Ch. 15 Pilbeams Flashcards
What are the levels of sedation?
• Minimal sedation
• Moderate sedation
• Deep sedation
• Anesthesia
What is the Ramsey sedation scale?
Why are benzodiazepines the drugs of choice for anxiety in critical care?
• Low cost
• ability of the drugs to produce anxiolytic, hypotonic, muscle relaxation, anticonvulsants, and anterograde amnesic effects.
What can reverse the effects of benzodiazepines?
Flumazenil (romazicon)
Based on weight and works really fast
What is precedex?
An a2 agonist used for short term sedation and analgesia in the ICU. It has shown to reduce sympathetic tone with attenuation of the neuroendocrine and hemodynamic responses to anesthesia and surgery.
What are neuroleptics?
Used to treat patients demonstrating evidence of extreme agitation & delirium. Disorganized thinking and unnecessary motor activity characterized delirium.
What is propofol?
General anesthetic agent that possesses sedative amnesia and hypotonic properties at low doses although it has no analgesic properties
Key point 15.5
Propofol is an ideal sedative when rapid awakening is important such as when neurological assessment is required or for extubation.
What can reverse the side effects of opioids (opiates)?
Narcan
What are opioids (opiates)?
Endogenous & exogenous substances that can bind to a group of receptors located in the CNS and peripheral tissues
How long does Narcan last?
30 sec
longest is 30mins
What is Morphine?
A potent opioid analgesic agent that is the preferred agent for intermittent therapy because of it’s longer duration of action. It can produce significant effects on the CNS and alter the control of breathing even in normal healthy individuals
What is fentanyl?
A synthetic opioid that is approximately 100 to 150 times more potent than morphine. Its high lipid solubility and short transit time across the blood brain barrier produce a rapid onset of action.
Most common reasons for using NMBAs in patients with mechanical ventilation:
• patient-vent asynchrony that cannot be corrected by just a ventilator settings
• facilitation of less conventional mechanical ventilation strategies
• facilitation of intubation, ensuring stability of the airway, during transport, or repositioning
• dynamic hyperinflation that cannot be corrected
• adjunctive therapy for controlling raised ICP
• reduction of oxygen consumption, and carbon dioxide production
What are depolarizing agents?
They resemble acetylcholine in their chemical structure
What are some paralytics used in the ICU?
What are some initial vent settings based on pulmonary disorder?
