Drug therapy that supports anesthesia

How would you administer barbiturates?

Infusion is a method of delivering fluids or medications into the body. - It involves using an IV pump to administer a slow and controlled flow of fluids or medications. Barbiturates for anesthesia are given through IV injection or infusion only. - It is important to ensure that the IV catheter is properly placed in the vein before administering. - If the catheter is not in the vein, there is a risk of extravasation. - Extravasation refers to the leakage of the medication into the surrounding tissue.

What does inhibiting GABA mean?

Inhibiting GABA refers to the process of blocking or reducing the activity of gamma-aminobutyric acid (GABA), which is a neurotransmitter in the central nervous system. GABA is known for its inhibitory effects, meaning it helps to regulate and reduce neuronal activity, thus promoting relaxation and reducing anxiety.

What are interventions in nursing?

Interventions refer to the actions or steps taken by healthcare professionals to help people with their health issues or to prevent problems from occurring. These actions can include giving medications, performing surgeries, providing therapies or treatments, advising on lifestyle changes, educating and counseling patients and their families, monitoring progress, and taking preventive measures.

What are the interventions for barbituates?

Since this causes CNS depression monitor vitals and and respiratory rates

What are interactions for barbituates?

Taking barbiturates with other CNS depressants increases their effects on the brain and nervous system. - This combination raises the risk of respiratory depression (difficulty breathing) and hypotension (low blood pressure). - Using benzodiazepine medications like midazolam along with barbiturates has similar effects and is redundant therapy. - Combining these medications can prolong anesthesia and keep you asleep for longer during medical procedures.

What are ester drugs

These drugs have a group called "COO" in their chemical structure. They are often used as pain relievers (like aspirin) and anesthetics. Ester drugs are not as stable as amide drugs and can break down easily in the body.

what are . Amide drugs:

These drugs have a specific group called "CONH" in their chemical structure. They are often used as pain relievers (like acetaminophen) and antibiotics. Amide drugs are known for being stable and safe to use.

Why would i lower the bed if hypotension occurs:?

This is because changes in body position can affect blood flow and help improve blood pressure

Why is epinephrine added to lidocaine?

To increase the length on anestethic effects

Why would a provider use local anesthesia?

To provide pain relief to a specific area of the body or do small surgies such as stitches

What are the precautions and contraindications for localm A's

allergys to amides topical forms to children under 3

What are the therapuetic effects of barbituates

allows for quick and immediate onset of sleep and anesthesia for short medical procedures. Additionally, for procedures lasting longer than 15 minutes, this anesthesia can be used in combination with other medications to enhance its effects and ensure sustained sedation throughout the duration of the procedure.

What are the risks of adding epinephrine to lidocaine?

gangrene (loss of blood supply to a certain area of the body, resulting in tissue death.) in end-artery sites such as fingers toes and noes.

What are precautions for barbituates?

hepatic(liver) or renal disease(kidneys)

what are the two drug types for anesthesia?

local and general anesthesia

What is the prototype drig for general A/barbituates?

methohexital sodium

Fentanyl pharmacologic action

opioids are substances that act as narcotic agonists. They are commonly used to provide pain relief and induce sedation. These effects are beneficial in the field of general anesthesia, where opioids are often administered as additional medications to enhance the overall anesthesia process.

What would the client instructions be for local A's?

please report dizziness, parasthesia(tingling), breathing difficulty

What do general anesthesia drugs do in the barbituate caetgory?

provide rapid induction of anesthesia and hypnosis(deep relaxation for brief procedures. In some cases, these drugs can also be used together with other medications to keep someone under anesthesia for longer procedures that last more than 15 minutes.

What is the prototype to opiods in general anesthesia?

1. General Anesthesia/Neuroleptic-Opioid Combination: This drug classification refers to the combination of drugs used in general anesthesia, specifically involving the use of both neuroleptic and opioid medications. Neuroleptics are a class of antipsychotic medications that can have sedative effects, while opioids are pain-relieving medications. 2. Prototype drug: Within the opioids used as part of a general anesthetic regimen in a neuroleptic-opioid combination, fentanyl is considered the prototype drug. Fentanyl is a powerful opioid medication that can be administered in various forms, such as Duragesic (a transdermal patch) or Actiq (a lozenge or lollipop), to provide potent and rapid pain relief during anesthesia and certain medical procedures.

