CNS Anesthetics(1)

Of action ultra short acting drugs cns depressants

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Unformatted text preview: ugs, CNS depressants. CNS Pharmacokinetics---IV with short duration of IV action action Uses---conscious sedation (no loss of conscious consciousness), deep sedation(controlled state of anesthesia with decreased consciousness, neuroleptanalgesia (quiet state with reduced motor activity)---usually use for short surgical procedures activity)---usually Adverse Reactions---drug specific, apnea, drug bronchospasm, hypotension, respiratory depression, confusion depression, 22 Short-Acting Barbiturates (Thiobarbiturates) (Thiobarbiturates) Administered intravenously Employed for induction of anesthesia Two agents – Thiopental sodium (Pentothal) – Methohexital sodium (Brevital) 23 Benzodiazepines Benzodiazepines Diazepam – Induction with IV diazepam (Valium) – Unconsciousness within a minute – Very little muscle relaxation Midazolam – Unconsciousness within 80 seconds – Can cause dangerous cardiorespiratory Can effects effects 24 Propofol Propofol Actions and uses – Unconsciousness develops within 60 Unconsciousness seconds and lasts 3-5 minutes seconds – Sedative-hypnotic for induction and Sedative-hypnotic maintenance of analgesia maintenance Mechanical ventilation and procedures Adverse effects – Can cause profound respiratory depression – Can cause hypotension – Risk of bacterial infection Due to the lipid composition of the drug 25 Population Specific Precaution Precaution Alcoholism – Tolerance – Impaired CNS, liver, kidney Obesity – Increased body surface area Smoking – Respiratory impairment, potent vasoconstriction Pregnancy Young age – Fast metabolism Advanced age – Low metbolism 26 Nursing Management of Adverse Effects Effects Anxiety Risk of aspiration Nausea and vomiting 27 General Anesthetics General Nursing Implications thorough preoperative physical assessment careful drug history before surgery administer preoperative medication complete preoperative check list emotional reassurance explain preoperative medications/assess explain effects effects observe for drug interactions post operative care 28 General Anesthetics in Children Children Greater risk of side effects---laryngospasm, Greater bronchospasm, aspiration. bronchospasm, All body systems are sensitive to the effects of All anesthesia Halothane is commonly used. anesthesia Infants and children have higher anesthetic Infants requirement than healthy adults. requirement More likely to have post operative nausea and More vomiting. vomiting. Need carefully calculated doses. 29 General Anesthetics in Older Adults Adults more susceptible to adverse effects lower doses are needed delayed excretion llong term infusion may lead to ong accumulation accumulation 30 31 31 Critical Thinking Exercise Critical On what does effective concentration of an On inhalation anesthetic depend? inhalation 2. What determines effective induction and What emergence? emergence? 3. Why do patients shiver after when they awake Why from anesthesia? from 4. Why do patients get inj...
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This document was uploaded on 09/11/2013.

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