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NSU AA Denver Drugs and Inhalational Agents > Sedative Agents > Flashcards

Sedative Agents Flashcards

1
Q

What is the typical IV sedation dose of midazolam in adults?

A

0.01–0.1 mg/kg; Typically dose 1-2mg

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2
Q

What is the approximate onset of action for IV midazolam?

A

2–5 minutes

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3
Q

How long does a typical dose of IV midazolam last?

A

30–60 minutes (less than 2 hours)

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4
Q

What is the primary mechanism of action of midazolam?

A

GABA-A receptor modulation

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5
Q

Which of the following is NOT a primary clinical use of midazolam?

A

Analgesia

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6
Q

Which of the following is a potential side effect of midazolam?

A

Respiratory depression

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7
Q

In what situation is midazolam particularly useful?

A

Sedation for MRI in a claustrophobic pediatric patient

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8
Q

What is the reversal agent for benzodiazepines like midazolam?

A

Flumazenil

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9
Q

Midazolam has both sedative and analgesic properties.

A

False

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10
Q

Midazolam is water-soluble, making it different from other benzodiazepines.

A

True

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11
Q

Midazolam can cause anterograde amnesia.

A

True

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12
Q

Midazolam has a faster onset and shorter duration than diazepam.

A

True

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13
Q

Midazolam is commonly used for induction of anesthesia in unstable trauma patients.

A

False

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14
Q

The respiratory depressive effects of midazolam are dose-dependent.

A

True

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15
Q

Midazolam can be given IV, IM, PO, and intranasally.

A

True

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16
Q

What is the usual PO dose range of midazolam for pre-op in pediatrics?

A

PO = 0.5 mg/kg

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17
Q

What is the primary neurotransmitter system affected by midazolam?

A

GABAergic system (GABA-A receptors)

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18
Q

Name two key clinical effects of midazolam.

A

Sedation, anxiolysis, amnesia (any two)

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19
Q

What is a major concern when using midazolam in elderly or debilitated patients?

A

Increased sensitivity leading to prolonged sedation and respiratory depression

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20
Q

How can the sedative effects of midazolam be reversed?

A

With flumazenil, a benzodiazepine antagonist

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21
Q

Why is midazolam not a good choice for pain control during procedures?

A

Because it does not provide analgesia

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22
Q

Name one situation where midazolam is preferred over other agents.

A

Pediatric sedation, preoperative anxiolysis, seizure control, or short procedures with minimal stimulation

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23
Q

What is the typical IV dose of diazepam for anxiety or sedation in adults?

A

0.05-0.2 mg/kg

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24
Q

What is the onset time of action of diazepam when administered intravenously?

A

1–3 minutes

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25
Q

What is the approximate duration of diazepam’s clinical effects after IV administration?

A

1–3 hours

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26
Q

What is the primary mechanism of action of diazepam?

A

Potentiation of GABA-A receptors

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27
Q

Which of the following is NOT a primary clinical use of diazepam?

A

Chronic pain relief

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28
Q

Diazepam is preferred in the treatment of:

A

Acute alcohol withdrawal

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29
Q

Which of the following best describes a disadvantage of diazepam compared to midazolam?

A

Prolonged half-life and active metabolites

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30
Q

Diazepam has both anxiolytic and muscle relaxant properties.

A

True

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31
Q

Diazepam is commonly used for long-term management of epilepsy.

A

False (Used more for acute seizure control)

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32
Q

Diazepam has a shorter half-life than midazolam.

A

False

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33
Q

Diazepam is highly lipid-soluble, which contributes to its rapid CNS penetration.

A

True

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34
Q

Respiratory depression is not a concern when using diazepam.

A

False

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35
Q

Diazepam has active metabolites that contribute to its prolonged effects.

A

True

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36
Q

The effects of diazepam can be reversed with flumazenil.

37
Q

What is the usual IV dose range of diazepam for status epilepticus?

A

5–10 mg IV, repeated every 10–15 minutes if needed (max 30 mg); Muscle Spasm 5-10 mg IV

38
Q

What is the primary receptor system affected by diazepam?

A

GABA-A receptor system (enhancing inhibitory neurotransmission)

39
Q

List two major clinical uses for diazepam.

A

Seizure control, anxiety, alcohol withdrawal, muscle spasms

40
Q

What are common side effects of diazepam?

A

Drowsiness, respiratory depression, confusion, hypotension, ataxia

41
Q

Why is diazepam not preferred for continuous IV sedation in critical care?

A

Because of its long half-life and accumulation due to active metabolites

42
Q

In what clinical scenario is diazepam considered a first-line option?

A

Status epilepticus or acute alcohol withdrawal seizures

43
Q

What drug can be administered to reverse the sedative effects of diazepam?

