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CAPA Anesthestic Adjunct Medications

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