Pharm

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Author:
shirljoa
ID:
214663
Filename:
Pharm
Updated:
2013-04-20 15:09:52
Tags:
IV ane
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Description:
IV Anesthetics
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  1. Propofol (Diprivan)
    • - Induction 15-30 sec
    • - give slow d/t vessel irritant
    • - awake time faster than other IV induction agents
    • - < hangover effect
    • - antiemetic, antipruitic and anticonvulsant
    • - Duration 5-10 min
    • - 1/2 life 2-3 hrs
    • - liver and renal disease don't effect elimination
  2. S/E of propofol
    • - Bradycardia, pain, hypertriglyceridemia
    • - allergic reaction (soybean & egge lecithin- proteins in egg whites)
    • - lactic acidosis
    • - decreased BP d/t decreased CO and SVR
    • - depresses ventilation
  3. Etomidate (Amidate)
    • - weak base
    • - 99% unionized at physiologic pH
    • - Vd large (tissue distribution)
    • - reaches peak brain levels w/in 1 min
    • - rapid recovery d/t rapid redistribution & metabolism (by plasma esterases & hepatic P-450)
    • - emergence 5-10 min
    • - 1/2 life 2-5 hrs
  4. Etomidate S/E
    • - minimal cardio effects
    • - < resp depression (occasional apnea on rapid admin
    • - > incidence of myoclonus on rapid IV induction
    • - adenocortical supression (> risk of sepsis and bleeding)
  5. Dexmetomidine (Precedex)
    • - alpha 2 agonist
    • - use: control of stress, anxiety or pain
    • - Vd 118 L
    • - 1/2 life = 2 hrs
    • - metabolism =  mainly via glucoronidation and P-450
  6. Midazolam (Versed)
    • - benzo w/ strong hypnotic activities
    • - duration 15 min
    • - good amnesic
    • - minimal cardio effects
  7. Ketamine (Ketalar)
    • - rapid induction
    • - duration 15 min
    • - metabolism by N-demethylated (P450) to norketamine, then by hydoxylation (P450) to hydroxynorketamine (inactive)
    • - glucoronated and excreted inurine
  8. Ketamine S/E
    • - stimulates CNS. increases HR, CO & BP-good analgesic and amnesic
    • - blocks glutamate excitatory NMDA receptors in CNS
    • - triggers catalepsy (dissociative anesthesia

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