Flashcards in induction agents Deck (23):
sedativ and hypnotic properties result from substitutions at the...
2 and 5 carbon atoms of barbaturic acid
branched on 5...
greater hypnotic activity than straight chain
phenol group on 5...
enhanced anticonvulsant activity
oxygen on 2
sulfur on 2
thiobarbituates, greater lipid solubility, faster onset, greater potency, shorter DOA
malonic acid + urea
return of awareness after IV administration reflects...
rapid redistribution to inactive sites
distribution depends on...
-lipid solubility (most important)
-degree of ionization
-tissue blood flow
EEG small dose
low volt, fast wave activity (1-5 HZ), clouding of consciousness
EEG moderate dose
high volt, slow wave activity (<4 Hz), similar to physiologic sleep
EEG large dose
1-3 Hz, electrical silence
barbs stimulate activity of the mitochondrial enzyme...
D-aminolevulnic acid synthetase...production of heme is increased
porphyria exacerbated d/t inc in..
porphobilinogen deaminase....porphyrin accumulates (s/s- abdominal pian, constipation, musc weakness, seizures, severs NV)
Acute Intermittent Porphyria/ Variegate Porphyria Treatment
-d/c causative agent
-10% glucose solution
-opioids for pain
-gabapentin for seizures
intra-arterial injection STP
-vasoconstriction, pain, extremity cyanosis, gangrene, limb loss
-treatment: dilution with saline, injection of lidocaine, papaverine, phenoxybenzamine, stelate ganglion block, brachial plexus block, urokinase, heparin
propofol solution made up of...
1% solution (2, 6- diisopropylphenol)
-10% soybean oil
-1.2% egg phosphatide
-0.005% disodium edetate added as microbial retardant (or metabisulfite)
propofol...peds require higher dose b/c...
-larger central distribution
(elderly- smaller central distribution, low clearance)
propofol (rigid, arched back, abnormal position...)
carboxylated imidazole derivative
isomer responsible for hypnotic effects in etomidate
ester-hydrolysis by plasma esterase's and microsomal enzymes