sedatives

Question 1

ramsay scale 1

Answer 1

anxious/agitated

Question 2

ramsay 2

Answer 2

cooperative/oriented/tranquil

Question 3

ramsay 3

Answer 3

responds only to verbal commands

Question 4

ramsay 4

Answer 4

asleep with brisk response to stimulation

Question 5

ramsay 5

Answer 5

asleep with sluggish response to stimulation

Question 6

ramsay 6

Answer 6

asleep with no response to stimulation

Question 7

level 1 sedation

Answer 7

anti anxiety; can respond to verbal commands

Question 8

level 2 sedation

Answer 8

moderate sedation/analgesia; can respond to verbal commands

Question 9

level 3 sedation

Answer 9

deep sedation/analgesia; can impair airway, responds to painful stimuli

Question 10

level 4 sedation

Answer 10

general anesthesia; pt can’t be aroused

Question 11

what do barbiturates have

Answer 11

sedatives, hyponitcs, some amnesia

Question 12

what is the sedative of choice in head trauma/icp/ status epilepticus

Answer 12

barbiturates

Question 13

what side effects do barbiturates have

Answer 13

not good for pts with lung disease, causes broncho/laryngospasm; not good for asthmatics, causes hypovolemia/tension and so use 1/2 dose

Question 14

methohexital

Answer 14

anesthetic, hypnotic, sedative; causes loss of spent ventilations, quick onset/duration, histamine release

Question 15

pentothal

Answer 15

sedative/hyponotic, short acting/rapid onset, decreases cerebral metabolic rate and ICP, negative inotrop

Question 16

propofol

Answer 16

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

Question 17

etomidate

Answer 17

not barbiturate; good for intubations, not good for seizure patients, short duration, not continuous infusion

Question 18

benzodiazepines

Answer 18

sedative/hypnotic/anxiolysis agents; anticonvulsant with amnesia affects, causes decreased ventilations, no analgesic

Question 19

diazepam

Answer 19

benzo; rapid onset/duration 2-4 hours

Question 20

lorazepam (ativan)

Answer 20

benzo; longer term sedation, peaks in 20-30 min

Question 21

midozolam (versed)

Answer 21

benzo; good procedural drug, short acting, anxiolysis; duration 60-90 min

Question 22

what is the benzo reversal agent

Answer 22

flumuzenil or romazican

Question 23

chloral hydrate

Answer 23

sedative/hypnotic, used in children for long procedures, no analgesic, can cause respiratory depression if combined with other sedative

Question 24

meperidine-demeral

Answer 24

analgesic - narcotic - duration 2-3 hours (in b/w fentanyl/morphine) causes increased HR, and seizures, watch in pts with renal failure

Question 25

fentanyl

Answer 25

analgesic - narcotic - potent short duration of action, preferred drug for short procedures, alternate to morphine in trauma with hemodynamic compromise

Question 26

morphine

Answer 26

analgesic - narcotic - most frequently used and excreted renal; duration 3-4 hours preferred for trauma and prolonged injuries

Question 27

ketamine

Answer 27

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

Question 28

nitrous oxide

Answer 28

mixed with 50% o2; anxiolytic, analgesic, used in minor procedures or with other analgesic for severe pain

Question 29

what do NSAIDS do

Answer 29

analgesic, antipyretic, no sedation or antianxiety

Question 30

keterolac

Answer 30

NSAID given with outpatient with other opioid analgesic

Question 31

depolarizing does what

Answer 31

promotes/maintains depolarized state

Question 32

non depolarizing does what

Answer 32

prevents depolarization/blocks acetycholine

Question 33

what are the 4 non depolarizing

Answer 33

pan/roc/vec/trac

Question 34

pan

Answer 34

20-60 min

Question 35

roc

Answer 35

20-35 min

Question 36

vec

Answer 36

20-35 min

Question 37

what reverses non depolarizing

Answer 37

neostigmine - or anticholinergic/cholinesterase inhibitor

Question 38

use caution with what for non depolarizing

Answer 38

hepatic/renal disease, asthma, cold, and obesity

Question 39

depolarzing agent

Answer 39

succinylcholne - 5-10 min with mild histamine release

Question 40

when do u use caution with succ

Answer 40

neuromuscular disease; causes hyperkalemia; and respiratory depression

Question 41

TAC

Answer 41

tetraccine/epi/cocaine

Question 42

LET

Answer 42

lidocaine/epi/tetracine

Question 43

onset of topical anesthetics

Answer 43

30-45 min

Question 44

EMLA

Answer 44

lidocaine/priolociaine 3-5 mm depth with 1-2 hour onset

Question 45

ela max

Answer 45

liposomal/lidocaine - 30 min onset