University:
University of North Carolina at Chapel Hill
Course:
NURS 312 | Pharmacology
Academic year:

2020
Views:

176

Pages:

1
Author:

esfredint7qo

2.1 – “You’re getting sleepy… sleepy…”” IV anesthetic anestheticss (Propofol, eto etomidate, midate, ketamine) • IV anesthetics are used for rapid induction of anesthesia (lots of ivy in the picture). Preferred over inhaled for induction in most settings. Propofol (Prospero the hypnotist) • Most frequently used anesthetic for induction of anesthesia (“Introducing”). Lipophilic; preferentially enters CNS, accounting for rapid onset. Allows for continuous infusion, so used for maintenance as well (“Maintain your sanity!”). Can be used standalone or in combination with sedatives, opioids, inhaled anesthetics. • MOA presumed to be by potentiating chloride current through the GABA-A complex (Cab-A in the background) • Profound venous & arterial vasodilation →hypotension (dilated sleeves and pants of hypnotist) Etomidate (The Intimidator) • Can be used for induction of anesthesia (“Introducing”). Lipophilic & preferentially enters CNS, accounting for rapid onset. • MOA presumed to be by potentiating chloride current ought the GABA-A complex (Cab-A in the background) • Maintains CV stability, with minimum change to CO, HR, BP (person being lifted is stabilized) Ketamine (snaKE TAMING) • Used for induction (“introducing”) • MOA complex. Major effects probably d/t inhibition of NMDA receptor complex (nomadic camel tied up). Results in dissociative anesthesia. Eyes remain open with slow nystagmus (entranced men with wide eyes) • Common emergence reactions involve vivid colorful dreams, hallucinations, out of body experiences, visual/tactile sensitivity (vividly colored smoke). May induce fear and anxiety or euphoria (used recreationally) • Stimulates CV →↑BP, HR, CO (heart shaped cobra) • Other unique properties include analgesia, minimal respiratory depression, bronchodilation, convenient route of administration. Useful in mentally challenged & Peds patients Benzos (Ben’s Diner) • Midazolam may be used IV perioperatively. • Used for conscious sedation for minor procedures (e.g. colonoscopy) (colonic pump) Barbiturates • Occasionally used for induction (Introducing the Barber). Have been largely replaced as induction agents by propofol • Thiopental used for induction (Sweeney Pentol) • Highly lipid soluble, acts rapidly & finishes quickly (“the Ol’ Quick Shave”)