Flashcards in Box 2 Deck (92)
Other name for Sufentanil?
Classification of Sufentanil?
Induction: 1 to 30mcg/kg
Epidural bolus: 25-50mcg
Epidural infusion 5-30mcg/hr
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.
Sufentanil half life?
Onset: 1-3 minute
Peak: 5.6 minutes
Duration: Dose Dependent.
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.
Other name for Ketamine?
Phencyclidine (PCP) derivative: Non-barbiturate dissociative anesthetic: NMDA (N-Methyl-D-Aspartate) receptor antagonist
Contraindications to Ketamine?
patients with CAD (inotropic effect increases cardiac myocardial O2 requirements)
Induction- 1-2mg/kg IV
Why would you give Ketamine for induction?
acts as an anesthetic (non-barbiturate anesthetic)
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.
O: 30-60 sec. IV
P: 1 min IV
D: 10-20 min.
What patients would Ketamine be good for induction?
causes bronchodilation and may be useful in patients with ASTHMA
Does ketamine produce resp. depression?
No, does not produce significant resp. depression.
What does ketamine commonly cause?
nystagmus (also causes increased ICP)
What is ketamine known for upon emergence?
emergence delirium, can be prevented with a benzo such versed.
Patients that should not be given ketamine?
PTSD (patients who have trauma past)
What can giving a sub anesthesia dose of ketamine prevent?
Ketamine comes supplied as a vial concentration of?
Flumazenil trade name?
Classification of Flumazenil?
competitive benzodiazepine-receptor antagonist
Contraindications to Flumazenil?
avoided in patients who take chronic oral benzos and
those taking antiepileptic drugs chronically due to risk of having withdrawal seizure.
Flumazenil dose for adults?
Dose if person becomes
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.
MOA of flumazenil?
competitively inhibits the activity at the benzodiazepine recognition site on the GABA/benzodiazepine receptor complex.
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.
O: 1-2 minutes
P: 2-10 minutes
D: 30-60 minutes, depending on benzodiazepine plasma concentration.
Flamazenil and NMB, whats the deal?
Do not use flumazenil until the effects of neuromuscular blockade have been fully reversed.