2. Intravenous anesthetics. Neurolept analgesia. Perioperative medication .3. Benzodiazepines Flashcards Preview

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1

Intravenous anesthetics

Propofol
Etomidate
Ketamine
Barbiturates
Benzodiazepines
Opioids
α2 adrenergic agonists

2

Propofol

sedative / hypnotic (no analgesia)
for: induction and maintenance
acts on GABAA receptors
fast onset
liver metabolism
short half life
antiemetic
AE: Vasodilation, can have excitatory phenomena, pain at site of injection

3

Etomidate

hypnotic (no analgesia)
induction due to rapid onset and short duration
Cardiovascular stability
AE: myoclonic movements

4

Ketamine

NMDA antagonist (PCP site)
Anesthetic and analgesic!
“dissociative anesthesia”
increases sympathetic activity
good for hypovolemic / cardiogenic shock patients
clinical indication: strok, hypertension
No muscle relaxation effect
AE: risk of convulsions

5

Barbiturates for intravenous anesthesia

Thiopental
Methohexital

6

Benzodiazepines for intravenous anesthesia

Midazolam
Lorazepam
Diazepam

7

Opioids for intravenous anesthesia

Analgesic | choice based on duration
IV / Intrathecal injection
AE: hypotension, respiratory depression, muscle rigidity opioid “hangover” - nausea and vomiting
suffix - entanil

druges ...
Fentanyl
Alfentanil
Remifentanil
Sufentanil

8

α2 adrenergic agonists for intravenous anesthesia

Clonidine
Dexmedetomidin

9

dissociative anesthesia

characterized by catalepsy, catatonia, analgesia, and amnesia

not always involve loss of consciousness so it is not a state of general anesthesia

10

Fentanyl

longest duration than other opiod

11

Naloxone

antagonize opioids effect

12

Dexmedetomidin

α2 adrenergic agonists
Sedative (without respiratory depression), analgesic, sympatholytic, anxiolytic effects

13

Benzodiazepines

lipophilic
act on GABA.A

druges ..
Midazolam
Triazolam
Lorazepam
Oxazepam
Alprazolam
Nitrazepam
Chlordiazepoxide
Diazepam
Flurazepam
Clonazepam
Temazepam

14

very short acting Benzodiazepines

Midazolam
Triazolam

15

short acting Benzodiazepines

Lorazepam
Oxazepam

16

medium acting Benzodiazepines

Alprazolam
Nitrazepam

17

long acting Benzodiazepines

Chlordiazepoxide
Diazepam
Flurazepam

18

Midazolam

Hypnotic, induction of general anesthesia (retrograde amnesia)

19

Triazolam

Hypnotic
for difficulties falling asleep

20

Lorazepam

Anxiolytic, Hypnotic, Antiepileptic , induction of general anesthesia (retrograde amnesia)

21

Oxazepam

Anxiolytic
dont have active metabolite

22

Alprazolam

Anxiolytic, used in Panic attack and mental depression as well

23

Nitrazepam

Hypnotics

24

Chlordiazepoxide

Anxiolytic

25

Diazepam

Centrally muscle relaxant, Antiepileptic, premedication before general anesthesia

26

Flurazepam

Hypnotic

27

Clonazepam

prolonged treatment of anxiety disorders, panic, Antiepileptic (adjunctive therapy)
First line drug in absence seizure and Lennox-Gastaut syndrome
disadvantageous Sedation and tolerance

28

Temazepam

intermediate acting
for patients experiencing frequent wakening

29

Flumazenil

**not benzodiazepine** used as an antidot for BZN
GABA receptor antagonist
IV only

30

Anxiolytic Benzodiazepines

Chlordiazepoxide
Oxazepam
Clonazepam
Alprazolam