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What are two distinct advantage of Gylcopyrrolate over Atropine?
More potent in decreasing secretions (duration of action is 7 hours), causes less Tachycardia
The secondary metabolite caused by Diazepam is responsible for what?
Contributes to sedation and causes it to have a long duration
Effects of Diazepam
Loss of airway control, respiratory depression, hypotension. Synergistic effect with opiods
Why is Midazolam a better choice than Diazepam
Greater amnesia than Diazepam, no secondary metabolite, can be used on children
What receptors does Ketamine affect
NMDA receptors. Close these receptors, blocking signals from passing to the brain and spinal cord (very difficult to titrate for this "open or closed" action)
Effects of Ketamine
Hallucinations, Inc. HR and BP (inc production of endogenous catecholamines) Inc. Salivation (fear of laryngospasm is rational for use of anti-cholinergic)
Does Ketamine cause muscle relaxation?
No, pt. may move extremities, or vocalize (reason for use of benzos or propofol)
What are some advantages of Propofol
Rapid induction, Rapid return to consciousness, minimal residual effects opn CNS, decreased N/V
Does Propofol have analgesic properties
No, must be used with analgesia adjunct (opiates, ketamine, regional)
CI for Propofol
Hemorrhaging pts., poor cardio function, head injuries w/ ICP, allergies to soy or egg, Pts w/ reactive airway disease (asthma)
Effects of Fentanyl
Sedation, Euphoria, Respiratory depression, N/V, constipation, muscle rigidity if administered too quickly
What is the most common cause of cardiac arrest during anesthesia
Hypoxia and Hypercardia due to insufficient oxygenation and ventilation
TX for anaphylaxis
Epi (1:1000) 0.3-0.5 SC or IM Epi (1:10,000) reserved for resistant life threatening cases. Albuterol 2.5 nebulized, Benadryl 50-100mg
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