sedative-hypnotic meds Flashcards Preview

MOHD IV > sedative-hypnotic meds > Flashcards

Flashcards in sedative-hypnotic meds Deck (26):
1

lorazepam-ativan

benzo
peak 1-6 hours
elimination time 10-18 hours
tx
-insomnia
-anxiety
-muscle relaxant

2

midazolam-versed

peak 0.2 to 1 hour
elimination ultra short 2-5 hours
tx
-pre anesthetic

3

alprazolam-xanax

peak 1-2 hours
elimination short 12-15 hours
tx
-insomnia
-anxiety

4

non benzos

zolpidem-ambien
zaleplon-sonota
eszopiclone

5

other anxiolytics

buspirone
doxepin

6

other hypnotics

ramelteon
diphenydramine
doxylamine

7

phenobarbital

barbiturate
long onset 1-3 hours
long elimination 80-120 hours
tx
-anticonvulsant

8

pentobarbital

barbiturate
onset short to intermediate 0.5 to 1 hour
intermediate elimination 15-50 hours
tx
-preoperative sedation

9

amobarbital

barbiturate
onset ultra short/immediate
elimination short 10 hours
tx
preoperative sedation

10

thiopental

barbiturate
onset ultra short/immediate
elimination ultra short 3-10 hours
tx
anesthetic induction

11

flumazenil

competitive antagonist of BZD receptor
benzo OD reversal agent
same day surgeries
doest antagonize other CNS/GABA depressants
duration of action shorter than benzo so multiple doses required

12

buspirone

partial agonist 5HT1a receptor
mainly anxiolytic
1/2 life 2 hours-> take a week for efficacy
doesn't potentiate sedative-hypnotic effect of CNS depressants
little risk of tolerance/dependance

13

doxepin

antidrepressant
anxiolytic

14

ramelteon

melatonin Mt1 and Mt2 agonist in suprachiastmatic nucleus
not CNS depressant, no anxiolytic
take 30 min before bed
little risk of tolerance

15

sedative-hypnotic AE

drosiness
impaired motor
impaired judgement
anterograde amnesia
lightheadness
ataxia
nausea
vertigo
incontinence

16

desflurane

volatile anesthetic
MAC 6.6
lowest blood gas Coeff
pungent smell
-airway irritation
--bronchospasm and laryngospasm
decreased cerebral metablosism
decreased HR, PVR, myocardial function, tidal volume
AE N/V, malignant hyperthermia

17

isoflurane

volatile anesthetic
MAC 1.17
highest oil gas coeff
pungent
- airway irritation
--bronchospasm and laryngospasm
decreased cerebral metabolism
decreased HR, PVR, myocardial function, tidal volume
AE N/V, malignant hyperthermia

18

nitrous oxide

volatile anesthetic
MAC 104, use high percentages, hyperbaric
decreased cerebral metabolism
decreased HR, PVR, tidal volume
AE N/V, diffusion expansion into airspace, neurotoxic in developing brain

19

sevoflurane

volatile anesthetic
MAC 1.8
rotten banana smell
decreased cerebral metabolism
decreased HR, PVR, myocardial function, tidal volume
AE N/V, malignant hypertension

20

propofol

IV anesthetic
emulsion (soybean oil, glycerol, egg lecithin)
px during injection (use lido)
rapid onset, short duration, low hangover
rapid hepatic metabolism (infusion)
hypotension and profound decreased resp

21

sodium pentothal

barbiturate
not in US anymore
rapid onset, short duration
long elimination (no infusion)
decreased cerebral metabolism -> decreased ICP
hypotension, tachycardia, upper airway obstruction and apnea

22

etomidate

iv anesthetic
pain on injection
rapid onset and rapid redistribution
most cardiostable IV induction
ventilation less affected
30-60% myoclonus
adrenocortical suppression

23

ketamine

NMDA receptor antagonist
dissociative anesthetic
distribution 1/2 life 10-15 minutes
minimal resp depression
indirect sympathetic stimulation (increased BP)
AE sialorrhea, hallucinations, nightmares, delerium (mollified by benzo)

24

midazolam (less so lorazepam and diazepam)

benzos
premedication and procedural sedation
amnesia, anxiolytic
potent resp depression
antagonized by flumazenil

25

balanced anesthetic technique

anesthetic
opioid
muscle relaxant
pharm based hemodynamic support

26

diazepam- valium

benzo
peak 1-2 hours
long elimination time 30-60 hours
tx
-anxiety
-withdrawal
-muscle relaxant