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NUR 2115 ( LATEST 2024 / 2025 ) EXAM 1 PHARMACOLOGY | COMPLETE ANSWERS 100% CORRECT
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NUR 2115 ( LATEST 2024 / 2025 ) EXAM 1 PHARMACOLOGY | COMPLETE ANSWERS 100% CORRECT
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NUR 2115 Exam 1 Pharmacology1. Medications used during mechanical ventilation fall into four categories
Answer
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sedatives, neuroleptics, analgesics, and paralytics
2. Sedatives include
Answer
benzodiazepines, barbituates, and propofol. These drugs decrease anxiety and produce amnesia,
but they don't relieve pain. Most of these drugs also have anticonvulsant effects without causing
cardiac depression. The exceptions to this are midazolam (Versed) and propofol (Diprivan),
which can cause cardiac depression.
3. The primary concerns related to use of sedatives during mechanical venti- lation are that
Answer
many have long half lives, and that drug levels can accumulate and cause prolonged effects in the
critically ill and elderly. This is particularily true of the barbituates, and may negatively impact
weaning attempts.
4. has the shortest half life of the benzodiazepines (1 hour), thus it is the most commonly used.
Answer
Midazolam (Versed)
5. The other benefit to benzodiazepines is that their effects can be reversed with
,Answer
flumazenil (Romazicon)
6. One precaution should be mentioned regarding midazolam (Versed).
Answer
It tends to accumulate in the tissues if administered for longer than 48 hours, and can cause
excessive sedation. This is especially true of obese patients because of the lipophilic properties
of the drug and the high degree of lipid solubility. In obese patients, the ideal body weight
should be used to calculate dosing, rather than the actual weight
7. Propofol (Diprivan) is the sedative of choice for
Answer
rapid induction of anesthesia in the ICU for minor invasive procedures. It has a rapid onset and
a half-life of less than 30 minutes. However, it often causes hypotension and is very expensive
8. Lorezapam (Ativan)
Answer
Onset
5-15 minutes
Half Life
6-15 hours
Loading Dose
0.05mg/kg Infusion rate
, 0.5-5mg/hr
9. In addition to sedation, neuroleptics may be given to patients who
Answer
are experiencing delirium or "ICU psychosis." This is common in critically ill patients who lose
sense of time and events because of altered sleep patterns and a different daily schedule while
they're hospitalized. Symptoms include disorganized thinking, audio and visual hallucinations,
and disorientation. Sedatives and narcotics often worsen the delirium because they further alter
sensory perception. The neuroleptic drug of choice is haloperidol (Haldol). It's usually given
intravenously in 2-10 mg doses every 2 to 4hours. Effects should be observed within 30-60
minutes. Haloperidol can prolong the QT interval on the EKG, and should be used cautiously
in patients who are at risk for QT prolongation from other causes.
10. Morphine is preferred unless
Answer
the patient has cardiovascular instability. In this case, the patient may not tolerate the transient
hypotension produced by morphine-related histamine release, so fentanyl (Sublimaze) or
hydromorphone (Dilaudid) can be used instead.
11. If a patient receives large or continuous doses of narcotics, they must be monitored for
Answer
the development of ileus. Tolerance of tube feedings and bowel movements should be assessed
frequently.
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