GENERAL

ANESTHETICS

RAPID ACTING
HYPNOTIC'S
Mechanism of action
Stabilize neuronal
membranes to
produce progressive,
reversible CNS
depression

DRUG EXAMPLES

Methohexital
Midazolam HCL
(Versed)
Propofol (Diprivan)
Thiopental Na
(Penthotal)

INDICATION

Anesthesia
induction and
maintenance
Anesthesia
extension

CONTRAINDICATIONS AND
PRECAUTIONS

Use
cautiously in
pts. with
respiratory
and
cardiovascula
r instability

ADVERSE REACTION
Respiratory depression
Apnea
Hypotension
Tachycardia
N/V
Muscle twitching
Tissue necrosis with
extravasation

INTERACTIONS

Additive CNS
depression
when used
with similaracting drugs

NURSING RESPONSIBILITIES
Determine if pt has any
allergy before the surgery
Inform the pt on what to
expect before, during and
after surgery
No foods or fl uids will be
allowed for at least 8 hours
before surgery
Assess pts CV status,
respiratory and renal status
and LOC before and after

INHALATION
ANESTHETICS

MECHANISM OF ACTION

Depress the CNS

to produce loss of
consciousness, loss
of responsiveness
to sensory
stimulation, and
muscle relaxation

DRUG EXAMPLES
Desflurane
(Suprane)
Enflurance
(Ethrane)
Halothane
(Fluothane)
Isoflurane (Forane)
Nitrous oxide

INDICATIONS

Promotion of loss of
consciousness, loss of
responsiveness to
sensory stimulation
including pain and
muscle relaxation
Anesthesia
maintenance

CONTRAINDICATION AND
PRECAUTION

Hypersensitivity
(allergy to the
drug)
Liver disorders
History of
malignant
hyperthermia

ADVERSE
REACTIONS/INTERACTIONS
If use with other CNS
depressants (increases CNS and
respiratory depression and
hypotension)
Postanesthesia (NAUSEA and
VOMITING)
Hypotension
Arrythmias
Tachycardia
Confusion
Agitation
Memory loss

NURSING RESPONSIBILITIES
Fin d o u t if p t is a l l er g i c to t he d r u g
Ad v i ce n o t to ea t o r d r in k a n y t h i n g f o r a t le a s t 8 h o u r s b e f o re
s u rg e r y ( t o p r e v e nt a s p i r a t i o n o f s t o m a c h c o nt e nt s to t h e
I n f o rm t h a t p s y c h o m o to r f u nc t i o ns m ay b e i m p a i r ed f or 2 4
o r m o re ( in h a la t io n a n es t h e s i a )

l u ng s )
hours

Ke e p a t ro p in e a v a ila b le a t a l l t i m e s ( to r e v e r s e p o s s i b l e
bradycardia)
Mo n i to r a d v e r s e r e a c t i o ns f o r t h e e n t i re d r u g a d m in i s t r a t i o n .
Mo n i to r p t s t e m p e r a t u r e fr e q u e n tl y (h y p o t h e rm ia )
S h i v e r i n g is n o rm a l d u r i n g r e c o v e r y ; i f s h i v e r i ng o c c u r s ke e p p t
w a r m w i t h e x t r a b l a n ket s o r he a t a n d a d m i n i s t e r O 2 ( t o
co m p e n s a t e f o r in c rea s e d O 2 d e m a n d

INJECTABLE
ANALGESICS
ANESTHETHICS

MECHANISM OF ACTION

Same as
general
anesthet
ics

DRUG EXAMPLES

Alfentanil (Alfenta)
Etomidate
Remifentaril
(Ultiva)
Sufentaril
(Sufenta)

INDICATION
Induced rapid anesthesia
(situations requiring
anesthesia of short
duration) out patient
surgery
Decreased pain

CONTRAINDICATION AND
PRECAUTIONS

Hypersensitivity
to the drug
Use cautiously in
pts with CVA and
Respiratory
instability

ADVERSE REACTIONS
Respiratory depression
Arrythmias
Bradycardia
Skeletal and thoracic muscle
rigidity
Possible seizures
Asystole
Dry mouth
Urine retention and shivering
(alfentanyl and fentanyl)

INTERACTION
If used with other
opioids,inhalation
anesthetics,hypnotics
or sedatives
increase effects of
injection anesthetic
respiratory
depression and apnea

NURSING RESPONSIBILITIES

Continuously assess
respiratory status
Only those
experienced with
endotracheal
intubation should
used these drugs

NEUROLEPTANESTHETICS
Produced
dissociation from
the environment
during induction of
anesthesia by
directly acting on
the cortex and
limbic system

 Drug examples :
Droperidol (Inapsine);
Ketamine (ketalar)
Adverse reaction:
EPS,prolonged
recovery,torsade de
pointes (droperidol)
HPN
Hallucinations
Tachycardia (Ketamine)

NURSING RESPONSIBILTY

Monitor VS and
cardiopulmonary status
Minimize environmental
stimulation (to prevent
untoward reactions on
emergence from
anesthesia)

LOCAL ANESTHETICS
Provide analgesic
relief ( blocks the
conduction of nerve
impulses at the point
of contact) causing
INABILITY of the
cell to depolarise
preventing impulse
transmission

DRUG EXAMPLES
Benzocaine (Dermoplast)
Bupivacane HCL (Marcaine)
Chloroprocaine
HCL( Nasacaine)
Cocaine HCL
Dibucaine (Nupercainal)
Lidocaine HCL (Xylocaine
HCL)
Mepivacaine (Carbocaine)
Procaine HCL (Novocaine)
Ripovacaine (Naropin)
Tetracaine (Pontocaine)

INDICATION

Prevent or
relieve pain
from a medical
procedure,
disease or
injury

ADVERSE REACTIONS

Anxiety
restlessness,
arrythmias ,
bradycardia ,
hypotension,
chills

NURSING RESPONSIBILITIES
Assess for return of
motor function and
sensation postoperatively
Ensure that the gag
refl ex has return before
feeding- pt whose throat
has been anesthetized

TOPICAL
ANESTHETICS

Atopical
anestheticis a
localanesthetict
hat is used to
numb the surface
of a body part.

Blocks nerve
impulse
transmission
Stimulate the
nerve endings
and interfere
with pain
reception

Benzocaine
Benzyl alcohol
Butacaine
Butamben
Dyclonine
Ethyl chloride
Lidocaine
Menthol
Procaine
Tetracaine

INDICATION

Pain
Anesthesia
Surface
numbing

ADVERSE REACTION

Hypersensi
tivity

NURSING RESPONSIBILITY
Assess the area where
topical anesthetic is to
be applied before, during
and after application
Dont apply refrigerated
topical anesthetic to
broken skin or mucus
membrane