Fentanyl intervention

1. Monitoring vital signs 2. Monitoring consciousness: 3. Reporting nausea and antiemetic drugs: (medications to prevent vomiting) can help manage this side effect. 4. Having resuscitation equipment 5. Naloxone availability: Naloxone is an opioid antagonist, meaning it can reverse the effects of opioids on the central nervous system, including respiratory depression (slowing of breathing). It is crucial to have naloxone readily accessible, as it can be used as an antidote in the event of opioid overdose or severe respiratory depression.

why would a provider use opiods?

1. Opioids as a supplement to general anesthesia: Opioids can be used in addition to general anesthesia to enhance its effects. When opioids are administered with drugs like droperidol (an antiemetic) and nitrous oxide (a gas anesthetic), they can induce a state called "neuroleptanalgesia." This anesthetic state allows for manipulation of the client's level of consciousness while providing pain relief and sedation. 2. Opioids and skeletal muscle relaxants: In certain situations involving high-risk clients, opioids can be used along with a skeletal muscle relaxant as a form of anesthesia. This combination can be beneficial in these selected cases to provide adequate pain relief and muscle relaxation during surgical procedures.

What are thye adverse reactions for local A's

Adverse reactions occur when systematic absorption occurs. (When the local A is accidentally injected into blood stream). Adverse reactions: CNS stimulants (increase activity in the central nervous system.) CNS depressant (decrease activity in the central nervous system) Spinal -Hypotnesion (low blood pressure)

What are contraindications for barbituates?

Allergy to barbituates

Whaqt us the admin for Benzo's

-Administer benzodiazepines IM into a large muscle for moderate sedation prior to a procedure: This means that the medication should be injected into a large muscle (intramuscularly) to achieve moderate sedation before a medical procedure. -Administer benzodiazepines orally to children prior to surgical procedures -Give benzodiazepines by IV bolus and titrate with additional doses: Intravenous (IV) bolus administration of benzodiazepines is used, followed by adjusting the dosage with additional doses as needed, aiming for the desired level of sedation or to induce general anesthesia. -Combine benzodiazepines with an opioid for conscious sedation: When conscious sedation is required, benzodiazepines can be used in conjunction with an opioid medication to achieve the desired level of sedation while maintaining the patient's consciousness. -Avoid giving IV bolus doses of benzodiazepines to neonates: Neonates, referring to newborn infants, should not receive IV bolus doses (direct injection) of benzodiazepines. The administration route or dosage for benzodiazepines may differ for neonates due to their specific physiological characteristics or potential risk factors.

What are the adverse drug reactions to Benzo's

-Amnesia -Cardiac and resp arrest (heart and lungs stop working)

What are the interventions to Benzo's

-Clients should be informed that amnesia will occur -Clients may experience ongoing amnesia: Their inability to recall recent events may continue for several hours after the procedure. -Potential for cardiac and pulmonary arrest: -Administering an IV bolus with a delay: When administering the medication via intravenous (IV) route, it should be done slowly over a period of at least 2 minutes. -Clients need someone to accompany them at discharge:

What is the therapuetic use for benzo's

-Sedation before general anesthesia -Conscious sedation with induction of amnesia during procedures, such as endoscopy. (This means that the person is kept in a relaxed and drowsy state, but still conscious and able to respond to commands.) -Supplement to inhalation anesthesia for surgeries (During some surgeries, where general anesthesia is utilized, an additional sedative may be given to improve the effect of the anesthesia and promote a deeper state of relaxation. This is often done by using inhalation anesthesia, which is inhaled through a mask or tube, in combination with a sedative medication.)

Fentanyl adverse effects

-sedation -nausea -resp and circulatory depression

What are the interactions for Benzo's?

