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Topics of Respiratory Care > Test 1 Ch.15 Sedatives, Analgesics, and Paralytics > Flashcards

Test 1 Ch.15 Sedatives, Analgesics, and Paralytics Flashcards

1
Q

Sedatives are used to reduce (4)

A

anxiety, agitation, promote sleep and for anterograde amnesia

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2
Q

Analgesics are used to

A

lessen pain

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3
Q

Paralytics are used to facilitate……
And prevent _________________ and ensure the stability of _____________ airways

A

invasive procedures (e.g surgery, ETT intubation)
movement;
artificial;

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4
Q

What are the different levels of sedation

A
  • Minimal sedation
  • Moderate sedation (Conscious sedation)
  • Deep sedation
  • Anesthesia
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5
Q

With minimal sedation pt’s can respond to verbal commands, although

A

cognitive function may be impaired. Ventilatory and cardiovascular functions are unaffected

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6
Q

Moderate sedation (conscious sedation) the pt can perform purposeful response after repeated or

A

painful stimulation. Spontaneous ventilation is adequate, and cardiovascular function is maintained

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7
Q

Deep sedation, the pt is not easily

A

aroused but can respond to painful stimulation. Spontaneous ventilation and maintenance of pt airway patent airway may be inadequate. Cardiovascular function is usually maintained

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8
Q

In Anesthesia, this level involves general anesthesia, spinal, or major regional anesthesia. Pt cannot be

A

aroused, even by painful stimulation. Ventilatory assistance is typically required. Cardiovascular function may be impaired

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9
Q

Ramsay Sedation Scale (RSS) is used to

A

assess the level of sedation in adults in children

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10
Q

______________________ have been the drugs of choice for tx of __________ in critical care

A

Benzodiazepines;
anxiety

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11
Q

What are the drugs in the Benzodiazepines group?

A
  • Diazepam
  • Midazolam
  • Lorazepam
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12
Q

Benzos are relatively low cost and the ability of these drugs produce: (5)

A
  • anxiolytic
  • hypnotic
  • muscle relaxtion
  • anticonvulsant (anti- seziure)
  • anterograde amnesic effects
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13
Q

______________________ is an a2- adrenorecptor agoinst used for….

A

Dexmedetomidine (Precedex);
short-term sedation in the ICU

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14
Q

Dexmedetomidine (Precedex) has no effect on…
and is used alot in

A

pt’s breathing;
weaning

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15
Q

Neuroleptics are used to treat pt’s demonstrating evidence of

A

extreme agitation and delirium

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16
Q

What is the generic name for neuroleptics

A

Haloperidol

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17
Q

Haloperidol (Haldol) is used to treat

A

delirium in pts in ICU

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18
Q

Anesthetic agents such as __________ is an IV, generic anesthetic agent that possesses sedative, amnesic, and hypnotic properties at low doses, although it has no

A

Propofol (Diprivan);
analgesic properties

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19
Q

Opiodes (opiates) are used to

A

relieve pain

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20
Q

generic names for opiodes

A
  • Morphine
  • Fentanyl
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21
Q

What drug is a naturally occurring opioid agonist?

A

Morphine sulfate

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22
Q

What are opioids reversed with?

A

Naloxone (Narcan)

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23
Q

Morphine is a potent opioid analgesic that is the preferred agent for intermittent therapy b/c of its…..

A

longer duration of action

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24
Q

Fentanyl citrate (Sublimaze) is a synthetic opioid that is approximately

A

100 to 150 times more potent than morphine

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25
Q

Which opioid has a longer half-life and can accumulate in the peripheral tissues after prolong infusion?

A

Fentanyl

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26
Q

Propofol has a _______ onset and _____ duration of sedation once it is discontinued

A

rapid;
short

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27
Q

The rapid awakening from propofol allows interruption of the infusion for

A

neurological assessment

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28
Q

Reversal of the effects of benzos can be accomplished w/

A

flumazenil (Romazicon)

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29
Q

What are the 2 classes of NMBAs available for paralyzing pts on MV?

A
  • Depolarizing agents
  • Nondepolarizing agents
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30
Q

What is the name of the 1 depolarizing drug for NMBA?

A

Succinylcholine

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31
Q

Succinylcholine chloride (Anectine) is short acting 5 to 10 mins depolarizing muscle relaxant that has an onset of action of approximately

A

60 seconds

32
Q

What is the brand name for Diazepam?

