Iv sedatives/hypnotics Flashcards
(23 cards)
Negative effects of thiopental
Respiratory depression, decreased contractility, causes histamine release, bad for porphyria disease, hyperalgesic effects
Positive effects of thiopental
cerebral vasoconstriction - decreased ICP, anticonvulsant, and amnestic properties
What kind of solution is thiopental stored in
high pH - keeps drug in ionized form
Why is propofol a drug of choice with sedation?
rapid metabolism - quick onset and complete awakening
What kind of patients cannot have propofol?
decreased BP, hypovolemic, lipid metabolism disorders, liver failure
Adverse effects of propofol
massive decrease in BP and respiratory depression
Positive effects of propofol
Cerebral vasoconstriction (decreased ICP), antipruritic, anticonvulsant, and anti emetic
How much pain control is propofol?
none
Benzodiazepine receptors
GABA - enhance chloride entry into cell - hyperpolarization
Benefits of benzo’s
anxiolytics, decrease muscle tension, sedation, AMNESIA, anticonvulsant effects, and decreased ICP
Major complication with benzo’s without adequate blood volume?
massive BP drop
Ketamine classification
PCP derived, non-opioid analgesic/anesthetic drug
Ketamine receptor
NMDA type - glutamate receptor
Who cannot have ketamine?
Heart, hypertension, increased ICP, elderly, PTSD, delirium, confused, and glaucoma
Negative effects of ketamine
hypertonus, nystagmus, increased ICP, stimulates SNS activity!
What is severe emergence?
Waking up confused, combative, hallucinations, and N/V
How to prevent severe emergence with ketamine?
benzo’s
3 common short acting benzo’s
diazepam, midazolam, lorazepam
Analgesic effects of benzo’s
none
What does antipruritic mean?
anti-itching
Are barbiturates unionized or ionized? What percent?
unionized - 60%
What do barbiturates do?
work on the RAS system and depress CNS
What is the significance of hypoproteinemia with barbiturates?
intensifies the response because the free fraction fo drug is increased, causing more to diffuse from blood to brain
