BIOM 3090 Lecture Notes - Lecture 19: Premedication, Pre-Medical, Lorazepam
9 Jun 2018
School
Department
Course
Professor
General anesthesia
- To permit major surgery – start with alert patient (usually)
o Administer sedative or anxiolytic + analgesic
o Induce unconsciousness
o Maintain in unconscious state
- Pharmacological approach
1) Premedicate patient
2) Induce general anesthesia rapidly using a short-acting injectable
drug
3) Transfer to inhalant anesthetic for maintenance
4) Recovery
Anesthetics and Pre-anesthetics
1) Premeds including sedatives and the opioid analgesics
2) Induction agents
3) Inhalant anesthetics
4) Local anesthetics
Pre-anesthetics premeds
- Premedication’s: a broad term that refers to a variety of injectable drugs
administered prior to inducing general anesthetic, in order to calm the
patient, reduce the amount of general anesthetic needed, and inhibit intra-
and post-operative pain
- Main types:
o Sedatives/anxiolytics – to calm patient/reduce activity
o Hypnotics – to induce sleepiness
o Analgesics – to minimize/abolish intra- & post-op pain
- Most premedication’s also reduce the amount of general anesthetic needed to
produce unconsciousness → increases safety of the anesthetic procedure
- Sedatives/hypnotics
o Main types, for example:
▪ Phenothiazine’s
▪ Alpha2-agonists
▪ Benzodiazepines
▪ Barbiturates
Benzodiazepines (BZDs)
- Ex. diazepam, lorazepam
- Many others; differ mainly in duration of action (diazepam ~ 48h; lorazepam
~ 20h)
- Diazepam – trade name: Valium
o Useful pre-med effects:
▪ Anxiolytic/sedative
▪ Hypnotic
▪ Muscle relaxant
▪ Also has anticonvulsant effects
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
To permit major surgery start with alert patient (usually: administer sedative or anxiolytic + analgesic, induce unconsciousness, maintain in unconscious state. Pharmacological approach: premedicate patient, induce general anesthesia rapidly using a short-acting injectable drug, transfer to inhalant anesthetic for maintenance, recovery. Anesthetics and pre-anesthetics: induction agents, inhalant anesthetics, local anesthetics, (cid:498)premeds(cid:499) including sedatives and the opioid analgesics. Premedication"s: a broad term that refers to a variety of injectable drugs administered prior to inducing general anesthetic, in order to calm the patient, reduce the amount of general anesthetic needed, and inhibit intra- and post-operative pain. Main types: sedatives/anxiolytics to calm patient/reduce activity, hypnotics to induce sleepiness, analgesics to minimize/abolish intra- & post-op pain. Most premedication"s also reduce the amount of general anesthetic needed to produce unconsciousness increases safety of the anesthetic procedure. Sedatives/hypnotics: main types, for example, phenothiazine"s, alpha2-agonists, benzodiazepines, barbiturates. Many others; differ mainly in duration of action (diazepam ~ 48h; lorazepam.
