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32 terms

IV induction agents PPT

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How is ketamine differentiated?
By lack of respiratory/myocardial depression
MOA of ketamine
Antagonizes NMDA receptors
Which IV induction agent is associated w/ anti-analgesic properties?
Na thiopental
What is the only IV induction agent that is associated w/ no amount of histamine release?
Etomidate
In addition to hepatic, renal, & enzymatic metabolism, these organs often have a significant role in the metabolism of IV induction agents, particularly propofol?
The lungs
Effects of propofol on ICP, CMRO2, CBF?
Decreases them
Propofol causes ____-____ on EEG
burst suppression
What happens to etomidate upon entry to the cell?
It undergoes molecular rearrangement, where lipid solubility increases (similar to versed)
What does etomidate suppress?
The reticular activating system (RAS)
Effects of etomidate on the EEG
Increases EEG potentials, good for seizure mapping
How does etomidate affect CBF, CMRO2, & ICP?
Decreases them
Etomidate can cause myoclonus d/t ____ ____.
subcortical inhibition
Etomidate produces burning upon injection d/t ____ _____.
propylene glycol
Etomidate causes ____ of _____ ____ ____ for up to 8 hours.
suppression of adrenocortical hormone synthesis
What does ketamine produce?
'Dissociative anesthesia' by inhibiting thalamocortical pathway/stimulating limbic system
How does ketamine affect ICP?
Increases it d/t cerebral vasodilation
Ketamine ____ IOP
increases
How is the emergence delirium associated w/ ketamine treated?
Versed/propofol
Why should ketamine be used cautiously in patients w/ cardiac complications & CAD?
Increases workload on the heart & O2 consumption
Ketamine causes ____, even though is _____ oral secretions.
bronchodilation
increases
Effects of barbiturates on ICP, CMRO2, CBF.
Decreases them
What do barbiturates induce?
Reverse cerebral steal (Robin Hood effect) & free radical scavenging = neuroprotective
Barbiturates cause ___-___ on EEG
burst-suppression
In what patients are barbiturates contraindicated?
Asthmatics (histamine release), & intermittent porphyria
Are benzos lipid or H20 soluble?
Mostly lipid soluble except midazolam (H20 soluble until encountering the body's pH at the lipid bilayer)
How are benzos metabolized?
Primarily hepatic w/ renal excretion
In regard to metabolism, what does diazepam & lorazepam produce and what is the effect?
Active metabolites
Prolonged DOA
Effects of benzos on CMRO2 & CBF
Decreases them
How are benzos reversed?
W/ flumazenil 0.1 mg q 30 s - 1 min
Which IV anesthetic agent comes closest to being a sole anesthetic agent?
Ketamine
How does one treat an intraarterial barbiturate injection?
Heparin, papaverine, lidocaine, phentolamine, or sympathectomy
T/F Propofol is safe to administer to a pt w/ a documented allergy to eggs
True...but it is contraindicated by the manufacturer