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Pharmacy NP > Sedatives/Anesthetics > Flashcards

Sedatives/Anesthetics Flashcards

1
Q

Definition of sedative/anesthetics (3 words)

A

sedatives/anxiolytics/hypnotics

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2
Q

GABA how many subunits?

A

5

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3
Q

Site for convulsant work on

A

Picrotoxin site

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4
Q

Steroid site these medications work here

A

Allopregnanolone anesthetics and anxiogenic

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5
Q

GABA site a medication works here

A

bicucline

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6
Q

Medications that work on the benzodiazepine site

A

Agonists (diazepam and zolpidem) and inverse agonist here, and antagonist

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7
Q

Orthosteric site of the gaba receptor

A

GABA binds at the orthosteric site on the GABAA receptor

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8
Q

Promote the gaba receptor

A

allopregnanolone, anesthetics, agonst (daizepam and zolpidem)

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9
Q

Inhibit the gaba receptor

A

inverse agonist, antagonists, bicucline, convulsants, anxiogenics

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10
Q

Benzo plus an opioid can cause

A

resp depression, coma, death

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11
Q

Midazolam can interact with

A

antifungals

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12
Q

Midazolam are prolonged with these conditions

A

obesity and decreased albumin levels

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13
Q

Lorazepam is preferred when

A

long term sedations >72 hours

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14
Q

Lorazepam is offered in these routes

A

oral im and iv

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15
Q

benzodiazepine withdrawal can occur ____ length of time

A

after 2 weeks of benzo use

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16
Q

symptoms of benzo withdrawal

A

insomnia, anxiety, inc hr, autonomic instability

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17
Q

to avoid benzo withdrawal

A

convert to longer acting agent to taper slowly

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18
Q

time frame for emergence of symptoms of benzo withdrawl

A

corresponds to the half life of the benzo

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19
Q

these medications do not stay in the tissues for a long time

A

etomidate, prop and ketamine

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20
Q

propofol is a ____ agonist

A

GABA agonist (inhibitory activity)

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21
Q

How does Propofol cross the BBB

A

Highly lipid solubility

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22
Q

ketamine can cause this state of anesthesia.

A

dissociative (eyes open talking moving but dissociated from pain)

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23
Q

Hemodynamic effect of ketamine

A

little* resp depression

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24
Q

secondary effect of ketamine

A

hyperalgesia and chronic pain post surgery

25
Q

ketamine cane be used a ____therapy

A

adjunct; extreme response to pain-analgesic effect

26
Q

etomidate is classified as

A

general anesthetic/anesthesia induction; hypnotic used for the induction of anesthesia

27
Q

etomidate is ___acting

A

ultra short actiing non barbiturate; <1 minute duration 3-5min

28
Q

midazolam interacts with this organ

A

liver-cyp450

29
Q

Paradoxical effects of benzos

A

irritability, paranoia heighted anxiety

30
Q

Cardiovascular effects of denzos

A

decrease BP

31
Q

CNS effect of benzos

A

tolerance

32
Q

midazolam can accumulate due to

A

active metabolite in renal failure- due to lipophillic can take long ot clear

33
Q

lorazepam Propeties

A

anxiolytic, amnestic, anticonvulsant, hypnotic

34
Q

less lipid soluble than midazolam

A

lorazepam

35
Q

contain propylene glycol, lactic acidosis, atn and hyperosmolar states

A

lorazepam

36
Q

gastric lavage/activated charcoal for benzo OD

A

no longer recommended

37
Q

benzo OD

A

supportive care, symptomatic care’ IV hydration and maintain adequate airway

38
Q

hemodynamic effects of general anesthesia

A

Hemodynamic instability-vasodilation, myocardial depression​

39
Q

respiratory effect of general anesthesia

A

Respiratory drive diminished, suppress the gag reflex​

40
Q

hypo or hyper temp effect of general anesthesia

A

Hypothermic bc general anesthesia slows down metabolic rate ​<36 degrees

41
Q

GI effect of general anesthesia

A

N/V/decreased lower esophageal tone

42
Q

MAC anesthesia stands for

A

monitored anesthesia care (local and some sedation/analgesia) these pts usually can protect their airway, but they wont remember anything that happened. Don’t need to be intubated

43
Q

Anesthetic state of a person

A

Amnesia​

Analgesia​

Unconsciousness​

Immobility in response to noxious stimulation​

Attenuation of autonomic responses to noxious stimulation​

44
Q

Onset of propfol

A

rapid onset short duration

45
Q

General anesthetic with sedative and hypnotic properties at lower dose, refractory status epilepticus

A

propofol

46
Q

Propofol Infusion Syndrome

A

Observed with sustained (> 48 hr) high-doses (> 75 mcg/kg/min)​

High dose, seen in younger folks​

Potential risk factors​

Corticosteroids, sepsis, catecholamine therapy and brain injury​

​

47
Q

Propofol Infusion Syndrome Symptoms

A

↑ TG, metabolic acidosis, hypotension, bradycardia, rhabdomyolysis, hepatomegaly, cardiac and renal failure

48
Q

single dose of etomidate can causes

A

adrenal insufficiency

49
Q

The use of ________is associated with longer EEG and motor seizure durations. This might be because the absence of anticonvulsant effect

A

etomidate

50
Q

anesthetic adjuncts

A

Benzodiazepines​

Analgesics​

A2 Adrenergic Agonist ​

Neuromuscular Blocking Agents

51
Q

this medication is a alpha 2 adrenergic agonist

A

dexmedetomidine

52
Q

what does alpha 2 do? side effects?

A

reduces noradrenergic tone; releases substance p to have analgesic properties.

decreases hr and bp; not resp depression.

53
Q

precedex

A

8x more selective than clonidine​

Anxiolytic, hypnotic, anti-shivering analgesic sparing​

No respiratory depression​

Cooperative sedation​

Bradycardia​

Hypotension

54
Q

this syndrome is a risk factor when on corticosteroids septic patient brain injury

A

propofol infusion syndrome

55
Q

high triglycerides, metabolic acidosis hypotension bradycardia rhabdo hepatomegaly cardiac and renal failure

A

propofol infusion syndrome

56
Q

___ &______are two opiate medications that can precipitate serotonin syndrome and seizures in at-risk individuals.

A

Tramadol and meperidine

57
Q

what paradoxical effects do you see with benzos

A

fast speech excitability and restlessness

58
Q

this long acting Benz works with status epileptics

A

diazepam

59
Q
A

Pharmacy NP (8 decks)

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