1. CNS depressant effects: Benzodiazepines have a depressant effect on the central nervous system (CNS), which means they can slow down brain activity and produce sedation. This effect can be enhanced if benzodiazepines are taken concurrently with other drugs that also have CNS depressant effects, such as anticonvulsants. The combination of these medications may increase sedation, drowsiness, or respiratory depression. 2. Cimetidine and midazolam interaction: Cimetidine is a medication commonly used to reduce stomach acid production. When administered with midazolam, it can potentially cause an increase in midazolam levels in the body, leading to midazolam toxicity. This means that cimetidine can interfere with the metabolism or elimination of midazolam, resulting in higher-than-intended levels of the medication. 3. Herbal products and midazolam effects: The effects of midazolam can be influenced by herbal products. Some herbal products may enhance the effects of midazolam, potentially leading to increased sedation or respiratory depression. On the other hand, certain herbal products may decrease the effects of midazolam, reducing its sedative or anxiolytic properties.

Fentanyl interventions

1. Concurrent administration with other CNS depressants: When fentanyl is administered along with other medications that have CNS depressant effects, such as sedatives, tranquilizers, or alcohol, there is an increased risk of excessive sedation and respiratory depression. This means that combining fentanyl with other CNS depressants can cause a greater level of sedation and suppress the respiratory system, leading to potentially dangerous consequences. 2. Safety alert for MAOI antidepressants: MAOI antidepressants are a specific class of antidepressant medications. When clients take MAOIs within two weeks of receiving fentanyl, there is a risk of a hypertensive crisis. A hypertensive crisis refers to a sudden and severe increase in blood pressure that can lead to serious health complications. This interaction between fentanyl and MAOIs can be potentially life-threatening. 3. Asking about antidepressant use: It is crucial for healthcare providers to ask clients if they are taking any antidepressant medications, particularly MAOIs, before administering fentanyl. This is important to identify the potential risk of a hypertensive crisis and take appropriate precautions or consider alternative medications if necessary.

What are the contraindications and precautions for Benzo's?

1. Contraindications during pregnancy, delivery, and lactation: Benzodiazepines are considered teratogenic drugs, which means they have the potential to cause birth defects or harm to a developing fetus. Therefore, they should not be used during pregnancy, delivery, or while breastfeeding. 2. Sensitivity to benzodiazepines or history of acute angle-closure glaucoma: If a client has a known sensitivity or allergic reaction to benzodiazepines, they should not be administered the medication. Additionally, individuals with a history of acute angle-closure glaucoma, a condition where the fluid pressure inside the eye increases rapidly, should also avoid the use of benzodiazepines. 3. Cautious use with clients who have certain disorders: Benzodiazepines should be used with caution in clients who have neuromuscular, cardiac, pulmonary, or renal disorders. This implies that closer monitoring and lower doses may be needed in such cases to minimize any potential risks or adverse effects associated with the medication.

Fentanyl client instructions

1. Expecting drowsiness: Clients should be informed that drowsiness is a common side effect of fentanyl when used as part of the preanesthetic drug regimen or during the procedure. It is important for them to be mentally prepared for this potential effect. 2. Reporting nausea: Clients should be instructed to notify their healthcare providers if they experience nausea. This is important to enable timely administration of an antiemetic medication to prevent vomiting and manage any discomfort. 3. Reassurance of monitoring: Clients should be assured that they will be closely monitored before, during, and after the procedure. This monitoring is essential to ensure their safety and detect any complications that may arise.

Fentanyl admin

1. Fentanyl availability: Fentanyl is available in various forms, including as a surgical premedication (given before surgery) and as intravenous (IV) preparations (administered through a vein). 2. Stick lozenge administration: Stick lozenges are a specific form of fentanyl that can be given to both children and adults. To administer a stick lozenge, it should be placed between the cheek and gum of the patient. 3. Instructions for stick lozenge use: Patients should be informed not to chew the lozenge but instead to suck on it. They should continue sucking on the lozenge for at least 15 minutes or longer.

