Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > General Anesthetics > Flashcards

General Anesthetics Flashcards

1
Q

General anesthetics is divided into inhaled and IV anesthetics. What is the subdivision of inhaled anesthetics

A 
Nitrous Oxide
Halogenated Hydrocarbons: HEMIDS Fluranes
Halothane
Enflurane
Methoxyflurane
Isoflurane
Desflurane
Sevoflurane
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the IV anesthetics and what are they used for

A

-used as adjuncts to inhaled anesthetics

Barbiturates
Etomidate
Ketoamine
Opioids
Propofol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what drug is usually used in the induction phase (phase from administration of anesthetic to development of surgical anesthesia)

A

IV Thiopental

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what drug is used in the maintenance phase (phase where the patient is surgically anesthetized)

A

maintained with inhaled anesthetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the stage of anesthesia with their signs

A

-Stage I: Analgesia. Amnesia.
-Stage II: Excitement. Delirium. Respiration is irregular. Vomiting. To avoid this
stage, thiopental is given IV before.
-Stage III: Surgical anesthesia. Unconsciousness.
-Stage IV: Medullary depression. No eye movement. Respiratory and cardiovascular
failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

most reliable indication that stage III has been reached (surgical anesthesia)

A

loss of eyelash reflex and establishment of respiratory pattern that is regular in rate and depth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

mechanism of action of inhaled anesthetics

A

direct interactions with ligand gated ion channels

  • GABA mediated inhibition at GABA-A receptors
  • inhibition of nicotinic receptors
  • interaction with glycine receptors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is minimum alveolar concentration (MAC)

A
  • standard of comparison for potency of general anesthesia
  • % of alveolar gas mixture or partial pressure of anesthetic as a percentage of 760mmHg
  • conc that results in immobility of 50% of patients when exposed to a noxious stimuli such as surgical incision (ED50)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

things that decrease minimum alveolar concentration aka MAC

A
  • opioid analgesics or sedative-hypnotics
  • hypothermia
  • hypothyroidism
  • pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what increases MAC

A

anxiety
hyperthryoidism

SN: MAC is additive–> .7 MAC for isoflurane and .3 MAC for N20 = 1 MAC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

relationship between MAC and liposolubility

A

as liposolubility (λ(oil:gas)) increases, MAC decreases because potency of anesthetic increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

relationship between blood solubility, rate of rise in tension of arterial blood, and onset of anesthesia

A

the higher the blood solubility ( λ(blood:gas) ) –> more molecules need to dissolve in blood –> arterial tension in blood increases slowly –> slower onset of anesthesia

high liposolubility is also associated with high blood solubility so more potent inhaled anesthetics have slower onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

relationship between ventilation, arterial tension, and blood solubility

A
  • increase in pulmonary ventilation will cause only a slight increase in arterial tension if anesthetic has low blood solubility
  • increase in pulmonary ventilation would cause a significant increase in arterial tension if anesthetic has high blood solubility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the CVS effects of inhaled anesthetics

A
  • most depress cardiac contractility –> decreased mean arterial pressure
  • Halothane and Enflurane cause myocardial depression via reduced cardiac output –> decreased mean arterial pressure
  • Isoflurane, Desflurane, and Sevoflurane cause vasodilation –> decreased mean arterial pressure and have minimal effect on cardiac output
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

which inhaled anesthetics is best to give patient with myocardial dysfunction

A

the ones that have minimal effect on cardiac output –> Isoflurane, Desflurane, Sevoflurane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

cardiac AE seen with use of halothane

A

it makes myocardium more sensitive to circulating catecholamines –> ventricular arrhythmias

17
Q

which inhaled anesthetic is less suitable for patient with bronchospasm and why

A

Isoflurane and Desflurane because they are very pungent

18
Q

which inhaled anesthetic is best to use for those with increased cerebral pressure due to brain tumor or injury and why?

A

Nitric oxide because it increases cerebral blood flow the least hence least increase in intracranial pressure

19
Q

effect of halogenated hydrocarbon inhaled anesthetic on uterine smooth muscle

A

potent uterine relaxants

20
Q

AE of inhaled anesthetics

A

Hepatotoxicity (Halothane)
Hematoxocity
Nephrotoxicity (Methoxyflurane)
Malignant Hyperthermia (esp with use of succinylcholine)
Megaloblastic Anemia (prolonged exposure to N2O causes decrease methionine synthase)

21
Q

malignant hyperthermia is caused by what defect

A

defect in ryanodine receptor gene (RYR1) –> altered release of Ca

22
Q

treatment of malignant hyperthermia

A

Dantrolene (prevents calcium release from sarcoplasmic reticulum

23
Q

barbiturate most commonly used for induction of anesthesia

A

Thiopental

the other barbiturate is Methohexital

24
Q

important effect of the barbiturates (name them)

A

thiopental and methohexital

  • decreased intracranial pressure (good especially if cranial swelling)
  • do not produced analgesia
25
Q

important effects of using propofol and fospropofol

A
  • post operative vomiting is unlikely
  • no analgesia
  • reduces intracranial pressure
26
Q

AE of propofol

A

causes hypotension

27
Q

type of patients that Etomidate is used on

A

those at risk for hypotension

28
Q

important effect of etomidate

A

no analgesic

reduces intracranial pressure

29
Q

AE of etomidate

A

nausea and vomiting

adrenocortical suppression

30
Q

only IV anesthetic that has ability for analgesic properties and stimulation the cardiovascular system

A

Ketamine - dissociative anesthesia

good for geriatric patients and high risk patients in cardiogenic or septic shock because of cardiostimulatory properties

31
Q

AE of Ketamine

A
  • increases intracranial pressure

- emergence phenomena (post-op disorientation, sensory and perceptual illusions)

32
Q

name the benzos given during surgery and their prupose

A

Diazepam, Lorazepam, Midazolam

for their anxiolytic and anterograde amnesic properties

33
Q

what is used to achieve muscle relaxation during surgery

A

competitive neuromuscular blocker Pancuronium

Depolarizing blocker Succinylcholine

34
Q

what is used to reverse the effect of competitive neuromuscular blockade

A

Neostigmine

35
Q

used to prevent aspiration of stomach content

A

anti-emetic Ondansetron

36
Q

prevents salivation and bronchial secretion and to protect heart from arrhythmias caused by inhalation agents and neuromuscular blockade

A

antimuscarinic - Scopolamine

Pharmacology (79 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions