Non Barbiturates Hypnotic Agents

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Non Barbiturates Hypnotic Agents

• Vicente Gonzalez CRNA, MS
• Assistant Professor
• Florida International University

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OBJECTIVES

• Explain the mechanism of action of nonbarbiturate
  IV anesthetics.
• Discuss the pharmacokinetic properties of
  propofol, ketamine, and etomidate.
• Compare the effects that nonbarbiturate IV
  anesthetics have on organ systems.

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OBJECTIVES

• Discuss clinical uses of propofol, ketamine, and
  etomidate.
• State specific contraindications of
  nonbarbiturate IV anesthetics in the clinical
  setting.
• List potential side effects associated with
  nonbarbiturate IV anesthetics.

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REFERENCES

• Morgan, G.E., Mikhail, M.S., and Murray, M.J.
  (2006).
• Clinical Anesthesiology. (4th Ed.) New York, NY
• McGraw-Hill.
• Nagelhout, J.J. and Naglaniczny, K.L. (2005).
  NurseAnesthesia. (3rd Ed.) St. Louis, MO
  Elsevier-Saunders

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REFERENCES

• Stoelting, R.K. (2006). Pharmacology Physiology
  in
• Anesthesia Practice. (4th Ed.) Philadelphia, PA
• J.B. Lippincott Company.

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Non barbiturate Agents

• Agents
• Uses
• PK-PD
• Effects on Organ Systems
• Induction Doses
• Contraindications

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Non barbiturate Agents

• Propofol
• Etomidate
• Ketamine

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Non barbiturate Agents

• Propofol
• Chemical Structure
• Commercial Preparations
• MOA

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Non barbiturate Agents

• Chemical structure of propofol

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Non barbiturate Agents

• Propofol contd.
• Pharmacokinetics
• Clinical Uses
• Other Uses

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Non barbiturate Agents

• Propofol contd
• Organ System Effects
• CNS
• Cardiovascular
• Respiratory
• Renal/Hepatic

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Non barbiturate Agents

• Propofol contd
• Contraindications

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Non barbiturate Agents

• ETOMIDATE
• Chemical Structure
• Commercial Preparations
• MOA

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Non barbiturate Agents

• Chemical Structure of Etomidate

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Non barbiturate Agents

• Etomidate contd
• Pharmacokinetics
• Clinical Uses
• Other Uses

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Non barbiturate Agents

• Etomidate contd
• Organ System Effects
• CNS
• Cardiovascular
• Respiratory
• Renal/Hepatic
• Other

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Non barbiturate Agents

• Etomidates pathway of inhibition of cortisol and
  other corticosteroids

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Non barbiturate Agents

• Etomidate contd
• Contraindications

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Non barbiturate Agents

• Ketamine
• Chemical Structure
• Commercial Preparations
• MOA

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Non barbiturate Agents

• Chemical Structure of Ketamine

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Non barbiturate Agents

• Ketamine contd
• Pharmacokinetics
• Clinical Uses
• Other Uses

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Non barbiturate Agents

• Ketamine contd
• Organ System Effects
• CNS
• Cardiovascular
• Respiratory
• Renal/Hepatic
• Other

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Non barbiturate Agents

• Ketamine contd
• Contraindications