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Sedation Flashcards

1
Q

At what level of sedation may airway intervention be required?

A

deep sedation

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2
Q

What class of drug is midazolam (versed)?

A

benzodiazepine

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3
Q

What is the MOA of benzodiazepines?

A

GABA-A receptor agonists

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4
Q

What is the dosage for oral midazolam (Versed)?

A

0.5-1mg/kg up to 15mg

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5
Q

What is the dosage for nasal midazolam (Versed)?

A

0.2-0.3mg/kg up to 10mg

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6
Q

What is the approximate onset of oral midazolam (Versed)?

A

15-30min

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7
Q

What is the approximate onset of nasal midazolam (Versed)?

A

5min

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8
Q

What is the approximate working time of midazolam (Versed)?

A

30-40min

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9
Q

What are potential side effects of midazolam (Versed)?

A

hiccups, paradoxical reactions, hypotension

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10
Q

What drug concentration is used for oral midazolam (Versed)?

A

2mg/1mL

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11
Q

What drug concentration is used for nasal midazolam (Versed)?

A

5mg/1mL

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12
Q

What is the drug class of diazepam (Valium)?

A

benzodiazepine

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13
Q

What is the dosage for oral diazepam (Valium)?

A

0.2-0.3mg/kg up to 10mg

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14
Q

What is the onset of oral diazepam (Valium)?

A

45min

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15
Q

How long is the working time with oral diazepam (Valium)?

A

60-90min, peak at 60min

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16
Q

What is the active metabolite of diazepam (Valium)?

A

desmethyldiazepam - causes a “hangover” period with feelings of re-sedation

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17
Q

What are common side effects of diazepam (Valium)?

A

ataxia and prolonged drowsiness

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18
Q

What medical condition is contraindicated for use of diazepam (Valium)?

A

narrow angle glaucoma - can cause pupil dilation which can lead to a glaucomic attack

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19
Q

What drug class is hydroxyzine (Vistaril)?

A

antihistamine/antiemetic

20
Q

What is the MOA of hydroxyzine as an antihistamine/antiemetic?

A

H1 receptor competitive antagonist

21
Q

What is the concentration of oral hydroxyzine (Vistaril)?

22
Q

What is the dosage of oral hydroxyzine (Vistaril)?

A

0.5-1.0mg/kg up to 25mg

23
Q

What is the duration of onset for hydroxyzine (Vistaril)?

24
Q

What is the working time for hydroxyzine (Vistaril)?

25
What are side effects of hydroxyzine (Vistaril)?
dry mouth, constipation, confusion, headache, dizziness, skin rash
26
What are contraindications for use of hydroxyzine (Vistaril)?
pregnancy, long QT syndrome
27
What is the MOA of flumazenil (Romazicon)?
competitive antagonist of GABA-A
28
What is the concentration of IM flumazenil (Romazicon)?
0.1mg/mL
29
What is the recommended dose of IM flumazenil (Romazicon)?
0.01mg/kg up to 0.3mg, repeating every 5min PRN
30
What is the MOA of nitrous oxide?
GABA-A receptor agonism and NMDA receptor antagonism
31
What are significant clinical actions of nitrous oxide?
amnesia, analgesia, CNS depression and euphoria, minor depression of CO
32
What are contraindications to use of nitrous oxide?
COPD, current URTI, recurrent middle ear disturbances, first trimester of pregnancy, vitamin B12 deficiency, cancer tx with bleomycin sulfate
33
What occurs during a laryngospasm?
forceful, involuntary spasm of the laryngeal musculature caused by stimulation of the superior laryngeal nerve
34
What is the first line of treatment for laryngospasm?
positive pressure ventilation with chin tilt and jaw thrust
35
What drug is used as the second line of treatment for laryngospasm?
succinylcholine
36
How does a pulse oximeter measure oxygenation?
2 wavelengths of light to compare oxyhemoglobin and deoxyhemoglobin
37
What is health oxygen saturation?
95-100%
38
What can affect the accuracy of a pulse oximeter?
nail polish, skin pigmentation, cold skin with inadequate blood flow
39
What data is captured by capnography?
expired CO2
40
Around what oxygen saturation does low oxygen start to affect the brain?
80-85%
41
What oxygen saturation is considered cyanosis?
67%
42
What range is considered normal for capnography peaks?
35-45mmHg
43
T/F: you should give more meds if a patient does not seem sufficiently sedated when you wish to begin treatment
False: you don't know exactly when peak onset will occur and giving more medication could compound the effects and lead to overdose
44
What is the minimum fasting period for clear liquids before sedation?
2h
45
What is the minimum fasting period for breast milk before sedation?
4h
46
What is the minimum fasting period for light foods before sedation?
6h
47
What is the minimum fasting period for heavy fried/fatty foods before sedation?
8h +

Board Exam Flashcards (4 decks)

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