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Pharmacology > 1 Anesthetics (General and Local) > Flashcards

1 Anesthetics (General and Local) Flashcards

1
Q

_________ anesthetics are usually administered during more extensive surgical procedures

A

General anesthetics are usually administered during more extensive surgical procedures

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2
Q

Local anesthetics are given when analgesia is needed in a relatively _____, _____________ area, or when a patient needs to ___________________.

A

Local anesthetics are given when analgesia is needed in a relatively small, well-defined area, or when a patient needs to remain conscious during surgery

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3
Q

Physical Therapists need to have a knowledge of the residual effects that may occur when the patient is recovering from anesthesia because…

A

This will help the PT understand that anesthesia may directly influence the therapy session.

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4
Q

Anesthetic agents must produce each of the following conditions:

A
  • Loss of consciousness and sensation
  • Amnesia ( no recollection )
  • Skeletal muscle relaxation ( with skeletal muscle blockers)
  • Inhibition of sensory and autonomic reflexes
  • A minimum of toxic side effects
  • Rapid onset of anesthesia; easy adjustment of the anesthetic dosage during the procedure; and rapid, uneventful recovery after administration is treminated
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5
Q

What is stage 1 of general anesthesia?

A

Analgesia

Patient lose somatic sensation
Still conscious and somewhat aware

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6
Q

What is stage 2 of general anesthesia?

A

Excitement/ delirium

Unconscious and amnesiac
*agetated and restless
Undesirable
Move to stage 3 quickly

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7
Q

What is stage 3 of general anesthesia?

A

Surgical anesthesia

This level is desirable for the surgical procedure and begins with the onset of regular deep respiration.

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8
Q

What is stage 4 of general anesthesia?

A

Medullary Paralysis:

Cessation of spontaneous respiration because respiratory control centers located in the medulla are inhibited by excessive anesthesia.

The ability of the medually vasomotor center to regulate blood pressure is also affected. Respiratory and circulatory support must be provided or the patient will die.

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9
Q

How many stages of general anesthesia are there?

A

4

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10
Q

What are the 2 primary roots of administration for general anesthetics?

A

Intravenous and inhaled

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11
Q

How long are general anesthesias typically stored in adipose?

A

*not starred

3-4 days

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12
Q

What is dissociative amnesia?

A

Dissociative anesthesia - the patient appears detached and dissociated from their surroundings. Pt appears awake, but sedated

Twilight

Caused by ketalar

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13
Q

What is a neuroleptanalgesia?

A

Neuroleptanalgesia- used for short surgical procedures.

Characterized by dissociation from surroundings with or without loss of consciousness.

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14
Q

What is a common preoperative medication used to relax the patient and reduce anxiety?

A

Valium/ barbiturates

Opioids

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15
Q

Which drugs are used preoperatively to decrease vomiting and produce sedation?

A

Antihistamines

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16
Q

Which drugs are used preoperative to decrease pain and vomiting?

A

Anti-inflammatory/ dexamethisone

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17
Q

True or false: neuromuscular blockers are used with general anesthesia because skeletal muscle paralysis is essential during surgical procedures.

A

True

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18
Q

Local anesthesia produces a ___________.

A

Local anesthesia produces a loss of sensation in a specific body part or region

19
Q

The goal of a local anesthetic is…

A

Goal is to block afferent neural transmission along the peripheral nerve so the procedure is painless

20
Q

What are the advantages of local anesthetics?

A
  • Rapid recovery
  • Lack of residual effects
  • No post operative confusion
  • No lethargy
  • No hospital stays
  • Does not interfere with cardiovascular, respiratory, and renal functioning
  • No neonatal general anesthesia
21
Q

What are the disadvantages of using a local anesthetic?

A
  • Length of time required to establish an anesthetic effect.

* Risk that analgesia will be incomplete, or insufficient.

22
Q

What are some non surgical uses for local anesthetics?

A
  • not starred

• Short term pain relief for musculoskeletal and joint pain

• Long term for pain relief in cancer, or
treatment of chronic pain

• Block efferent sympathetic activity in reflex sympathetic dystrophy

23
Q

What are the pharmacokinetics of local anesthetics?

