Page 455 - Clinical Application of Mechanical Ventilation

Pharmacotherapy for Mechanical Ventilation 421

Key Terms

acetylcholine haloperidol (Haldol)
antiemetic inotropic
anxiolysis nitric oxide
barbiturates nondepolarizing agents
benzodiazepines opioid analgesics
cathartic agents parasympatholytic bronchodilators
chronotropic propofol (Diprivan)
corticosteroids Ramsay Scale
depolarizing agents sympathomimetic bronchodilators
dexmedetomidine (Precedex) xanthine bronchodilators
gamma-aminobutyric acid (GABA)

Learning Objectives

After studying this chapter and completing the review questions, the learner
should be able to:
Provide the mechanism of action, adverse effects, and examples of: adrener-
gic, anticholinergic, xanthine bronchodilators, and anti-inflammatory agents.
Differentiate depolarizing and nondepolarizing neuromuscular blocking
agents and provide the mechanism of action and examples of these agents.
Provide the mechanism of action, adverse effects, and examples of seda-
tives and antianxiety agents.
Provide the mechanism of action, adverse effects, and examples of opioid
analgesics.
Provide the mechanism of action, adverse effects, and examples of barbiturates.
List the clinical application of propofol, haloperidol, dexmedetomidine,
and nitric oxide.

INTRODUCTION

Two primary purposes of drug therapy for patients using mechanical ventilation are
that they (1) provide patient comfort and (2) facilitate airway management and
mechanical ventilation. For example, some drugs are used to facilitate intubation
(neuromuscular blockers and sedatives) and reduce airflow resistance (bronchodila-
tors), while others are necessary to manage pain (opioids) and induce sedation
(sedatives). Proper use of drug therapy is necessary to achieve desired outcomes.
A clear understanding of these drugs is also essential to avoid misuse, complications,
and prolonged mechanical ventilation.

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