Flashcards in Pharm 2 Exam 1 Drug List Deck (28)
short acting ester type LA
short acting ester type LA for infiltration, epidural, spinal
short acting ester type LA for topical use in throat and nose procedures
SE: vasoconstriction and tachycardia
longer acting amide LA for infiltration, Bier block, peripheral, epidural, spinal
longer acting amide LA for peripheral
adjunct w/ local anesthetic
Reduces systemic absorption of LA by vasoconstriction
adjunct w/ local anesthetic for epidural and spinal administration to further reduce pain transmission
adjunct w/ local anesthetic
Tx convulsions d/t systemic absorption of LA into CNS
extracellular Na channel blocker (binds in all states) vs local anesthetic (use dependent blockade)
cocaine, procaine, tetracaine, benzocaine
SE: allergy d/t PABA
met. by plasma and liver psuedocholinesterases
lidocaine, mepivacaine, bupivacaine, etidocaine, prilocaine, ropivacaine
met. in liver by p450
1 MAC=105%. Blood:gas 0.47, very insoluble in blood, rapid induction and emergence. Analgesic, 70-80% in O2 used.
GOOD: analgesia b4 anesthesia, little toxicity, rapid induction/recovery
BAD: weak agent, hypoxia may occur, closed air spaces may expand
Avoid in pt w. pneumothorax, obstructed middle ear, air embolus, obstructed bowel loop, intraocular air bubble, intracranial air
Blood:gas 1.8=relatively high, induction slow
BAD: CV depression d/t dec in contractility, seizures, uterine muscle relaxant
MC used inhalation anesthetic in US
1 MAC=1.4%, Blood:gas 1.4=relatively low, somewhat fast induction
GOOD: CO maintained, systemic vessels dilate causing sm dec in BP, arrhythmias uncommon, potent coronary vasodilator
BAD: more pungent than halothane, progressive respiratory depression
Blood:gas .69= relatively low, fast induction
GOOD: can be used for outpt anesthesia b/c of its rapid recovery profile
BAD: some reports of toxicity
Blood:gad 0.42, low, very fast induction. Very fast emergence, usu does not exceed 5-10 min.
GOOD: useful for outpt surgery d/t rapid onset and recovery. Not very fat soluble.
BAD: irritating to airway can cause coughing, salivation, bronchospasm. Low volatility=requires use of specially heated vaporizer. May evoke tachycardia.
Blood:gas 12, highly soluble in rubber so special equipment needed, not used much anymore.
GOOD: very potent
BAD: extensive metabolism, may produce renal failure and nephrotoxicity.
Blood:gas 2.3=relatively high, induction slow
soluble in fat
BAD: halothane hepatitis: immune response evoking hepatic necrosis, fever, nausea, rash, vomiting
Barbiturates (sodium thiopental)
GOOD: little post-anesthetic excitement or vomiting, water soluble
BAD: respiratory and CV depression, no antagonist, slow recovery, no analgesia
GOOD: rapid metabolism and recovery, little accumulation, milk of amnesia as it produces a hypnotic and forgetful rest
BAD: not water soluble, no antagonist, no analgesia, cardiorespiratory depression, can elicit pain on initial injection.
GOOD: ANTAGONIST available, anterograde amnesia, CV stability=is primarily used for pt at risk of hypotension.
BAD: accumulates=slow recovery, no analgesia, pain on injection
GOOD: analgesia, NO resp depression=may inc BP, hypnotic state=dissociative anesthesia
BAD: inc musc tone and incidence of involuntary movements, hallucinations, adverse effects are less common in kids
Fentanyl and Morphine