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NSU AA Denver Drugs and Inhalational Agents > Sedative Agents > Flashcards

Sedative Agents Flashcards

1
Q

What is the typical IV sedation dose of midazolam in adults?

A

0.01–0.1 mg/kg; Typically dose 1-2mg

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2
Q

What is the approximate onset of action for IV midazolam?

A

2–5 minutes

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3
Q

How long does a typical dose of IV midazolam last?

A

30–60 minutes (less than 2 hours)

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4
Q

What is the primary mechanism of action of midazolam?

A

GABA-A receptor modulation

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5
Q

Which of the following is NOT a primary clinical use of midazolam?

A

Analgesia

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6
Q

Which of the following is a potential side effect of midazolam?

A

Respiratory depression

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7
Q

In what situation is midazolam particularly useful?

A

Sedation for MRI in a claustrophobic pediatric patient

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8
Q

What is the reversal agent for benzodiazepines like midazolam?

A

Flumazenil

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9
Q

Midazolam has both sedative and analgesic properties.

A

False

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10
Q

Midazolam is water-soluble, making it different from other benzodiazepines.

A

True

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11
Q

Midazolam can cause anterograde amnesia.

A

True

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12
Q

Midazolam has a faster onset and shorter duration than diazepam.

A

True

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13
Q

Midazolam is commonly used for induction of anesthesia in unstable trauma patients.

A

False

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14
Q

The respiratory depressive effects of midazolam are dose-dependent.

A

True

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15
Q

Midazolam can be given IV, IM, PO, and intranasally.

A

True

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16
Q

What is the usual PO dose range of midazolam for pre-op in pediatrics?

A

PO = 0.5 mg/kg

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17
Q

What is the primary neurotransmitter system affected by midazolam?

A

GABAergic system (GABA-A receptors)

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18
Q

Name two key clinical effects of midazolam.

A

Sedation, anxiolysis, amnesia (any two)

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19
Q

What is a major concern when using midazolam in elderly or debilitated patients?

A

Increased sensitivity leading to prolonged sedation and respiratory depression

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20
Q

How can the sedative effects of midazolam be reversed?

A

With flumazenil, a benzodiazepine antagonist

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21
Q

Why is midazolam not a good choice for pain control during procedures?

A

Because it does not provide analgesia

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22
Q

Name one situation where midazolam is preferred over other agents.

A

Pediatric sedation, preoperative anxiolysis, seizure control, or short procedures with minimal stimulation

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23
Q

What is the typical IV dose of diazepam for anxiety or sedation in adults?

A

0.05-0.2 mg/kg

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24
Q

What is the onset time of action of diazepam when administered intravenously?

