Flashcards in Pharm Quiz #9 Deck (117)
What is the hallmark characteristic of Propofol as an induction agent?
Most rapid and complete awakening of any induction drug
It has a rapid return of consciousness
Minimal residual CNS effects
What is the #1 adverse affect of Propofol?
Pain on injection when a small vein is used
How can you minimize the #1 adverse affect of Propofol?
Minimize pain of injection by using larger veins, lidocaine or an opioid
What is responsible for the prompt awakening after receiving Etomidate?
prompt awakening due to REDISTRIBUTION from brain to inactive tissues although rapid metabolism plays a secondary role
Does Etomidate have any post op affects?
It has a GREATER INCIDENCE OF PONV
Does Etomidate have any negative affects on specific patient populations?
Greater frequency of excitatory spikes on EEGs, may activate seizure foci, so USE WITH CAUTION IN EPILEPSY PATIENTS--->avoid in patients with history of seizures!!
How does Etomidate affect the adrenal-cortical?
Etomidate causes adrenocortical suppression via dose dependent inhibition of the conversion of cholesterol to cortisol
Specific enzyme inhibited is 11-bets-hydroxylase
What illegal drug is Ketamine chemically related to?
PCP derivative that produces dissociative anesthesia--->"the lights are on but nobody is home"
It is a "dirty drug"
What is the #1 mechanism for the CV effects of Ketamine?
Greater SNS outflow--->patients with depleted catecholamine reserves may drop BP with ketamine as direct myocardial depressant effects are blocked by increased SNS outflow.
By what mechanism does Ketamine cause emergence delirium?
Due to depression of inferior colliculus and medial geniculate nucleus
What is the chemical class of propofol?
What is the chemical name for propofol?
Which drug has the most rapid and complete awakening of any induction drug?
Propofol has pain on injection when____veins are used. Minimize pain by _____, _____ and _____.
Propofol interacts with _____, the principal inhibitory neurotransmitter.
Propofol leads to a slower rate of dissociation for GABA from receptors allowing increased durations of opening of ____ channels and hyper polarization of cell membranes.
How is propofol cleared/metabolized in the body?
Hepatic and extra-hepatic metabolism
Tissue uptake by the vessel rich group
Very rapid clearance
Less than ____ of propofol is excreted unchanged in urine?
All metabolites of propofol are pharmacologically ___?
Inactive(water soluble sulfate & glucuronic acid compounds excreted in urine)
What is the elimination 1/2 time of propofol?
0.5 to 1.5 hours
Does the length of infusion alter the context sensitive 1/2 time?
T or F: Propofol has a long effect-site equilibration time like Thiopental.
False--->it is short
Does cirrhosis and ESRD impair propofol elimination?
No it does not
There is an impairment of elimination with patients over ___ years old.
Propofol crosses the ___ but rapidly cleared from fetal circulation.
Give propofol ___ to avoid cardiovascular adverse effects
True or False: Propofol is a trigger agent for malignant hyperthermia?
falso; it is not
For total intravenous anesthesia, we can dose the patient based off of ___ for sedation:
Consciousness in sedation doses range from ___ to ___ mcg/kg/min.
25 - 300(minimal analgesia effects, excellent amnesia effects)