A
  • Variety of administration techniques
  • Drug should remain it the site of administration

• A vasoconstricting agent is often
administered simultaneously to help
prevent washout from the desired site

• Local anesthetics can cause toxic side effects when sufficient amounts reach the systemic circulation

• Local anesthetics are eliminated by
hydrolyzing or breaking apart the drug molecule

• Kidneys then excrete the drug metabolites

24
Q

True or false: a local anesthetic can be topically applied to the skin, mucus membrane or cornea.

A

True

25
Q

When would a topical local anesthetic be used?

A
  • Used for symptomatic relief of minor surface irritation and injury
  • Used to reduce pain prior to minor surgical procedures – wound care
  • used to improve motor function in muscle hyertonicity after a CVA or TBI
26
Q

Transdermal administration of local anesthetics are enhanced with _________.

A

electrical current; iontophoresis,

phonophoresis

27
Q

How are infiltration local anesthetics are administered? What is their use?

A

• Drug is injected directly into selected tissue, allowing it to diffuse to sensory nerve endings within the tissue

• It saturates the area, so that minor
procedures can be performed

28
Q

What is a peripheral nerve block?

A

Anesthetic is injected close to the nerve trunk

so that transmission along the peripheral nerve is interrupted

29
Q

When are peripheral nerve blocks commonly used?

A

Common in dental procedures, and block

peripheral nerves to allow surgical procedures of the hand, foot, and shoulder

30
Q

What’s the difference between a minor nerve block and a major nerve block?

A

Minor block = one distinct nerve

major block = several peripheral nerves

31
Q

What is a central neural blockage?

A

Drug is injected into space surrounding spinal cord.

32
Q

What are the two types of central neural blockades?

A

• Epidural blockade –
injection of drug into
epidural space

• Spinal nerve block –
injection into subarachnoid space
• Usually between L3-L4 or L4-L5
• Risk of neurotoxicity

33
Q

True or false: A spinal nerve block allows for motor function to continue and is used for birthing.

A

False: epidural blocks allow for motor function and are used for birthing.

Spinal nerve blocks are used for c sections and stop motor and sensory sensations

34
Q

What is a sympathetic block?

A

Break pain cycle

• Used for selective interruption of efferent
discharge

  • Used for complex regional pain syndrome CRPS, and RSDS
  • Injection into the sympathetic chain ganglion
  • Performed in series of 4

• Goal is not to provide analgesia,
but to impair efferent sympathetic
oitflow

35
Q

What is another name for a bier block?

A

Intravenous regional anesthesia

36
Q

What is intravenous regional anesthesia?

A

Intravenous Regional Anesthesia ( Bier block)

  • injected into a peripheral vein
  • Local vasculature carries the drug to the nerves in the limb
  • Can be applied with a tourniquet to prevent drug from reaching systemic circulation
37
Q

Local anesthetics work by blocking ______ ______ _______ along ________ ______ ( working on _____ _____)

A

Local anesthetics work by blocking action potential propagation along neuronal axons ( working on sodium channels)

38
Q

Local anesthetics can inadvertenly _______________ and ___________ if drug reaches the systemic circulation

A

Local anesthetics can inadvertenly disrupt

the excitability of the CNS and cardiac tissue if drug reaches the systemic circulation

39
Q

What are the side effects of local anesthetics?

A

• Side effects: confusion, agitation, excitation, seizure, impaired respiratory function, cardiac depression

40
Q

What are the symptoms of CNS toxicity?

A

• Symptoms of CNS toxicity: ringing/buzzing in the ears, agitation, restlessness, decreased sensation around the mouth

41
Q

Working with pt with neural blocks, PT

must be aware of pts ______________ to avoid harm with __________.

A

PT must be aware of pts decrease sensation

to avoid harm with modalities

42
Q

Working with pt with neural blocks, PTs must be aware of _______ ________ for ambulation training

A

PTs must be aware of decrease motorfunction for ambulation training

43
Q

Choose: Local anesthetics block (afferent/efferent) (sympathetic/parasympathetic) activity.

A

Efferent sympathetic activity

Pharmacology (24 decks)

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