A

1–3 minutes

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25
What is the approximate duration of diazepam’s clinical effects after IV administration?
1–3 hours
26
What is the primary mechanism of action of diazepam?
Potentiation of GABA-A receptors
27
Which of the following is NOT a primary clinical use of diazepam?
Chronic pain relief
28
Diazepam is preferred in the treatment of:
Acute alcohol withdrawal
29
Which of the following best describes a disadvantage of diazepam compared to midazolam?
Prolonged half-life and active metabolites
30
Diazepam has both anxiolytic and muscle relaxant properties.
True
31
Diazepam is commonly used for long-term management of epilepsy.
False (Used more for acute seizure control)
32
Diazepam has a shorter half-life than midazolam.
False
33
Diazepam is highly lipid-soluble, which contributes to its rapid CNS penetration.
True
34
Respiratory depression is not a concern when using diazepam.
False
35
Diazepam has active metabolites that contribute to its prolonged effects.
True
36
The effects of diazepam can be reversed with flumazenil.
True
37
What is the usual IV dose range of diazepam for status epilepticus?
5–10 mg IV, repeated every 10–15 minutes if needed (max 30 mg); Muscle Spasm 5-10 mg IV
38
What is the primary receptor system affected by diazepam?
GABA-A receptor system (enhancing inhibitory neurotransmission)
39
List two major clinical uses for diazepam.
Seizure control, anxiety, alcohol withdrawal, muscle spasms
40
What are common side effects of diazepam?
Drowsiness, respiratory depression, confusion, hypotension, ataxia
41
Why is diazepam not preferred for continuous IV sedation in critical care?
Because of its long half-life and accumulation due to active metabolites
42
In what clinical scenario is diazepam considered a first-line option?
Status epilepticus or acute alcohol withdrawal seizures
43
What drug can be administered to reverse the sedative effects of diazepam?
Flumazenil
44
What makes diazepam’s duration of action longer than that of midazolam?
Its long elimination half-life and the presence of active metabolites
45
What is the typical IV dose of lorazepam for status epilepticus in adults?
2–4 mg IV; Typical (non-status epilepticus) 0.05 mg/kg
46
What is the usual onset of action of lorazepam when given intravenously?
1–3 minutes
47
How long do the clinical effects of lorazepam last after IV administration?
6–8 hours
48
What is lorazepam's primary mechanism of action?
GABA-A receptor potentiation
49
Which of the following is a clinical use of lorazepam?
Status epilepticus treatment
50
Which property makes lorazepam superior to diazepam in treating seizures?
Longer duration in the CNS
51
Which of the following is NOT a common side effect of lorazepam?
Hypertension
52
Lorazepam is more water-soluble than diazepam.
False
53
Lorazepam is effective in the treatment of status epilepticus.
True
54
Lorazepam has no respiratory depressant effects.
False
55
Lorazepam causes anterograde amnesia.
True
56
Lorazepam is suitable for preoperative sedation and anxiety reduction.
True
57
The effects of lorazepam can be reversed with naloxone.
False (Reversed with flumazenil)
58
Lorazepam has a relatively short duration of action compared to midazolam.
False
59
What is the usual IV dose range of lorazepam for treating acute seizures?
Typically 4 mg IV given slowly at 2 mg/min
60
What receptor does lorazepam act on to exert its sedative and anxiolytic effects?
GABA-A receptor
61
List two major clinical uses of lorazepam.
Seizure control, preoperative sedation, anxiety, alcohol withdrawal
62
Why is lorazepam preferred over diazepam in status epilepticus?
Longer CNS duration due to less lipid solubility and slower redistribution
63
What are the common side effects of lorazepam?
Drowsiness, confusion, respiratory depression, hypotension
64
What is the reversal agent for lorazepam?
Flumazenil
65
In what scenario might lorazepam be avoided or used cautiously?
In patients with respiratory compromise or severe liver dysfunction
66
How does lorazepam differ from midazolam in terms of duration of action?
Lorazepam has a longer duration of clinical effects than midazolam
67
What is the recommended dose of dexmedetomidine (Precedex)?
0.2-1 mcg/kg
68
What is the typical maintenance infusion rate of Precedex?
0.2–1.4 mcg/kg/hr
69
What is the primary mechanism of action of dexmedetomidine?
Alpha-2 adrenergic receptor agonism
70
Which of the following is a common effect of Precedex?
Analgesia with minimal respiratory depression
71
What is the typical onset time of Precedex after IV administration?
2–5 minutes
72
Which of the following is a notable side effect of dexmedetomidine?
Bradycardia and hypotension
73
Precedex is most appropriately used for which of the following clinical scenarios?
Sedation of intubated ICU patients
74
Dexmedetomidine causes significant respiratory depression similar to propofol.
False
75
Precedex provides both sedative and analgesic effects.
True
76
Dexmedetomidine is a selective alpha-1 receptor agonist.
False
77
Precedex can be used for awake fiberoptic intubation.
True
78
Bradycardia is a common side effect of Precedex.
True
79
Dexmedetomidine is often preferred for short-term post-op pain management only.
False (It's more often used for sedation in ICU or procedural settings)
80
Dexmedetomidine has amnestic effects equivalent to midazolam.
False
81
What is the typical onset of action for dexmedetomidine?
2–5 minutes after IV administration
82
What is the maintenance dose range for Precedex infusions?
0.2–1.4 mcg/kg/hr
83
What receptor does Precedex primarily act upon?
Alpha-2 adrenergic receptors
84
Name two common side effects of dexmedetomidine.
Bradycardia, hypotension
85
Why is Precedex preferred over other sedatives in some ICU settings?
It provides sedation without significant respiratory depression
86
Can Precedex be used in non-intubated patients? If so, in what setting?
Yes, for procedural sedation or monitored anesthesia care (MAC), especially when minimal respiratory depression is desired
87
How is Precedex beneficial during awake intubations?
It provides sedation and anxiolysis while maintaining airway reflexes and spontaneous breathing
88
Does Precedex provide muscle relaxation or anticonvulsant properties?
No, it does not

NSU AA Denver Drugs and Inhalational Agents (18 decks)

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