A

Valium

33
Q

Midazolam

A

Versed

34
Q

Lorazepam

A

Ativan

35
Q

Haloperidol

A

Haldol

36
Q

Propofol

A

Diprivan

37
Q

Morphine Sulfate

A

Generic only

38
Q

Fentanyl Citrate

A

Sublimaze

39
Q

Dexmedetomidine

A

Precedex

40
Q

Pancuronium

A

Pavulon

41
Q

Succinylcholine chloride

A

Anectine

42
Q

Hydromorphone

A

Dilaudid

43
Q

What are some sedatives (8)

A
  • Diazepam
  • Madazolam
  • Lorazepam
  • Chloriduazepoxide
  • Alprazolam
  • Triazolam
  • Flurazepam
  • Dexmedetomidine (precedex)
44
Q

Brand name for Chloriduazepoxide

A

Librium

45
Q

Alprazolam

A

Xanax

46
Q

Triazolam

A

Halcion

47
Q

Flurazepam

A

Daimane

48
Q

What are some examples of nondepolarizing agents (5) (-um)

A
  • Pancuronium
  • Vecuronium
  • Atracurium besylate
  • Cisatracurium
  • Rocuronium
49
Q

Vecuronium

A

Norcuron

50
Q

Atracurium besylate

A

Tracrium

51
Q

Cisatracurium

A

Nimbex

52
Q

Rocuronium

A

Zemuron

53
Q

Fentanyl has minimum effects on the

A

cardiovascular system

54
Q

Which drug is an acceptable substitute for morphine?

A

Hydromorphone (Dilaudid)

55
Q

Which non-depolarizing agent was one of the first NMBAs used for prolonged paralysis of pts on MV in ICU?

A

Pancuronium (Pavulon)

56
Q

What are the most common reasons for using NMBAs in pts on MV? (5)

A
  • pt-ventilator asynchrony that cannot be corrected with vent settings
  • Facilitation of less conventional MV strategies (i.e inverse I/E ratios, high-frequency ventilation, permissive hypercapnia)
  • Facilitation of intubation, ensuring the stability of the airway during transport, or repositioning
  • Dynamic hyperinflation that cannot be corrected
  • Reduction of oxygen consumption and carbon dioxide production
57
Q

Neuromuscular blocking agents are used for

A

paraylzing pts on MV in ICU

58
Q

How do you monitor neuromuscular blockade?

A

visual, tactile, and electrical assessment of the pt’s muscle tone

59
Q

What is a common method used to assess the pt’s depth of paralysis?

A

An electrical technique called train-of-four (TOF) monitoring

60
Q

Which nondepolarizing NMBA was an effective means of producing prolonged paralysis in pts with renal insufficiency?

A

Vecuronium bromide (Norcuron)

61
Q

Fentanyl is preferred for pts w/

A

hemodynamic instability and renal insufficiency

62
Q

What are some Sedatives (Benzos)

A
  • Diazepam (Valium)
  • Midazolam (Versed)
  • Lorazepam (Antivan)
63
Q

What are some Neuroleptics?

A

Haloperidol (Haldol)

64
Q

What are some Anesthetics?

A

Propofol (Diprivan)

65
Q

What are some Opioids (Narcotic Analgesics)

A
  • Morphine Sulfate
  • Fentanyl Citrate (Sublimaze)
  • Hydromorphine (Dilaudid)
66
Q

What are some hemodynamic effects of propofol?

A

Reduced blood pressure, bradycardia, reduces cerebral blood flow and ICP

67
Q

Continual use of lorazepam has been associated w/ serval side effects including: (3)

A
  • Lactic acidosis
  • hypersomolar coma
  • a reversible neurotoxicity
68
Q

Fentanyl does not cause ______________ release as does morphine

A

Histamine

69
Q

The severity of opioid side effects depends on what three things?

A
  • Dosage administered
  • Extend of pt’s illness
  • Integrity of organ function
70
Q

Diazepam elimination can be decreased in what type of pts?

A

Older pts, neonates and pts w/ compromised hepatic and renal functions

71
Q

Adverse effects of propofol administration (3)

A
  • Hypotension, dysrhythmias
  • Elevation of pancreatic enzymes
  • Bradycardia
72
Q

What 2 drugs should be used for rapid sedation of acutely agitated pts

A
  • Midazolam
  • Diazepam
73
Q

What is the drug of choice for sedating mechanically ventilated pts in the ICU for longer than 24 hours?

A

Lorazepam (Ativan)

74
Q

What are some of the most common side effects of flumazenil

A
  • Dizziness
  • Panic attack
  • Cardiac ischemia
    May lead to seizures in pts receiving long term administration
75
Q

Depolarizing agents resemble _______________ in their chemical structure

A

Acetylcholine

Topics of Respiratory Care (20 decks)

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