IV Anesthetics

Intravenous anesthetics are used commonly for induction and maintenance of anesthesia for surgical procedures and as sedatives for procedural sedation or as sedation for mechanically ventilated patients.  Medications in this class are used for a variety of off-label indications as well.  

Class Drugs:

• Propofol

• Etomidate

• Ketamine

• Dexmedetomidine

Class Mechanism of Action::

• See individual drug

Class Application:

• Induction of anesthesia

Class Adverse Effects:

• See Individual drugs

Drug Table

Drug Name	Application	Comments	Image
Propofol	Induction and/or maintenance of anesthesia; Sedation	Mechanism/Actions; -CNS Depression; -Decreases systemic vascular resistance; -Lowers blood pressure; -Decreases intracranial pressure; -Does not provide analgesia; -Antiemetic properties; Adverse Effects; -Respiratory depression; -Pancreatitis; -Drug is mixed in soybean oil and egg phospholipids; -Increases patient triglyceride levels when used for long-term sedation; High doses can lead to ; Propofol infusion syndrome:; -Heart failure; -Rhabdomyolysis; -Metabolic acidosis; Kidney failure; -Often fatal	"Prop" and "Fall"
Etomidate	Induction of anesthesia	Mechanism/Actions; -Sedative/hypnotic; -Rapid onset, short-acting; Adverse Effects; -Decreased plasma cortisol; -Decreased aldosterone levels; -Involuntary skeletal movements	"Atom" "Date"
Ketamine	Sedation; Minimal/No respiratory depression; Anesthesia; Treatment of pain (at subdissociative doses)	Mechanism/Actions; Induces dissociative state: Appears awake, but unconscious and no pain sensation; -Induced immobility; -Increases sympathetic outflow; -Increased cardiac output (increased chronotropy/inotropy); -Bronchodilation; Adverse Effects; -Increased secretions; -Hallucinations; -Worst effect in young adults; -Early evidence indicated increased intracranial pressure but clinical research has not supported this finding; -Contraindicated in hypertensive and stroke patients; -Also used as a street drug for its hallucinogenic properties. Known as "Special K" among other slang terms.	"Kettle" "Mine"
Dexmedetomidine	Sedation; No respiratory depression	Mechanism/Actions; ; -Alpha-2 Receptor agonist (strong); -Sedative effects; -Analgesic effects; -Sympatholytic effects; -Anxiolytic effects; Adverse Effects; Bradycardia; Hypotension	"Dex (phone book)" "Med Bottle" "Adam Dining"