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S3E1 - Induction Agents
Manage episode 286451301 series 2804755
Key principles of pharmacology :
Pharmacokinetics : What the body does to the drug.
A. Absorption
D. Distribution
M. Metabolism
E. Excretion
Pharmacodynamics: A drug’s biochemical and physiologic effects on the body.
- Receptor binding
- Receptor sensitivity
- Post-receptor effects
4 induction agents to familiarize yourself with for the first day in the OR:
1. Propofol
- Inhibitory neurotransmission via the GABA receptor
- Provides reliable amnesia and anesthesia, but does not have any analgesic properties
- Potent cardiac and respiratory depressant
- Easily titratable due to high volume of distribution and short initial distribution half-life
- Induction dose is 1-2.5 mg/kg
2. Ketamine
- NMDA receptor antagonist
- Has analgesic, amnesia and anesthetic properties.
- Can cause emergence delirium
- Causes central sympathetic stimulation
- Induction dose 0.5-2 mg/kg
3. Midazolam
- Enhances the affinity of GABA for its receptor
- Minimal cardiorespiratory depression and produces anxiolysis and anterograde amnesia
- Longer-acting; elimination half-life of 1-4 hours
- Induction doses: 0.02- 0.04 mg/kg (1-2 mg in adults)
- Antagonist available: Flumazenil
4. Etomidate
- Increases the receptor’s affinity for GABA
- Cardio-respiratory stable
- Very fast onset/offset due to high lipophilicity; an induction dose of 0.1 mg/kg will provide 1.5 minutes of unconsciousness
- Produces a light plane of anesthesia for laryngoscopy
- Can cause adrenocortical insufficiency
35 episodes
Manage episode 286451301 series 2804755
Key principles of pharmacology :
Pharmacokinetics : What the body does to the drug.
A. Absorption
D. Distribution
M. Metabolism
E. Excretion
Pharmacodynamics: A drug’s biochemical and physiologic effects on the body.
- Receptor binding
- Receptor sensitivity
- Post-receptor effects
4 induction agents to familiarize yourself with for the first day in the OR:
1. Propofol
- Inhibitory neurotransmission via the GABA receptor
- Provides reliable amnesia and anesthesia, but does not have any analgesic properties
- Potent cardiac and respiratory depressant
- Easily titratable due to high volume of distribution and short initial distribution half-life
- Induction dose is 1-2.5 mg/kg
2. Ketamine
- NMDA receptor antagonist
- Has analgesic, amnesia and anesthetic properties.
- Can cause emergence delirium
- Causes central sympathetic stimulation
- Induction dose 0.5-2 mg/kg
3. Midazolam
- Enhances the affinity of GABA for its receptor
- Minimal cardiorespiratory depression and produces anxiolysis and anterograde amnesia
- Longer-acting; elimination half-life of 1-4 hours
- Induction doses: 0.02- 0.04 mg/kg (1-2 mg in adults)
- Antagonist available: Flumazenil
4. Etomidate
- Increases the receptor’s affinity for GABA
- Cardio-respiratory stable
- Very fast onset/offset due to high lipophilicity; an induction dose of 0.1 mg/kg will provide 1.5 minutes of unconsciousness
- Produces a light plane of anesthesia for laryngoscopy
- Can cause adrenocortical insufficiency
35 episodes
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