Barbiturates Flashcards

0
Q

Protein bound

A

NaP 83% bound

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1
Q

Mechanism of action

A
Interact with GABA-A subunit receptor 
Directly activate Cl channel 
Increase duration of opening
Increase efficacy of GABA
Hyperpolarize post synaptic cell membranes 
Block AMPA
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2
Q

Lipid soluble

A

Highly- enters CNS Rapidly 30 secs

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3
Q

Awakening after single dose

A

Prompt

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4
Q

Metabolism

A

Hepatic (inactive)

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5
Q

Eliminated

A

Kidneys

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6
Q

Cardiovascular effects

A

decrease SBP, SVR

Increase HR

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7
Q

Pulmonary effects

A

Respiratory depression
Apnea
Return with slow respers
Decreases tidal volume

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8
Q

CNS effects

A

Decrease CBF, ICP, CMRO2

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9
Q

Renal effects

A

Modest decrease in blood flow and GFR

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10
Q

pH

A

Metabolic acidosis increase effect of barbs
Metabolic alkalosis decreases effect of barbs
Respiratory acidosis much less effect

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11
Q

Thiopental supplied

A

2.5% solution

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12
Q

Methohexital supplied

A

1% solution

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13
Q

Induction of anesthesia

A

3-5 mg/kg NaP
1-1.5 mg/kg methohexital
Rectal methohexital 20-30 mg/kg sedative

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14
Q

Caution if infiltrated

A

Tissue sloughing

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15
Q

NaP + SUX =

A

Concrete in The IV

16
Q

Intro arterial injection causes

A

Severe vasoconstriction

17
Q

Induce what system

A

P-450 system

18
Q

Contraindicated

A

Acute intermittent porphyria

19
Q

Awakens why?

A

Redistribution

20
Q

NaP causes

A

Dose dependent Decrease SBP, SVR, CO due to myocardial depression and increased venous capacitance

21
Q

Respiratory

A

Potent depressant

22
Q

Poor analgesia may cause

A

Hyper analgesia

23
Q

Contraindicated

A

Acute intermittent porphyria

24
Q

Histamine

A

Can be released and cause vasodilation

25
Q

SubQ & Intra-arterial

A

Avoid

26
Q

Onset and offset

A

Rapid