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Flashcards in Box 2 Deck (92)
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1

Other name for Sufentanil?

Sufenta

2

Classification of Sufentanil?

Opioid Agonist

3

Sufentanil dose:
induction?
Epidural bolus?
Epidural infusion?

Induction: 1 to 30mcg/kg

Epidural bolus: 25-50mcg

Epidural infusion 5-30mcg/hr

4

MOA Sufentanil?

Opioids act as agonists at specific opioid receptors at sites in the CNS as well as the periphery. Opioids mimic the action of endogenous ligands by binding to opioid receptors, resulting in activation of pain-modulating system.

5

Sufentanil half life?

6 hours

6

Sufentanil
Onset?
Peak?
Duration?

Onset: 1-3 minute
Peak: 5.6 minutes
Duration: Dose Dependent.

7

Contraindications to Sufentanil use?

caution in elderly, hypovolemic, pt. taking sedatives or narcotics.
Crosses the placental barrier can cause resp. depression in neonate if used during labor.

8

Other name for Ketamine?

Ketalor

9

Ketamine classification?

Phencyclidine (PCP) derivative: Non-barbiturate dissociative anesthetic: NMDA (N-Methyl-D-Aspartate) receptor antagonist

10

Contraindications to Ketamine?

patients with CAD (inotropic effect increases cardiac myocardial O2 requirements)

pulmonary HTN

increased ICP

11

Ketamine dose:
analgesic?
Induction?

analgesic- 0.2-0.5mg/kg

Induction- 1-2mg/kg IV

12

Why would you give Ketamine for induction?

acts as an anesthetic (non-barbiturate anesthetic)

13

Ketamine MOA?

exact MOA is unknown; primarily a noncompetitive antagonist for NMDA receptors, also acts on opioid, monoaminergic, muscarinic and neuronal nicotinic Ach receptors. High lipid solubility, not significantly bound to plasma proteins therefore peak brain concentration may be 5x that of plasma concentrantion.

14

Ketamine IV:
Onset?
Peak?
Duration?

O: 30-60 sec. IV
P: 1 min IV
D: 10-20 min.

15

What patients would Ketamine be good for induction?

causes bronchodilation and may be useful in patients with ASTHMA

16

Does ketamine produce resp. depression?

No, does not produce significant resp. depression.

17

What does ketamine commonly cause?

nystagmus (also causes increased ICP)

18

What is ketamine known for upon emergence?

emergence delirium, can be prevented with a benzo such versed.

19

Patients that should not be given ketamine?

PTSD (patients who have trauma past)

20

What can giving a sub anesthesia dose of ketamine prevent?

opioid tolerance

21

Ketamine comes supplied as a vial concentration of?

500mg/10ml

22

Flumazenil trade name?

Romazicon

23

Classification of Flumazenil?

competitive benzodiazepine-receptor antagonist

24

Contraindications to Flumazenil?

avoided in patients who take chronic oral benzos and
those taking antiepileptic drugs chronically due to risk of having withdrawal seizure.

25

Flumazenil dose for adults?

Dose if person becomes
resedated?

Max dose for no repsonse to Flumazenil?

0.2-1.0 mg IV boluses titrated to the patient’s response; up to 3 mg per hour.
After an initial response, patients may become resedated once the effects of flumazenil have subsided, in which case an IV infusion of flumazenil may be administered (0.1-0.4 mg/hr) until the benzodiazepine effects have resolved.
Lack of patient response after 5mg suggests that benzodiazepines are not the cause of sedation.

26

MOA of flumazenil?

competitively inhibits the activity at the benzodiazepine recognition site on the GABA/benzodiazepine receptor complex.

27

Elimination of Flumazenil (half-life)?

Flumazenil is quickly metabolized by hydroxylation through hepatic microsomal enzymes to inactive metabolites with a half-life of about 1 hour.

28

Flumazenil:
Onset?
Peak?
Duration?

O: 1-2 minutes
P: 2-10 minutes
D: 30-60 minutes, depending on benzodiazepine plasma concentration.

29

Flamazenil and NMB, whats the deal?

Do not use flumazenil until the effects of neuromuscular blockade have been fully reversed.

30

If you do not have a patient response to Flamazenil and you have given 5mg, what does that mean?

No patient response by 5 mg total dose suggests that benzodiazepines are not the cause of sedation or cardiopulmonary depression.