A

Flumazenil

44
Q

What makes diazepam’s duration of action longer than that of midazolam?

A

Its long elimination half-life and the presence of active metabolites

45
Q

What is the typical IV dose of lorazepam for status epilepticus in adults?

A

2–4 mg IV; Typical (non-status epilepticus) 0.05 mg/kg

46
Q

What is the usual onset of action of lorazepam when given intravenously?

A

1–3 minutes

47
Q

How long do the clinical effects of lorazepam last after IV administration?

A

6–8 hours

48
Q

What is lorazepam’s primary mechanism of action?

A

GABA-A receptor potentiation

49
Q

Which of the following is a clinical use of lorazepam?

A

Status epilepticus treatment

50
Q

Which property makes lorazepam superior to diazepam in treating seizures?

A

Longer duration in the CNS

51
Q

Which of the following is NOT a common side effect of lorazepam?

A

Hypertension

52
Q

Lorazepam is more water-soluble than diazepam.

53
Q

Lorazepam is effective in the treatment of status epilepticus.

54
Q

Lorazepam has no respiratory depressant effects.

55
Q

Lorazepam causes anterograde amnesia.

56
Q

Lorazepam is suitable for preoperative sedation and anxiety reduction.

57
Q

The effects of lorazepam can be reversed with naloxone.

A

False (Reversed with flumazenil)

58
Q

Lorazepam has a relatively short duration of action compared to midazolam.

59
Q

What is the usual IV dose range of lorazepam for treating acute seizures?

A

Typically 4 mg IV given slowly at 2 mg/min

60
Q

What receptor does lorazepam act on to exert its sedative and anxiolytic effects?

A

GABA-A receptor

61
Q

List two major clinical uses of lorazepam.

A

Seizure control, preoperative sedation, anxiety, alcohol withdrawal

62
Q

Why is lorazepam preferred over diazepam in status epilepticus?

A

Longer CNS duration due to less lipid solubility and slower redistribution

63
Q

What are the common side effects of lorazepam?

A

Drowsiness, confusion, respiratory depression, hypotension

64
Q

What is the reversal agent for lorazepam?

A

Flumazenil

65
Q

In what scenario might lorazepam be avoided or used cautiously?

A

In patients with respiratory compromise or severe liver dysfunction

66
Q

How does lorazepam differ from midazolam in terms of duration of action?

A

Lorazepam has a longer duration of clinical effects than midazolam

67
Q

What is the recommended dose of dexmedetomidine (Precedex)?

A

0.2-1 mcg/kg

68
Q

What is the typical maintenance infusion rate of Precedex?

A

0.2–1.4 mcg/kg/hr

69
Q

What is the primary mechanism of action of dexmedetomidine?

A

Alpha-2 adrenergic receptor agonism

70
Q

Which of the following is a common effect of Precedex?

A

Analgesia with minimal respiratory depression

71
Q

What is the typical onset time of Precedex after IV administration?

A

2–5 minutes

72
Q

Which of the following is a notable side effect of dexmedetomidine?

A

Bradycardia and hypotension

73
Q

Precedex is most appropriately used for which of the following clinical scenarios?

A

Sedation of intubated ICU patients

74
Q

Dexmedetomidine causes significant respiratory depression similar to propofol.

75
Q

Precedex provides both sedative and analgesic effects.

76
Q

Dexmedetomidine is a selective alpha-1 receptor agonist.

77
Q

Precedex can be used for awake fiberoptic intubation.

78
Q

Bradycardia is a common side effect of Precedex.

79
Q

Dexmedetomidine is often preferred for short-term post-op pain management only.

A

False (It’s more often used for sedation in ICU or procedural settings)

80
Q

Dexmedetomidine has amnestic effects equivalent to midazolam.

81
Q

What is the typical onset of action for dexmedetomidine?

A

2–5 minutes after IV administration

82
Q

What is the maintenance dose range for Precedex infusions?

A

0.2–1.4 mcg/kg/hr

83
Q

What receptor does Precedex primarily act upon?

A

Alpha-2 adrenergic receptors

84
Q

Name two common side effects of dexmedetomidine.

A

Bradycardia, hypotension

85
Q

Why is Precedex preferred over other sedatives in some ICU settings?

A

It provides sedation without significant respiratory depression

86
Q

Can Precedex be used in non-intubated patients? If so, in what setting?

A

Yes, for procedural sedation or monitored anesthesia care (MAC), especially when minimal respiratory depression is desired

87
Q

How is Precedex beneficial during awake intubations?

A

It provides sedation and anxiolysis while maintaining airway reflexes and spontaneous breathing

88
Q

Does Precedex provide muscle relaxation or anticonvulsant properties?

A

No, it does not

NSU AA Denver Drugs and Inhalational Agents (17 decks)

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