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Medications
CAPA Anesthestic Adjunct Medications
| Question | Answer |
|---|---|
| This class of drugs can cause post op agitation and anxiety | Benzodiazepines |
| This class of drugs is used as pre-op sedation and as an anesthetic adjunct | Benzodiazepines |
| This drug is 3 times as potent as Diazepam (Valium) | Midazolam (Versed) |
| Benzodiazepine with rapid onset, peak in 10 to 30 minutes with a 1 to 4 hour duration | Midazolam (Versed) |
| This class of drugs suppresses the ventilatory response to increased CO2 | Benzodiazepines |
| Hypnotic, anticonvulsant, muscle relaxant | Midazolam (Versed) |
| Causes profound amnesia and a reduction in anziety | Midazolam (Versed)and Lorazopam (Ativan) |
| Long acting benzodiazepam with slow onset (20-40 min) and a duration of up to 24 hours | Lorazepam (Ativan) |
| Benzo with good CV and resp stability | Lorazepam (Ativan) |
| This benzo causes decrease in BP and Systemic Vascular Resistance while increasing the HR | Midazolam (Versed) |
| IV route of this Benzo "burns" | Diazepam (Valium) |
| Benzo: Degree of respiratory depression increased with the use of opiates | Diazepam |
| Benzo can cause amnesia up to 48 hours | Diazepam |
| Half Life of this Benzo is age dependent (approximately = patient age) | Diazepam |
| What is the reversal agent for Benzodiazapines? | Flumazenil (Romazicon) |
| What are the side effects of Flumzaenil | transient agitation and N/V |
| How long do you observe a patient after giving flumzaenil? | 2 hours |
| What other drugs potentiate benzos? | Narcotics |
| What effect do Benzo's have on the respiratory system | Suppresses ventilatory response to increased CO2 |
| What cardiac effect may Benzodiazepines have? | Orthostatic changes |
| Fentanyl is _____ times more potent than Morphine | 100 |
| What is the peak time of Fentanyl (Sublimaze) | 3 - 5 minutes |
| How long does Fentanyl (Sublimaze)last? | 1/2 - 1 hour |
| High doses of Fentanyl (Sublimaze) can cause what? | Muscle Rigidity (may need to be reversed with neuromuscular blockers)and Chest wall rigidity |
| What opioid may cause histamine release and seizures in susceptible patients? | Morphine (Atramorph) |
| What is the onset, peak, and duration of Morphine (Astramorph) | onset - 5 mins., peak - 20 mins., and last 3-4 hours |
| what opioid preserves cardiac function and may cause mild hypotension? | Morphine (Atramorph) |
| What respiratory risk does Hydromophone (Dilaudid) have? | suppresses the cough reflex (direct action on the cough center in the medulla) |
| What is the onset, peak and duration of Hydromorphone (Dilaudid) | Onset 10-15 mins, Peak 15-30 mins, duration 2-3 hours |
| what Opioid puts the patient at higher risk for bronchospasm? | Hydromorphone (Dilaudid) |
| Which opioid is avoided for long term therapy? | Meperidine (Demerol) |
| Why is Meperidine (Demerol) not used for long term pain control | Breaks down into normeperidine which is an active metabolite and can lead to toxicity, especially in renal patients. |
| When does Meperidine (Demerol) toxicity show signs in the patient? | Usually several days after treatment of chronic pain. |
| What drug is 500-1000x more potent than Morphine? | Sufentanil (Sufenta) |
| What drug is 5-10x more potent than Fentanyl? | Sufentanil (Sufenta) |
| What drug (opioid) is used in balanced anesthesia and major surgical procedures? | Sufentanil |
| This drug is 1/10 as potent as Fentanyl but increases respiratory depression | Alfentanil |
| This opiod has an extremely short half life and sudden discontinuation will give the patient extreme pain | Remifentanil (Ultiva) |
| This is typically not a stand alone drug. It is usually used in conjuntion with general anesthesia | Remifentanil (Ultiva) |
| What is the reversal for Opioids? | Naloxone (Narcan) |
| What is the onset of Naloxone (Narcan)? | 1-2 minutes |
| What is a common concern when Naloxone is used? | Narcotic effect can outlast Naloxone - may need additional doses or symptoms of overdose may return. |
| What are some adverse reactions to Naloxone? | hypotension, tachycardia, N/V, reversal of pain control |
| What is the most common Post-operative compication? | N/V |
| What can cause Post Op N/V? | dehydration, electrolyte imbalance, position changes |
| Risk factors for post op N/V? | female, obesity, surgical procedure, hx of PONV, Hx of motion sickness |
| Ondansetron, Dloasetron, and Granisetron are all what? | Antiemetics. They are a Serotonin Antagonist |
| What is the only known side effect of Ondansetron (Zofran)? | headache |
| This antiemetic does not need a dose reduction for elderly patients. | Ondansetron (Zofran) |
| This antiemetic may cause prolonged QT intervals | Dolasetron (Anzemet) |
| Antiemetic with half life of 4 hours and is metabolized by the liver | Ondansetron (Zofran) |
| Less costly antiemetic usually given in OR prior to surgical cut. | Dolasetron (Anzemet) |
| Antiemetic used in cancer patients prior to chemotherapy | Granisetron (Kytril) |
| Sife effects of Granisetron (Kytril) | fever, headache, pain |
| Antiemetic used to control severe nausea and vomiting | Prochlorperazine (Compazine) |
| Antiemetic that depresses cough reflex and increases risk of aspiration | Prochlorperazine (Compazine) |
| Antiemetic that may cause sedation and potentiate sedation from other drugs. | Prochlorperazine (Compazine) |
| IV route of this antiemetic may cause hypotension. | Prochloperazine (Compazine) |
| Administer this antiemetic away form IV insertion site. | Promethazine (Phenergan). IV push close to the IV insertion site can cause necrosis. |
| Dopaminergic receptor antagonist (antiemetic) | Promethazine (Phenergan) |
Created by:
keviannk
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