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Pharm Chp 11
sedatives, anethesia, anagesics,
Question | Answer |
---|---|
What is the chemical neurotransmitter substance released to produce a muscle contraction | acetylcholine |
What happens when depolarization occurs | Muscle contraction occurs |
What is it called when an impulse moves down a fiber | Action potential |
What breaks down the acetylcholine so the muscle doesn't remain in a contracted state | actylcholinesterase |
What are the 2 divisions of neuromuscular blocking agents | 1) depolarizing 2) nondepolarizing |
What does the neuromuscular blocking agents do to the patient | They paralyze the patient it does nothing to there consciencousnes so they are awake but can't move |
Does neuromuscular blocking agents depress reps. drive | Yes you must have a et tube ready or a bag and mask due to the muscles not being able to move |
How do the neuromuscular blocking agents work in preventing the muscle from moving: nondepolarizing agents | They prevent the endplate from depolarizing they can be reversed with cholinesterase inhibitors (neostigmine, pyridostigmine |
How do the depolarizing agents work in the neuromuscular blocking agents | These bind the ache receptors and cause a massive depolarization of the muscle this cannot be reversed and is short lived |
What is the medication for the depolarizing agent | succinylcholine |
What are the medications for nondepolarizing agents | pancuronium, vecuronium, atracurium, rocuronium, cistracurium ium- inch receptors or preventing delay |
What are skeletal muscle relaxants for | Just for relaxing the muscle not paralyzing for muscle pain |
What are the 2 different areas the skeletal muscle relaxants are focused on | Central work in the CNS to decrease muscle tone and peripheral work of the muscle itself by interfering with the calcium release |
What are the common muscle relaxants | methocarbamol, cyclobenzaprine, orphenadrine, chlorzoxazone, carisoprodol, dantrolene( only peripheral) |
What does a sedative do | reduce the CNS arousal |
What does hypnotics do | induce sleep |
What do anxiolytics do | reduce anxiety |
What are benzodiazepines | These are the most common drug classes that have all the effects (sedative, hypnotic, anxiolytics these are Valium type drugs |
What are common medications that are benzodiazepines | alprazolam, chlordiazepoxide, diazepam, midazolam, lorazepam |
What is an example of a alpha2 adrenergic agonist | dexmedetomidine ( precedex) |
How do the alpha2 adrenergic agonist work | Works by stimulating central alpha2 receptors resulting I anesthetic and sedative properties. Benzodiazepines have a lower incidence of delirium |
What are nonbenzodiazepines | Sedative and hypnotic with fewer side effects called "z" compounds zolpidem, eszopilone, zaleplon |
What are barbiturates | These are used to treat seizures, sleep and anxiety disorders |
What is an example of a barbiturate | Phenobarbital commonly used in the ICU puts patient in a very deep sleep and has to wear off before patient wakes up can cause reps. Depression in overdose |
What is anesthetics | Anesthesia means without sensations |
What are the 2 divisions of anesthetics are there | 1) local 2) general |
What are local anesthetics used for | act locally to a certain area during minor operations or procedures |
What are general anesthetics used for | Inducing an anesthetic state where the patient will not respond to any stimuli such as in a surgery everything goes to sleep. Will need to be intubated |
What does induction mean in regards to anesthesia | Time it takes to create the appropriate level of anesthesia |
What does maintenance mean in regards to anesthesia | Continuation of the anesthetic state |
What does termination mean in regards to anesthesia | Time it takes a patient to recover from anesthesia |
What are the 4 stages of anesthesia | 1) conscious state patient is awake but can't feel pain 2) loss of consciousness but still has reflexes 3) surgical anesthesia leads to reps. Depression 4) complete loss of reps. drive and loss of cardiovascular tone |
What are common inhaled anesthetics | Nitrous oxide, enflurane, isoflurane, sevofluane, desflurane |
What are common local anesthetics | benzocaine, lidocaine, hurricaine |
Why would we as RT's give lidocaine | It is used as an injection with maintenance drip for vertical disrythmias you gradually turn down the dose when you think the disrythmias are solved |
What are some strategies for reducing post operative nausea | Avoid nitrous oxide, use oxygen, maintain hydration, minimize use of opioids |
What are some medications used for antiemetics | metoclopramide, Phenergan, dramamine |
What are ventilators stimulants | These are also called analeptic stimulants these stimulate the reps. Centers in the medulla to increase the rate and depth of ventilation |
Why would you use a ventilatory stimulant | For someone that has CNS depression |
What is an example of a vent. stimulant | caffeine |
What is an analgesic | This refers to the reduction of the sensation of pain |
What are the types of analgesics are there | Opioids, steroidal anti inflammatory agents and NSAIDS |
What are examples of analgesics | Morphine, fentanyl, codeine, oxycodone |
What is the reversing agent to an opioids overdose | naloxone (narcan) this only lasts usually 30-40 mins. May need to be given more than once to keep from regressing to previous state |
What are steroidal anti inflammatory drugs used for | relieve pain and inflammation |
What are NSAID's | nonsteroidal anti inflammatory drugs. These are the most common analgesic meds. Has antipyretic properties |
How do NSAIDS work | Inhibit the cyclooxygenase pathway which produces prostaglandins |
What are some common drugs that are NSAIDs | aspirin, ibuprofen, naproxen, |