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Reversals
Pharm (Test 2)
| Question | Answer |
|---|---|
| What are the receptor affinities for flumazenil? | benzo antagonist on GABA receptor, weak agonist effect |
| What is 1 indication for the use of flumazenil? | reverse benzo-induced respiratory depression |
| What is a dangerous side effect of flumazenil? | withdrawal seizures in pt on seizure treatment |
| True or False: Pts given flumazenil are likely to experience acute anxiety, stress response, HTN, tachycardia. | False |
| What is an initial dose of flumazenil? | 0.2 mg IV, additional 0.1 mg IV q 60 sec (up to 1 mg total) |
| What is the maximum total dose of flumazenil? | 1 mg |
| What dose of flumazenil should be given to decrease benzo-induced sedation? | 0.3-0.6 mg |
| What dose of flumazenil should be given to totally abolish a benzo effect? | 0.5-1 mg |
| What is the onset of flumazenil? | 2 min |
| What is the duration of flumazenil? | 30-60min |
| Which pts should be given flumazenil with extreme caution? | seizure disorder |
| What is the receptor affinity for narcan? | opioid antagonist for opioid receptors |
| What are some indications for the use of narcan? | opioid overdose, post-op resp. depression, neonatal resp. depression, adverse side effects of spinal and epidural opioids |
| What are some side effects of narcan? | acute pulmonary edema, sympathetic stim., tachycardia, ventricular irritability, HTN, N/V, return of airway reflexes |
| What is the adult dose of narcan? | 0.5-1mcg/kg q 3-5 min |
| What is the neonatal dose of narcan? | 10mcg/kg q 2 min |
| What is the onset of narcan? | 1-3 min |
| What is the duration of narcan? | 30-45 min |
| Where is narcan metabolized? | liver |
| What patients should be given narcan with caution? | neonates (can cause withdrawl with given to mothers), opioid-dependent patients, critically ill, CAD, preexisting lung disease, CHF, cardiac surgery |
| True or False: If titrated properly, the ventilator depression cause by opioids can be reversed w/o weakening analgesia/ | True |
| What is the mechanism of action of doxapram? | CNS stimulant; stimulates hypoxic drive via activation of chemoreceptors in carotid bodies (1mg/kg = PaO2 of 38mmHg) |
| What part of minute ventilation does doxapram influence? | tidal volume (small inc. in RR) |
| What are 2 indications for the use of doxapram? | COPD pts who need supplemental O2, resp. depression and CNS depression due to drugs |
| What are some side effects of doxapram? | mental status changes (confusion, dizziness, seizures @ 20-40X dose, inc. sympathetic outflow, vomiting, inc. body temp, inc. O2 consumption, wheezing, tachypnea, HTN, tachycardia, dysrhythmias |
| What is the dose of doxapram? | 0.5-1mg/kg (max=4 mg/kg) |
| What is the onset of doxapram? | 1 min |
| What is the duration of doxapram? | 5-10min |
| Where is doxapram metabolized? | liver |
| What pts should be given doxapram with caution? | seizure pts, cerebrovascular dis., acute head injury, CAD, HTN, asthma, halothane |
| Which reversal agent also has agonist effects? | flumazenil |
| Which reversal agent can cause acute pulmonary edema? | narcan |
| Which reversal agent should not be given to pts w/ seizure disorders? | flumazenil |
| Which reversal agent can cause tachycardia, HTN, and ventricular irritability? | narcan |
| Which reversal agent can cause N/V? | narcan |
| Which reversal agent should be diluted before administration? | narcan |
Created by:
lindseymontgomery
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