DRUG
FACTS
ACTION
INDICATION
CONTRA -INDICATION
ADVERSE EFFECT
INTERACTION
NURSING IMPLICATION
ANAESTHETICS
*GENERAL
-↓LOC

*LOCAL/REGIONAL
-specific area
-no ↓LOC

*Types:
-inhaled
-injectable-IV
-balanced-combi

*Types:
-topical
-parenteral IV/CNS spinal inject
(-caine) lidocaine
-central intrathecal/epidural
-peripheral nerve block

* ↓ CNS funxn / sensory
*Overton-Meyer Theory
↑fat solubility = ↑effect

*NEUROMUSCULAR BLOCKING DRUGS
-muscle paralysis
- (+)mechvent- d/t respi paralysis
- (+)paralyze, Conscious
-controlled ventilation during surgical procedure
-Diagnostic drug: Myasthenia G.

*MODERATE SEDATION
-conscious/procedural sedation
-IV benzodiazepine + opiate
-↓pt’s anxiety, mem of procedure
-for dx procedure
-rapid recovery time

*surgical procdre
-rapid onset

*surgical, dental, diagnostic

*drug allergy
*pregnancy
*glaucoma

*ophthalmic use
*drug allergy

*myocardial depression
*malignant hyperthermia (>40c)

*paralysis
Auto-Sensory-Motor (onset)
Motor-Sensory-Auto (recovery)
*spinal headache
Treat: epidural blood patch

*drug-to-drug:
-antihypertensives
-b-blockers
-tetracyclines

*epinephrine,
Bupicavaine, etc
=>dysrthymias

*assess:
-hx of surgeries
-allergies, meds
-alcohol use, illicit drugs
-VS (intra, peri, post)
-ABCs
-watchout ↑Temp
-re orient
-pre-op teaching
Postop turning, coughing,
Deep breathing
-NMBAs: Pt paralyzed, but awake
ANTIANXIETY
-tx mental, emotional health disorders

*ANXIETY
-neurotransmitter imbalance
>CATECHOLAMINES
Dopa. norEpi
>INDOLAMINES
Serotonin, Histamine

*Types:
-Benzodiazipines
(-lam/-pam) diazepam

-Antihistamine
-MIsc: BuSpar

*BARBITURATES CARBAMATES
- prev used to tx anxiety

-↓Brainstem, Limbic actv

-↓CNS sedation, allergc
-non-sedating

*anxiety
*sedation
*seizure control
*adjuvant:depress
*alcohol withdrwl

*sedatives
*alcohol=FATAL

*↓CNS activities
*hypotension
*drowsiness
*N/V

FLUMAZENIL
-txt benzo overdose

*assess:
-phx and emo state
-baseline VS –posturalBP
-LOC
-position slowly-postural hypotension and injury
-drug+psycho tx= effctiv
-alcohol=FATAL
-therapeutic effect:
Mental alertness

SEDATIVES and
HYPNOTICS
-CNS depressants

*SEDATIVE-HYPNOTICS- DOSE DEPENDENT
-↓dose= (-)sleep
-↑dose= (+) Sleep
•SEDATIVES

•HYPNOTICS

*Types:
-Barbiturates
(-bital) phenobarbital

-↓nervousness, ↓ excitability (-) SLEEP

-(+) SLEEP

-↓nerve impulse to cerebral cortex
-act on BrainStem primarily
*txt insomnia => sedation
*↓dose=sedative
*↑dose=hypnotic
*enzyme inducer
(liver enzyme to breakdown drugs)

*sedative
*hypnotic
*anticonvulsant
*anesthesia-surg

*respi difficulty
*severe liver dse
*REM (rapideyemovt) rebound –d/t discontinuing txt

*CNS-drowsiness, lethargy
*Respi- Res dpresn, apnea
*GI-N/V, diarrhea, consti
*Other-StevenJohnson Syn
*REM=>agitation

*TOXCITY/OVRDOSE
-respi arrest
-coma=>death

*↑CNS depression
*Inhibit metabolism -MAOIs prolong effects of barbirurates
*↑metabolism
-↑clot formation

DRUG
FACTS
ACTION
INDICATION
CONTRA -INDICATION
ADVERSE EFFECT
INTERACTION
NURSING IMPLICATION
SEDATIVES and
HYPNOTICS
(continuation)
*Types:
-Benzodiazipines Most frequently prescribed. d/t Safety,efficacy
*Classification:
>SEDATIVE-HYPNOTIC
>ANXIOLYTIC- ↓ anxiety

-Non-Barbiturate Non-Benzo

-↓CNS activity
- no REM suppression
-(+) calming effect
-muscle relaxation

*agitation
*depression
*epilepsy
*mod conscious sedation
*same as above under antianxiety

*glaucoma
*pregnancy

*headache
*drowsiness, vertigo
*fall hazard
*hangover effect

*CNS depressants
*kava/valerian=↓CNS
*Grapefruit/GFJuice
-alter absorption

*15-30min before bed
*REM rebound-caution!
*NO Alcohol
*rebound insomnia 3-4wks after d/c
*SAFETY:
-siderails up, bed alarms

ANTI
DEPRESSANTS
-tx mood dsorder

*MANIA- emotion
*DEPRESSION-↓emotion
*BIPOLAR-mania+depress

*AMINES:
-dopamine
-Serotonin
-norepinephrine

•ANTIMANIC
*Lithium-DOC
-serum level: 0.6-o.8mmol/L

•ANTIDPRESSANTs
*Types:
-Newer-Gen >SSRIs >2nd /3rd Gen