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sedation midterm > sedation midterm 4 > Flashcards

sedation midterm 4 Flashcards

1
Q

What is the ideal anxiolytic? ​

A
  • No antigenic​
  • Cheap​
  • Effective via any route​
  • Rapidly absorbed if given PO​
  • Tastes good, like chicken​
  • Reversible – has an antidote​
  • Makes patient happy, possibly amnesic ​
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2
Q

Digitalis

A

Digioxin is deadly in high quanities

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3
Q

What is a favorable therapeutic index for anxiolytic? ​

  • Discuss physiological effects​
  • Discuss your hepatic metabolism​
  • Discuss rewards center​
A

The perfect anxioltyic acts ONLY on the emotional center of the CNS and does not influence the cardiovascular or respiratory system. ​

  • There is NO active by products​
  • Not addicting
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4
Q

what does enteral mean?

A

oral

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5
Q

checklist for sedation?​

A
  • Consent​
  • Medical history ​
  • Responsible ride/escort​
  • Reversal drugs/oxygen read​
  • Baseline vital signs, O2 sats​
  • Discharge vital signs, O2 sats​
  • Document (wheel chair) stable to car
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6
Q

IM drugs

A

Narcotics​

Benzodiazepines​

Ketamine​

Hydroxysine​

Antiemetics​

Anticholinergics

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7
Q

Narcotics​ for IM

1) why do ppl take
2) always get what side effect?
3) reversal agent?

A

1) poeple take for euphoria
2) Know that you ALWAYS get respiratory depression at therapeutic doses ​- rarely given as sole agent
3) Know that the reversible agent is the Narcan (intranasal) ​

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8
Q

name Narcotics​ for IM

A

Morphine – 7 hour ​
Meperidine – 3 hours​
Fentanyl - 1.5 hours ​

​*some narcotics that last 30 minutes – why do this? You can drip in the narcotic into the root canal

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9
Q

Benzodiazepines for IM

1) similar to oral route how?
2) effective or not?
3) best choice?
4) reversal agent?

A

1) As with oral route, the best single agent for most patients​ –Pharmacology similar regardless of route
2) NOT effective
3) Midazolam best choice​
4) Romazicon available to reverse​

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10
Q

Ketamine in IM

1) commonly used in
2) side effects? KNOW
3) GOOD because?
4) overdose how

A

1) commonly used for animals
2) nystagmus gaze and that it produces a state of dissassociated anesthesia (lights on with nobody home) ​
3) Hard to overdose and get a respitory depression
4) increase BP and increase heart rate

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11
Q

Ketamine will cause weird? Help this with what drug?

A

flashback dreams – we get around the disassociate anesthesia and CUT IT with a VERSED to reduce the effects ​

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12
Q

Ketamine is a ____ antagonist?

does it have a reversal??

A

NMDA antagonist and does not have a reversal agent​

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13
Q

Anticholinergics

1) ____ usually cut with anticholinergic
2) Atropine
3) Scopolamine
4) Gycopyrrolate

A

1) Ketamine
2) best for heart rate​
3) sedates, combats motion sickness​
4) doesn’t cross BBB, no sedation or elevation of heart rate

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14
Q

When you sedate little kids, little kids blood pressure is dependent on their

A

heart rate

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15
Q

Anticholinergics are occasionally added to an IM cocktail to decrease

A

salivation, maintain/elevate heart rate​

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16
Q

Name Antiemetics can be given IM

A

Promethazine – H1 antatgonist in the vestibular cochlear area​

Hydroysine – H1 antagonist in the vestibular cochlear area​

Odansetron – 5HT3 inhibitor that inhibits the vagal stimulation of the nucelus tractus solitarius ​​

17
Q

What is the advantage of Intranasal vs oral sedation?

A

Intranasal is faster since much more rapid absorption​

18
Q

Give an example of an intranasal injection?

A

Midazolam being administered this way

19
Q

What is another way for antiemetics?​

A

Rectal​

20
Q

What’s an intrathecal injection?

A

A true spinal injection – used for cancer pain

21
Q

Can you do fentynl transdermal? ​

** What else is transdermal? ​

A

Yeah common for cancer patients due to nausea ​

** Nitrates ​

22
Q

Orexins

A

Responsible for keeping people awake

23
Q

Antihistamines are good and bad why?

A

Good- can use with N2O, anti-emetic, well known

Bad- no antidote, only mild sedation, pyramidal effect with promethazine

24
Q

2 antihistamine drugs

A

1) promethazine -used in perio, causes tardive dyskinesia

2) hydroxyzine - combined with narcotics in hospital

sedation midterm (4 decks)

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