ICU SAQs · Sedation & paralysis
The pharmacology of ICU sedatives and analgesics
A CICM First-Part basic-science SAQ on sedative pharmacology — the GABA-agonist mechanism of propofol and the benzodiazepines, the alpha-2-agonist mechanism of dexmedetomidine (sedation without respiratory depression), and the NMDA-antagonism of ketamine, with their kinetics and adverse-effect profiles.
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Prompt
Compare the receptor pharmacology, the onset and offset, and the principal adverse effects of propofol, midazolam, dexmedetomidine and ketamine. Explain why dexmedetomidine produces sedation without respiratory depression.
Question
Compare the receptor pharmacology, the onset and offset, and the principal adverse effects of propofol, midazolam, dexmedetomidine and ketamine. Explain why dexmedetomidine produces sedation without respiratory depression.
[2]References3ShowHide
- [1]Reade MC, Finfer S Sedation and delirium in the intensive care unit. New England Journal of Medicine, 2014.PMID 24476433
- [2]Riker RR, Shehabi Y, Bokesch PM, et al. Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial (SEDCOM). JAMA, 2009.PMID 19188334
- [3]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.