Anesthesia meds Flashcards Preview

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Flashcards in Anesthesia meds Deck (20):
1

pre-anesthetic meds (for anxiety, amnesia, drowsiness)

Benzodiazepines

Barbituates

2

Benzo agents and advantages

Agents :
Diazepam (little use)
Lorazepam
Midazolam

Raise threshold for CNS toxicity of local anesthetics

Rapid onset and short duration of action

Varying ability to cause amnesia

3

Barbiturate agents and advantages

Agents:
Pentobarbital
Thiopental


May yield disorientation if pain is present

Tolerance observed in patients with chronic use of alcohol

Onset: less than 1 minute / Duration: 5 – 10 minutes

Avoid in: porphyria
Limited availability in US

4

Potent ultra-short acting hypnotic without analgesic properties - conscious sedation - Must follow with analgesic and muscle relaxant drugs

Etomidate

5

Etomidate side effects

hypotension
carbon dioxide retention
suppresses corticosteroid synthesis at adrenal cortex

6

Selectively inhibit nociceptive reflexes and induce analgesia through action at mu receptors

Inhibit release of neurotransmitters including substance P
Antagonize effect of exogenous substance P

Opioids

Morphine
Fentanyl
Sufentanyl
Hydromorphone

7

Opioid equipotent dosing

Morphine
1 -2 mg

Fentanyl
0.05 – 0.1 mg

Sufentanyl
0.005-0.01 mg

Hydromorphone
0.1 – 0.2 mg

8

Used for induction of dissociative anesthesia
Often used for emergency surgical procedures

Ketamine

9

Chemically unrelated to other IV anesthetics
Oil emulsion at room temperature (1% solution)

Propofol

10

Inhaled anesthetic agents

Nitrous oxide (no muscle relaxant activity)
Sevoflurane
Isoflurane
Desflurane

11

Infiltration local anesthetics preferred for

Infiltrative anesthesia may be preferred for surgical or dental procedures.
-- subcutaneously for IV start, shave biopsy or sutures
-- submucosal for dental or laceration repair situations
-- wound infiltration for post-operative pain control
-- intra-articular injections
-- infiltrative nerve blocks

12

Nerve block local anesthetics preferred for

Surgical or diagnostic procedures
Pain management

13

Local anesthetics - Amino Amides

Lidocaine
Bupivacaine
Prilocaine
Dibucaine

14

Local anesthetics - Amino Esters

Benzocaine
Cocaine
Procaine
Tetracaine

15

Amino esters - benzocaine, cocaine, tetracaine - have a higher incidence of

allergic reaction

16

Lidocaine: concentration, dose, onset/duration action

1-2%

4.5-5mg/kg (max 300mg)

Onset < 2 min
Duration 0.5 - 1 hr

17

Lidocaine w Epinephrine: concentration, dose, onset/duration action

1-2% Lido
1:100,000 or 1:200,000 Epi

7mg/kg (max 500mg)

Onset < 2min
Duration 4-6 hours

18

Bupivicaine: concentration, dose, onset/duration

0.25%

2.5mg/kg (max 175mg)

Onset 5 min
Duration 2-4 hours

**often used as epidural for labor delivery**

19

Bupivicaine w Epinephrine: concentration, dose, onset/duration

0.25% Bupi
1:100,000 or 1:200,000 Epi

Max 225mg

Onset 5 mins
Duration 3-7hrs

20

Procaine: concentration, dose, onset/duration

0.25-0.5%

350-600mg

Onset 2-5 min
Duration 0.25-1hr