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Flashcards in Induction Agents Deck (12):
1

Drug receptors for:
-benzodiazepines
-barbiturates
-etomidate
-propofol
-ethanol

GABA-A (ligand gated ion channel)

2

Egg allergy

Egg albumin (white), NOT egg lecithin (yolk)

3

Side effects of etomidate?

-adrenal suppression
-myoclonus and jaw clenching (pre-treat w/opioids or benzos)
-burning on injection (pre-treat w/lidocaine)
-nausea/vomiting (most of all induction agents)

4

Side effects of ketamine

-psychotomimetic effects
-direct myocardial depression (usually masked by sympathetic nervous system activation)

5

What drugs are metabolized by esterase's in the RBC cytosol within the plasma?

Succinylcholine
Remifentanil
Cisatracurium
Esmolol
Mivacurium

6

G-protein couple receptor:
-drugs
-pathway

Alpha and beta agonists
Opioids
Serotonin
Histamine
Prostaglandins

7

G-protein couple receptor pathways

-increases levels of cAMP-->PKA-->cellular effect
*eg. beta receptors

-activates phospholipase C-->cleaves PIP2 to IP3-->signals

8

Ligand gated ion channel receptors

GABA-A (BZs, prop, barbs, etomidate)
NMDA receptor (ketamine)

9

Propofol side effects

-vasodilation-->hypotension (both venous/preload and arterial/afterload)
-baroreceptor reflex response inhibition

*does not interrupt sympathetic outflow, per se

10

Fospropofol

-prodrug metabolized by liver to propofol (and formaldehyde)
-slower onset and recovery
-water soluble (doesn't require lipid emulsion so decreased pain on injection)

11

Barbiturate arterial injection (eg thiopental) and treatment

-spasm-->vasoconstriction-->limb loss
(also barbs crystalize and physically obstruct capillaries)
-central effects: vasodilation (w/o baroreceptor blunting), resp depression, decrease CMRO2/CBF/ICP, and decrease tolerance to pain (antianalgesic)

-treatment: stellate ganglion block

12

Active metabolites
-midazolam
-morphine
-meperidine
-ketamine

-midazolam: alpha-1-hydroxymidazolam
-morphine: morphine-6-gluconoride (major mu-R resp depr)
-meperidine: normeperidine (seizures, esp in renal failure)
-ketamine: norketamine (far less potent, not very imp)