Pharmacology Exam 1- anesthetic

propofol

GABA (duration) , NO REVERSE

sedation, amnesia, hypnosis, NO analgesia (yes man)

“milk of amnesia”

risk: hypotension, apnea, infusion syndrom (met acid)

use aseptic- egg base= bacteria breed - triglyceride and green urine

lorazepam

GABA (frequency), ANTIDOTE: flumazenil/romazicon

anxiolysis, sedation, antergrade amnesia, NO ANALGESIA

first line for seizures, flumazenil can cause seizures

risk: resp depress w opioids, paradox excitation

methohexital

GABA (duration-chloride-narrow safety), NO REVERSAL

hypnosis, amnesia, NO ANALGESIA (even increase pain)

risk: apnea, laryngospasm, extravasation (alkaline- no mix w LR/acid)

contra in porphyria, common electroconvulsive therapy

fentanyl

mu agonist- synthetic opioid (morphine x100) , NALOXONE

only partial amnesia, ANALGESIA

risk: resp depress, chest wall rigid

dose in MCG, hemodynamically stable, lipid sol=quick, transderm option can’t be cut or used w heat

succinylcholine

nicotinic-mimic ach= prolong depol-fasiculation then flaccid, NO REVERSE

fastest paralysis (rapid intubations), NO sedation/amnesia/analgesia

risk: hyperk/CA, malignant hyperthermia (Ca- rising tidal co2, rigid jaw, tachy)

treat hyperthermia w DANTROLINE, avoid 24-72hr after burn/crash/denerve injury, increased effect pt w decreased pseudocholinesterase, last months?

rocuronium

nicotinic- block ach=no depol- only flaccid, REVERSE

sugammedex remove from junction, neostimime block ach breakdown

longer lasting than succinylcholine

risk: prolong paralysis, muscle weak (airway), eye dry out (tape and lube)

lidocaine

local sodium channel-block depol, REVERSE LIPID 20% (push away)

pain/temp lose first, motor last but return first- keep pressure? ANALGESIA

epinephrine hold in place (epi cross BBB- no IV, stay local)

liver tox- tingle, metallic, tinnitus - CNS- Cardiac