Flashcards in sedatives Deck (45)
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1
ramsay scale 1
anxious/agitated
2
ramsay 2
cooperative/oriented/tranquil
3
ramsay 3
responds only to verbal commands
4
ramsay 4
asleep with brisk response to stimulation
5
ramsay 5
asleep with sluggish response to stimulation
6
ramsay 6
asleep with no response to stimulation
7
level 1 sedation
anti anxiety; can respond to verbal commands
8
level 2 sedation
moderate sedation/analgesia; can respond to verbal commands
9
level 3 sedation
deep sedation/analgesia; can impair airway, responds to painful stimuli
10
level 4 sedation
general anesthesia; pt can't be aroused
11
what do barbiturates have
sedatives, hyponitcs, some amnesia
12
what is the sedative of choice in head trauma/icp/ status epilepticus
barbiturates
13
what side effects do barbiturates have
not good for pts with lung disease, causes broncho/laryngospasm; not good for asthmatics, causes hypovolemia/tension and so use 1/2 dose
14
methohexital
anesthetic, hypnotic, sedative; causes loss of spent ventilations, quick onset/duration, histamine release
15
pentothal
sedative/hyponotic, short acting/rapid onset, decreases cerebral metabolic rate and ICP, negative inotrop
16
propofol
non barbiturate; deep sedation with less airway reactivity, decreases cerebral metabolic rate and ICP; not excreted by kidneys or liver; can cause metabolic acidosis; good for antiseizure
17
etomidate
not barbiturate; good for intubations, not good for seizure patients, short duration, not continuous infusion
18
benzodiazepines
sedative/hypnotic/anxiolysis agents; anticonvulsant with amnesia affects, causes decreased ventilations, no analgesic
19
diazepam
benzo; rapid onset/duration 2-4 hours
20
lorazepam (ativan)
benzo; longer term sedation, peaks in 20-30 min
21
midozolam (versed)
benzo; good procedural drug, short acting, anxiolysis; duration 60-90 min
22
what is the benzo reversal agent
flumuzenil or romazican
23
chloral hydrate
sedative/hypnotic, used in children for long procedures, no analgesic, can cause respiratory depression if combined with other sedative
24
meperidine-demeral
analgesic - narcotic - duration 2-3 hours (in b/w fentanyl/morphine) causes increased HR, and seizures, watch in pts with renal failure
25
fentanyl
analgesic - narcotic - potent short duration of action, preferred drug for short procedures, alternate to morphine in trauma with hemodynamic compromise
26
morphine
analgesic - narcotic - most frequently used and excreted renal; duration 3-4 hours preferred for trauma and prolonged injuries
27
ketamine
nonopiod analgesic - causes trancelike stae; rapid sedation, preserves respiratory drive; helps maintain BP, helps prevent bronchospasm, increases pressures in body, causes laryngospasm, and excessive secretions
28
nitrous oxide
mixed with 50% o2; anxiolytic, analgesic, used in minor procedures or with other analgesic for severe pain
29
what do NSAIDS do
analgesic, antipyretic, no sedation or antianxiety
30
keterolac
NSAID given with outpatient with other opioid analgesic
31
depolarizing does what
promotes/maintains depolarized state
32
non depolarizing does what
prevents depolarization/blocks acetycholine
33
what are the 4 non depolarizing
pan/roc/vec/trac
34
pan
20-60 min
35
roc
20-35 min
36
vec
20-35 min
37
what reverses non depolarizing
neostigmine - or anticholinergic/cholinesterase inhibitor
38
use caution with what for non depolarizing
hepatic/renal disease, asthma, cold, and obesity
39
depolarzing agent
succinylcholne - 5-10 min with mild histamine release
40
when do u use caution with succ
neuromuscular disease; causes hyperkalemia; and respiratory depression
41
TAC
tetraccine/epi/cocaine
42
LET
lidocaine/epi/tetracine
43
onset of topical anesthetics
30-45 min
44
EMLA
lidocaine/priolociaine 3-5 mm depth with 1-2 hour onset
45
