💉Anesthesia -IV INDUCTION

IV INDUCTION

What is the class of Propofol?

Alkylphenol hypnotic

What receptor does Propofol work on?

GABA-A receptor

What are the major effects of Propofol?

↓ cerebral metabolism

What is the induction dose of Propofol?

2.5–3 mg/kg IV (lower with opioids)

What is the onset and duration of Propofol?

Onset <1 min

What are the main indications of Propofol?

Induction

What are the key side effects of Propofol?

Hypotension

What is Propofol Infusion Syndrome (PRIS)?

Metabolic acidosis

Why is Propofol contraindicated in fixed cardiac output states?

Causes vasodilation → dangerous hypotension (e.g.

What can reduce burning sensation of Propofol?

Mix with lidocaine

Is Propofol safe in epileptic patients?

Yes

What is a special advantage of Propofol postoperatively?

Antiemetic

What class is Sodium Thiopental?

Ultra-short acting barbiturate (thiobarbiturate)

What is the mechanism of Thiopental?

GABA-A enhancer + glutamate inhibitor → CNS depression

What is the IV dose and onset of Thiopental?

3–5 mg/kg IV

What is the duration and half-life of Thiopental?

Duration 5 minutes

Why is Thiopental not used for maintenance?

Accumulates in fat → prolonged sedation

What are the indications for Thiopental?

Induction

What are the key side effects of Thiopental?

Hypotension

Why must you avoid intra-arterial injection of Thiopental?

Causes vasospasm

What happens if Thiopental is mixed with rocuronium?

Forms precipitates (incompatible)

What are absolute contraindications to Thiopental?

Porphyria

What class is Midazolam?

Benzodiazepine (anxiolytic

What is the mechanism of Midazolam?

Enhances GABA-A action + increases glycine inhibition

What are the indications for Midazolam?

Sedation

What is the IV onset of Midazolam?

Less than 5 minutes

What is a caution with Midazolam's duration?

Unpredictable and prolonged in elderly/liver disease

What is the antidote for Midazolam overdose?

Flumazenil (0.2 mg IV

What are key side effects of Midazolam?

Respiratory depression

What happens if Flumazenil is used in chronic benzo users?

May cause withdrawal seizures

Why is Midazolam not used for induction alone?

Too weak as a hypnotic

What class is Ketamine?

PCP derivative (dissociative anesthetic)

What is the mechanism of Ketamine?

NMDA receptor antagonist (also opioid and muscarinic effects)

What are the sympathetic effects of Ketamine?

↑ HR

What is the dose and onset of Ketamine?

1–2 mg/kg IV

What is the duration of Ketamine?

Unconscious 10–15 min

What are the main indications of Ketamine?

Trauma

Why is Ketamine great for asthmatic or hypotensive patients?

Provides bronchodilation and maintains BP

What are the psychological side effects of Ketamine?

Emergence reactions: hallucinations

How do we prevent emergence reactions in Ketamine?

Pretreat with benzodiazepines (e.g.

What drug reduces salivation from Ketamine?

Glycopyrrolate

What are contraindications to Ketamine?

Psychosis

What are other side effects of Ketamine?

Tonic-clonic movements

Does Ketamine preserve airway reflexes?

Yes — no laryngospasm or apnea (unlike other agents)