NAME Thiopental Trade Name Pentothal (truth serum) General Anesthetic IM/IV Ultra-Short acting barbiturate Rapid onset,

brief duration: <15 min. Used with nitrous oxide

INDICATION Causing drowsiness or sleep before surgery or certain medical procedures. It is also used to stop seizures. It may also be used for other conditions as determined by your doctor.

CLASSIFICATION Pentothal is a barbiturate. MOA:It works by depressing the central nervous system, causing mild sedation or sleep, depending on the dose.

SIDE EFFECTS Clumsiness; dizziness; lightheadedness. Seek medical attention right away if any of these SEVERE side effects occur: Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); fast or irregular heartbeat; fever; hallucinations; severe dizziness; very slow breathing.

CONTRAINDICATIONS Hypersensitivity have the blood disease porphyria taking sodium oxybate (GHB)

NURSING CONSIDERATIONS Carefully monitor client condition Provide education as it relates to the prescribed drug treatment Thorough assessment Administer pre-meds Post-operatively monitor for s/s of CNS depression Use thiopental (Pentothal) cautiously if neuro hx Use cautiously: CVD, respiratory disorders

NAME Ketamine Trade Name - Ketalar Street Name - Special K General Anesthetic IM/IV *Produces dissociative anesthesia/analgesia Poor muscle relaxation Hallucinations common even after procedure.

INDICATION Inducing anesthesia (lack of sensation or feeling) before surgery or certain procedures that do not require skeletal muscle relaxation. It may also be used for other conditions as determined by your doctor..

CLASSIFICATION Ketalar is an anesthetic. MOA: It works by selectively interrupting certain pathways of the brain to inhibit painful sensations.

SIDE EFFECTS Blurred vision; confusion; drowsiness; increased or decreased blood pressure or heart rate; mental or mood changes; nausea; nightmares; vomiting. Seek medical attention right away if any of these SEVERE side effects occur: Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); difficulty talking; irregular heart rhythms; muscle tightness; pain, redness, or swelling at the injection site; slowed breathing.

CONTRAINDICATIONS allergic to any ingredient in Ketalar have a condition in which a large increase in blood pressure would be harmful

NURSING CONSIDERATIONS Psychological effects ranging from pleasant, dream-like states to delirium have occurred as Ketalar wears off. Be sure to have a responsible adult to monitor and assist patient for up to 24 hours after receiving Ketalar. 1. Instruct client NPO for 8 hours before administration. 2. Monitor cardio pulmonary depression and hypotension. 3. Monitor urinary retention. 4. Monitor body temperature - malignant hyperthermic crisis : dantrolene (antidote) 5. Avoid alcohol or CNS depressants for 24 hours after anesthesia. 6. In patient who received halothane, monitor signs of hepatic fatal side effects : - rash, fever, nausea, vomiting - jaundice and altered liver function.

NAME Isoflurane Trade Name - Forane General Anesthetic Inhalation *Less arrhythmias than Halothane Better skeletal muscle relaxation (with neuromuscular blocker on board) Less potent than Halothane

INDICATION Isoflurane, USP may be used for induction and maintenance of general anesthesia. Adequate data have not been developed to establish its application in obstetrical anesthesia.

CLASSIFICATION Isoflurane, USP is an inhalation anesthetic. MOA: Reduces pain sensitivity (analgesia) and relaxes muscles.

SIDE EFFECTS Shivering, nausea, vomiting and ileus have been observed in the postoperative period. Resp depression, hypotension, arrhythmias, malignant hyperthermia.

CONTRAINDICATIONS Known sensitivity to Isoflurane, USP or to other halogenated agents. Known or suspected genetic susceptibility to malignant hyperthermia.

NURSING CONSIDERATIONS 1. Instruct client NPO for 8 hours before administration. 2. Monitor cardio pulmonary depression and hypotension. 3. Monitor urinary retention. 4. Monitor body temperature - malignant hyperthermic crisis : dantrolene (antidote) 5. Avoid alcohol or CNS depressants for 24 hours after anesthesia. 6. In patient who received halothane, monitor signs of hepatic fatal side effects : - rash, fever, nausea, vomiting - jaundice and altered liver function.