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Non Barbiturates Hypnotic Agents
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  1. Non Barbiturates Hypnotic Agents Vicente Gonzalez CRNA, MS Assistant Professor Florida International University

  2. 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.

  3. 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.

  4. 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

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

  6. Non barbiturate Agents • Agents • Uses • PK-PD • Effects on Organ Systems • Induction Doses • Contraindications

  7. Non barbiturate Agents • Propofol • Etomidate • Ketamine

  8. Non barbiturate Agents • Propofol • Chemical Structure • Commercial Preparations • MOA

  9. Non barbiturate Agents • Chemical structure of propofol

  10. Non barbiturate Agents • Propofol cont’d. • Pharmacokinetics • Clinical Uses • Other Uses

  11. Non barbiturate Agents • Propofol cont’d • Organ System Effects • CNS • Cardiovascular • Respiratory • Renal/Hepatic

  12. Non barbiturate Agents • Propofol cont’d • Contraindications

  13. Non barbiturate Agents • ETOMIDATE • Chemical Structure • Commercial Preparations • MOA

  14. Non barbiturate Agents • Chemical Structure of Etomidate

  15. Non barbiturate Agents • Etomidate cont’d • Pharmacokinetics • Clinical Uses • Other Uses

  16. Non barbiturate Agents • Etomidate cont’d • Organ System Effects • CNS • Cardiovascular • Respiratory • Renal/Hepatic • Other

  17. Non barbiturate Agents • Etomidate’s pathway of inhibition of cortisol and other corticosteroids

  18. Non barbiturate Agents • Etomidate cont’d • Contraindications

  19. Non barbiturate Agents • Ketamine • Chemical Structure • Commercial Preparations • MOA

  20. Non barbiturate Agents • Chemical Structure of Ketamine

  21. Non barbiturate Agents • Ketamine cont’d • Pharmacokinetics • Clinical Uses • Other Uses

  22. Non barbiturate Agents • Ketamine cont’d • Organ System Effects • CNS • Cardiovascular • Respiratory • Renal/Hepatic • Other

  23. Non barbiturate Agents • Ketamine cont’d • Contraindications