IV Induction Agents Flashcards
(24 cards)
***What are the ‘5 Rights’ for medication administration?
Right patient, right route, right medication, right time, right dose.
***Who is responsible for patient safety when you order, mix, verify, and administer drugs yourself?
You are responsible for all roles, so cross-check thoroughly.
***What are properties of an ideal IV anesthetic agent?
Water soluble, rapid onset, short acting, non-toxic metabolites, no CV depression, non-irritating, no histamine release.
What drug class is Propofol?
Isopropylphenol.
What is the primary receptor target of Propofol?
GABA-A receptor.
What is the induction dose of Propofol for healthy adults?
1.5–2.5 mg/kg IV.
What receptor does Etomidate act on?
GABA-A receptor.
***Why is Etomidate useful in unstable cardiovascular patients?
It causes minimal cardiovascular depression.
**What enzyme does Etomidate inhibit that affects adrenal function?
11β-hydroxylase.
What drug class is Ketamine?
Phencyclidine derivative.
What is the primary mechanism of Ketamine?
NMDA receptor antagonist.
***What are key cardiovascular effects of Ketamine?
Increased BP, HR, CO due to sympathetic stimulation.
**What are major classification groups of IV anesthetic agents?
Isopropylphenols, barbiturates, benzodiazepines, phencyclidine derivatives, imidazoles, alpha-2 agonists.
What are examples of barbiturates used in anesthesia?
Thiopental, Methohexital.
***What is the classification and clinical use of Dexmedetomidine (Precedex)?
Alpha-2 adrenergic agonist used for sedation and analgesia.
What is the mechanism of benzodiazepines?
Enhance GABA-A activity via chloride influx.
What benzodiazepine is ultra-short acting and recently FDA-approved?
Remimazolam.
***What medication considerations must be made in elderly patients?
Lower doses due to reduced metabolism, lower protein binding, increased sensitivity.
***What is the pka of propofol
11
*** What is formed by the condensation of malonic acid and Urea
barbituric acid = how we make barbiturates
What is the difference between
omxybarbiturates
Thiobarbituates
At the C2 position
Thiobarbituates have a SULFUR group instead of an oxygen group
T/F : sulfur decreases lipid solubility
False- increases
therefore leading to more CNS penetration and faster onset
difference in effect of thiopental and phenobarb
thiopental- fast induction used for RSI
Phenobarb- slower but has more sedative and anticonvulsant effect
use for status epileticus
