ester-type local anesthetics
Side effects of Lidocaine
Seen with increasing dose–> drowsiness, tinitus, dizziness, twitching
Bupivicaine is more ____ than equi-effective doses of lidocaine.
cardiotoxic
Articaine (septocaine)
Dental shit
Chloroprocaine (Nessacaine)
Rapid onset and short duration, incr incidence of back pain
Mepivicaine (carbocaine, polocaine)
Similar to lidocaine, incr tox in neonates (related to ion trapping)
Ropivacaine (naropin)
This exists
Procaine
This also exhists
Tetracaine (pontocaine)
Long acting amino ester, widely used in spinal anesthesia
What is a lidocaine transdermal patch?
Lidoderm
OTC Local Anesthetic
Pramoxine hydrochloride, Dyclonine (sore throat lozenges), Benzocaine
Esters (2)
Procaine, Chloroprocaine
Amides (7)
Lidocaine Lidocaine w/ epi Mepivacaine (polocaine, carbocaine) Bupivacaine (marcaine) Bupivacaine w/ epi Etidocaine Prilocaine (citanest)
