Pharmacology - Chapter 27 - General Anesthetics

Question 1

Analgesia - def

Answer 1

loss of sensibility to pain.

Question 2

Anesthesia - def

Answer 2

refers not only to loss of pain but to loss of all other sensations.

Question 3

General anesthetics should produce… (2)

Answer 3

Unconsciousness and lack of response to all painful stimuli.

Question 4

What are the two groups of general anesthetics?

Answer 4

Inhalation and intravenous.

Question 5

An IDEAL inhalation anesthetic produces….(4)

Answer 5

Unconsciousness, analgesia, muscle relaxation, amnesia.

Question 6

The properties of an idea inhalation anesthetic are… (3)

Answer 6

Brief and pleasant, easy to titrate (depth could be raised or lowered easily) and margin of safety is large.

Question 7

The idea general anesthetic does exist. T/F?

Answer 7

False. It does not exist.

Question 8

Balanced anesthesia - def

Answer 8

the use of combinations of drugs to accomplish what inhalation anesthetic can not do alone.

Question 9

What are some agents used for balanced anesthetics?

Answer 9

Short acting barbituates,neuromuscular blocking agents, opioids and nitrous oxide.

Question 10

What are the 4 stages of anesthesia?

Answer 10

1. Stage of analgesia.
2. Stage of delirium.
3. Stage of surgical anesthesia.
4. Stage of medullary paralysis.

Question 11

Stage of Analgesia - def

Answer 11

begins with onset of anesthetic administration and extends until consciousness is lost. Some major surgeries can be performed here.

Question 12

Stage of Delirium - def

Answer 12

includes memory loss, hallucinations, etc. Begins with loss of consciousness and extends to the onset of the stage of surgical anesthesia. Characterized by delirious excitement and reflex muscle activity and irregular respiration.

Question 13

Stage of Surgical Anesthesia - def

Answer 13

most surgeries performed here. Extends from end of stage 2 to the point where spontaneous respiration ceases. Deep unconsciousness. Suppression of certain reflexes. etc.

Question 14

Stage of Medullary Paralysis - def

Answer 14

begins when all spontaneous respiration is lost. Results from anesthetic overdose. Death can occur from circulatory collapse.

Question 15

MAC - def

Answer 15

Minimum Alveolar Concentration - index of inhalation anesthetic potency. MAC of drug in the alveolar air that will produce immobility in 50% of patients exposed to a painful stimulus.

Question 16

Low MAC = ____.

Answer 16

High anesthetic potency.

Question 17

To produce therapeutic effects, an inhalation anesthetic must reach _____ ….

Answer 17

a concentration in the CNS that is sufficient to suppress neural excitability.

Question 18

Distribution of anesthetic - what gets it first and what gets it last?

Answer 18

First is the vital organs - like the brain, heart, etc. Last is the adipose tissue.

Question 19

General Anesthetic - Adverse Effects (5.)

Answer 19

Respiratory depression, Cardiac depression, Malignant hyperthermia, aspiration of gastric contents, hepatotoxicity.

Question 20

Adjuncts to inhalation anesthetic complement ___ effects of inhalation anesthetics and ____ adverse effects.

Answer 20

Complement/Counteract.

Question 21

Preanesthetic Medications - what do they do?

Answer 21

Reduce anxiety, produce properative amnesia, relief preoperative pain, relieve postoperative pain.

Question 22

Preanesthetic Meds - What do they do? - Benzodiazepines -

Answer 22

reduce anxiety and promote amnesia.

Question 23

Preanesthetic Meds - What do they do? - Barbituates

Answer 23

relieve anxiety and induce sedation.

Question 24

Preanesthetic Meds - What do they do? - Opioids

Answer 24

relieve pain.

Question 25

Preanesthetic Meds - What do they do? - Clonidine

Answer 25

reduces hypertension and pain.

Question 26

Preanesthetic Meds - What do they do? - Anticholinergic Drugs

Answer 26

reduce the risk of bradycardia during surgery.

Question 27

Preanesthetic Meds - What do they do? - Neuromuscular Blocking Agents

Answer 27

induce muscle relaxation.

Question 28

Preanesthetic Meds - What do they do? - Analgesics

Answer 28

needed to control post-op pain.

Question 29

Preanesthetic Meds - What do they do? - Antiemetics

Answer 29

suppression of nausea and vomiting.

Question 30

Preanesthetic Meds - What do they do? - Muscarinic Agonist

Answer 30

Stimulation of muscarinic receptors by bethanechol and relieve abdominal distention and urinary retention in post-op patients.

Question 31

What are the two basic categories of Inhalation Anesthetics?

Answer 31

Gases - Nitrous Oxide and Volatile Liquids, like Halothane.

Question 32

Nitrous Oxide - always used alone. T/F?

Answer 32

False. It is never used alone!

Question 33

There are no serious side effects of NO but it can induce…

Answer 33

nausea and vomiting.

Question 34

halothane - may cause…

Answer 34

liver failure.

Question 35

When used in conjunction with inhalation anesthetics, IV agents serve two benefits :

Answer 35

Permit dosage of inhalation to be reduce and produce effects that cannot be achieved with an inhalation agent alone.

Question 36

Thiopental - Barbiturates -
\_\_\_ acting.
Produces unconsciousness within \_\_ to \_\_\_ seconds.
\_\_\_ lipid soluble. 
Good for induction of \_\_\_.

Answer 36

Short acting.
10-20 seconds.
Highly lipid soluble.
Unconsciousness.

Question 37

Diazepam - Benzodiazepines -
slower than ___.
Produce unconsciousness within ___ minute.
Good for __ and ___.

Answer 37

Barbituates.
1 minute.
Unconsciousness and amnesia.

Question 38

Diazepam - causes ___ and ___ depression.

Answer 38

Cardiovascular/Respiratory.

Question 39

Propofol -
__ onset (within __ seconds.)
__ duration of action (__ to ___ minutes.)
Good for _____.

Answer 39

rapid onset.
Short duration of action (3-5 minutes.)
mechanical ventilation/endoscopy.

Question 40

Propofol causes…..profound __ depression and ___.

Answer 40

Respiratory/hypotension.

Question 41

Ketamine - produces state of _____. Also, (4) things.

Answer 41

Dissociative anesthesia/sedation, immobility, analgesia, and amnesia.

Question 42

During recovery from ketamine, unpleasant ____ reaction may occur.

Answer 42

Psychological.

Question 43

Droperidol plus fentanyl (Innovar) - Similar to state of ____/good for ___.

Answer 43

Dissociative anesthesia/good for minor surgery.

Question 44

Droperidole plus fentanyl - causes __ and ___ depression.

Answer 44

Hypotension/respiratory depression.