Wk 1-Inductions & Benzos Flashcards
Define: Sedative
a drug that induces a state of calm or sleep, still arousable
What is an example of a sedative procedure?
MAC
Define: Hypnotic
a drug that induces hypnosis or sleep, form of disassociation from the environment
Define anxiolytic.
any drug that reduces anxiety
What is is sedative-hypnotics?
collective term, drugs that reversibly depress the activity of the CNS. This class of drugs play an important role in every aspect of anesthesia delivery from conscious sedation to general anesthesia
Define general anesthesia.
drug-induced unconsciousness that abolishes conscious memory as one component
What is the triad of general anesthesia?
amnesia, muscle relaxation, analgesia
The ______ have greater potency then the sedative effects.
Amnestic potency
What drug is important in the recall of events during general anesthesia and child birth? Why?
Benzodiazepines, Important consideration when concerned with “recall” of events (conscious memory) during anesthesia, especially during procedures that require general anesthesia.
But also an important consideration for events (as childbirth) where a patient’s memory of the event is warranted.
Define anterograde amnesia.
After receiving a drug
Define retrograde.
Before giving the drug
Benzos will _______ the GABA (A) receptor’s affinity for GABA
increase
Define an allosteric modulator
the binding of a substance(called an allosteric modulator) to a certain site on a receptor in a way that alters the conformation of other sites on the receptor, thereby increasing or decreasing the affinity of the receptor for other molecules.
γ-Aminobutyric acid type A (GABAA) receptors are inhibitory or excitatory
inhibitory CNS receptors in neurons, and major targets of general anesthetics such as etomidate and propofol.
What do GABAa receptors contain?
five subunits arranged around a chloride-conducting pore
_____ subunits account for the anxiolysis, whereas _______ account for the sedative, amnestic and anticonvulsive
α2; a1
States of _______ and ______ can increase bioavailability.
Hypoalbumenia/liver disease
What are the common side effects of benzos?
Fatigue, drowsiness (most common)
What is of concern with elderly taking benzos?
Concern with cognitive disturbances postoperative in the elderly.
What are some physiological changes that make the elderly more sensitive to benzos (6)?
aging brain with memory impairment and age related changes in CNS receptors. Decreased metabolism and clearance of drugs. Also increase in body fat and age-related decreases in serum albumin (more unbound drug available)
What other agents can produced synergistic sedative effects in combo with benzos?
ETOH, inhaled and injected anesthetics, opioids, and alpha2 agonists
What can happen with benzos and ETOH?
Life threatening CNS depression when used in conjunction with ETOH (they have cross tolerance).
What meds are used to treat alcohol withdrawal?
Lorazepam (Ativan) and valium
Do you have a burning sensation with midazolam?
No, easily well tolerated