Category: Critical Care Nursing Naloxone is a competitive antagonist of opioids and has been effectively used for the reversal of opioid-induced respiratory depression. It has a rapid onset of action and half-life of 45 minutes, although its effects last only 15 to 30 minutes.
Category: Critical Care Nursing Propofol is another ultra short-acting sedative-hypnotic that has no analgesic properties. It has an extremely rapid onset, short duration of action and predictable efficacy for inducing deep sedation.
Category: Critical Care Nursing Etomidate has been used for deep sedation because of its rapid onset, short duration of action and, most importantly, minimal effects on respiratory and cardiovascular function.
Category: Critical Care Nursing Etomidate is a short-acting, sedative-hypnotic agent and has no analgesic properties. Its use leads to the very rapid onset of profound sedation and hypnosis by enhancing neurotransmission at γ-aminobutyric acid (GABA) receptors.
Category: Critical Care Nursing Because of the potential for hypertension and tachycardia, ketamine should also be avoided in those with significant coronary artery disease. Ketamine also increases intraocular pressure and should be avoided in those with open globe injuries.
Category: Critical Care Nursing The most common side effect seen with ketamine is the emergence phenomenon. The patient awakens with unpleasant vivid dreams or hallucinations or reports nighttime awakenings as a result of unpleasant dreams.
Category: Critical Care Nursing Ketamine may be given by multiple routes but is administered almost exclusively by the IV route in adults. After an IV dose of 1 to 2 mg/kg, a dissociative state results in approximately 1 minute, with duration of action of approximately 15 minutes.
Category: Critical Care Nursing Ketamine use leads to the blockade of catecholamine reuptake and blood pressure is generally well supported. It also induces bronchial smooth muscle relaxation and is well tolerated in patients with reactive airway disease.
Category: Critical Care Nursing Ketamine has several advantages. The most notable are its profound analgesic effect and lack of respiratory depression. The protective airway reflexes, such as coughing, swallowing and muscular tone of the tongue and pharynx are preserved.
Category: Critical Care Nursing Ketamine leads to analgesia, amnesia and catalepsis. It does not produce unconsciousness, but rather a trancelike state. Patients often experience nystagmus, roving eye movements and random movements of the extremities.
Category: Critical Care Nursing Ketamine is a derivative of the street drug phencyclidine and is classified as a dissociative agent. It causes disruption between the thalamoneocortical and limbic systems, preventing the centers from perceiving visual, auditory or painful stimuli.
Category: Critical Care Nursing Benzodiazepines are amnestic, hypnotic and anxiolytic medications. They also have anticonvulsant and muscle relaxant properties but do not have analgesic effects. Because of this, they are commonly given with an analgesic agent.
Category: Critical Care Nursing Morphine has a histamine release and therefore is more likely to produce hypotension, especially in preload-dependent patients. Morphine undergoes hepatic metabolism to an active metabolite, followed by renal excretion.
Category: Critical Care Nursing Because fentanyl readily creates a reservoir in adipose tissue, accumulated large doses may result in a progressively increasing duration of effect. This does not generally occur in doses less than 10 µg/kg.
Category: Critical Care Nursing Fentanyl has many advantages, given its rapid onset, short duration, lack of histamine release and favorable cardiovascular profile. Fentanyl rapidly crosses the blood-brain barrier and produces analgesia in as little as 90 seconds.