Fentanyl precautions and contraindications

1. Schedule II controlled substance: Fentanyl is classified as a Schedule II controlled substance, indicating that it has a high potential for abuse and is subject to strict regulations regarding administration and availability. 2. Contraindications: Fentanyl should not be used in clients with a history of substance abuse or during obstetric deliveries. It can be harmful to both the mother and the neonate if administered shortly before delivery, as it can cause respiratory depression in newborns. 3. Caution in certain populations: Fentanyl should be used with caution in clients who have increased intracranial pressure, older adults, young children, and debilitated clients. Additionally, clients with cardiac, respiratory, liver, or kidney disorders require cautious use of fentanyl due to potential complications associated with these conditions. In summary, this statement explains that fentanyl is classified as a Schedule II controlled substance with strict regulations. It outlines the contraindications for fentanyl use, including substance abuse history and obstetric deliveries. It also highlights the need for caution when using fentanyl in specific populations and individuals with certain medical conditions or vulnerabilities.

What are the interactions for local A's?

Beta blockers,cimietidine,quinidine increase lidocaine levels Phenytoin increases risk of cardiac effects Procainamide increases risk for CNS and cardiac effects

what do ephedrine and phenylephrine do for hypotension?

Both ephedrine and phenylephrine are medications used to treat hypotension, which is low blood pressure.+

What are the expected pharmacological effects of benzodiazepine?

CNS depressant. Inhibits (blocks)GABA

What is the difference between ester-type and amide-type local anesthetics?

Ester-type local anesthetics, such as procaine and cocaine, are metabolized by plasma esterases, while amide-type local anesthetics, such as lidocaine and bupivacaine, are metabolized in the liver by hepatic enzymes.

what is the prototype drug for local anestethics?

Lidocaine

How do local anesthetics achieve their analgesic and anesthetic effects?

Local anesthetics achieve their analgesic and anesthetic effects by interrupting the generation and conduction of nerve impulses, preventing the sensation of pain.

Describe the process of local anesthetic absorption and metabolism in the body.

Local anesthetics are absorbed systemically through various routes, such as diffusion and systemic circulation. In the body, they undergo metabolism and elimination via hepatic biotransformation and renal excretion.

what is the expected pharmacologic action of local a's?

Local anesthetics work by temporarily stopping the nerves in a specific area from sending pain signals to the brain. They do this by blocking a certain part of the nerve called sodium channels, which are like tiny gates that allow electrical signals to pass through. By blocking these gates, the local anesthetic prevents the signals from going through and stops you from feeling pain in that area.

What is the protoype drug for benzodiazapines?

Midazolam or Diazapam

What are interventions for local A's?

Monitor resp status and CNS effects prepare top give ephendrine and phenylephrine for hypotension

What are the interventions for local A's

Monitor vital signs if hypotension occurs lower the head of bed

can you put lidocaine in an open wound or in the eyes?

No, there is a risk of increased absorption which can lead to toxicity.

What are the factors that affect the onset and duration of local anesthesia?

Onset and duration of local anesthesia can be influenced by factors such as the drug's lipid solubility, vascularity of the injection site, and the addition of vasoconstrictors.

What is the role of vasoconstrictors, such as epinephrine, in local anesthetic formulations?

Vasoconstrictors, like epinephrine, are often added to local anesthetics to prolong their duration of action by constricting blood vessels, reducing systemic absorption, and enhancing anesthesia at the site. 10. Differential nerve block refers to the ability of local anesthetics to selectively block certain types of nerves (e.g., sensory fibers) while sparing others (e.g., motor fibers). This allows for targeted anesthesia and pain relief.

What are the adverse effects of barbituates?

When you take the right amount, they can make your heart beat slower and lower your blood pressure. But if you take too much, they can cause your blood pressure to drop too much, making your heart beat faster. They can also make it hard for you to breathe, and in extreme cases, you might even stop breathing completely. Taking too much of these medicines can be really dangerous and may even cause death, so they're risky if used in the wrong way. -resp depression -cardiovascular toxicity -suicide -abuse

What are amide and ester drug types?

amide drugs have a "CONH" group and are stable and safe, while ester drugs have a "COO" group and are less stable but still used for pain relief and anesthesia.

what are the expected pharmacologic action of barbituates?

depress cns and enhance Gaba

Why would a provider need to use iv local anestesia?

to provide regional anesthsia for hand or arm procedures as well as epidurals for spinal pain relief.

why would a provider use benzodiazapine?

to sedate before providing anesthesia. (Benzodiazepines are sometimes utilized to induce sedation before medical procedures or surgeries.)