important to use dilute solution Antianalgesic If pt in pain when given will not be able to sedate with pentothal (can sedate w/versed) r/t redistribution from fat and SKM “Hangover”- Porphyria defect in enzymes involved w/HgB synthesis – Barbs. Stimulate aminolevulinic acid synthetase causes – rate of heme production ↑ S/S- abd. Pain, MS, dark vomiting Δ Fatal neuro/CV complications can occur Treatment IV glucose + heme infusion, opiods (only – pure agonsists), phenothiazine for N/V, chloral hydrate or low dose benzos. For insomnia Will precipitate in solution at pH Drug Opiods Same Interactions Nuromuscular Blocking Agents Catecholamines Anaphylaxis Allergic Tx. With IVF and epinephrine Same Reactions High mortality rate Anaphylactoid Histamine Release Small doses Increase low-voltage, fast Beta wave activity Produces clouding of consciousness Larger doses High-voltage, slow Delta wave activity Similar to physiological sleep Effect on EEG Same Loss of consciousness have arousal w/painful stimuli – Somatosensory Evoke potentials remain intact Continuous infusion can produce isoelectric EEG requirements to 55% ↓CMO2 Reflects but not metabolic need for O2 ↓neuronal Hypothermia=only way to cellular metabolic O2 ↓basal requirement Propofol Ketamine Etomidate Induction of Anesthesia Induction of Anesthesia Induction of Anesthesia Clinical Use Sedation Sedation ***use with cardiac and unstable patients*** TIVA/MAC Analgesia (profound)
important to use dilute solution Antianalgesic If pt in pain when given will not be able to sedate with pentothal (can sedate w/versed) “Hangover”- r/t redistribution from fat and SKM Porphyria – defect in enzymes involved w/HgB synthesis Barbs. Stimulate aminolevulinic acid synthetase – causes ↑ rate of heme production S/S- abd. Pain, Δ MS, dark vomiting Fatal neuro/CV complications can occur Treatment – IV glucose + heme infusion, opiods (only pure agonsists), phenothiazine for N/V, chloral hydrate or low dose benzos. For insomnia Drug Interactions Will precipitate in solution at pH Opiods Nuromuscular Blocking Agents Catecholamines Same Allergic Reactions Anaphylaxis Tx. With IVF and epinephrine High mortality rate Anaphylactoid Histamine Release Same Effect on EEG Small doses Increase low-voltage, fast Beta wave activity Produces clouding of consciousness Larger doses High-voltage, slow Delta wave activity Similar to physiological sleep Loss of consciousness – have arousal w/painful stimuli Somatosensory Evoke potentials remain intact Continuous infusion can produce isoelectric EEG ↓CMO2 requirements to 55% Reflects ↓neuronal but not metabolic need for O2 Hypothermia=only way to ↓basal cellular metabolic O2 requirement Same Propofol Ketamine Etomidate Clinical Use Induction of Anesthesia Sedation TIVA/MAC Induction of Anesthesia Sedation Analgesia (profound) Induction of Anesthesia ***use with cardiac and unstable patients***
IV%20Induction%20Agents.docx