11, General Anesthesia

Question 1

What are the stages of General Anesthesia?

Answer 1

1- Analgesia

2- Excitement

3- Surgical

4- Medullary depression

Question 2

What drugs are used as Intravenous/ induction anesthetic agents?

Answer 2

Benzodiazepines

Barbiturates

Etomidate

Propofol

Ketamine

Question 3

What is the only IV anesthetic that will inhibit NMDA?

Answer 3

Ketamine

Question 4

What are the Benzodiazepines?

Answer 4

Midazolam

Lorazepam

Diazepam

Question 5

What anesthetics can cause anterograde amnesia?

Answer 5

Benzodiazepines

Question 6

What is the antidote for Benzodiazepines?

Answer 6

Flumazenil

Question 7

What drug is a barbiturate?

Answer 7

Thiopental

Question 8

What does Thiopental do?

Answer 8

Enhance actions of GABA

Depress brainstem

Question 9

What are side effects of Thiopental?

Answer 9

Nausea, Vomit

Profound respiratory depressant

Dose Dependent Inc in BP

Question 10

What anesthetic can be used in a pt with a head trauma?

Answer 10

Thiopental

Question 11

What does Etomidate do?

Answer 11

Inc affinity of GABA for its receptor

Question 12

What types of patients are Etomidate good for?

Answer 12

Elderly

Limited cardiac reserve pt

Pt at risk for HYPOtension

Question 13

Why is Etomidate good?

Answer 13

Minimal effect on heart, respiration

Question 14

What drug has a greater margin of safety than barbiturates?

Answer 14

Etomidate

Question 15

What does Propofol do?

Answer 15

Enhance action of GABA

Question 16

What is special about Propofol?

Answer 16

Rapid onset

Rapid recovery

Anti- emetic

Question 17

What are Propofol side effects?

Answer 17

HYPOtension

Cardiac depression

Impair baroreflex

Question 18

What does Ketamine do?

Answer 18

NMDA antagonist

Question 19

What drug produces “Dissociative Amnesia”?

Answer 19

Ketamine

Question 20

How can Ketamine be administered?

Answer 20

IM

Oral

Rectal

Question 21

What are Ketamine side effects?

Answer 21

HYPERtension

Inc:
HR
CO
Cerebral blood flow
Intracranial pressure

Post op:
Hallucination
Excitation
Vivid Dream

Question 22

What patients are Ketamine best for?

Answer 22

pt w/ Asthma

Child undergoing short painful surgery

Question 23

What are the inhalation anesthetics?

Answer 23

Nitrous Oxide (non hal)

Volatile inhaled anesthetics (halogenated)

• Desflurane
• Sevoflurane
• Isoflurane

Question 24

What does Nitrous Oxide do?

Answer 24

NMDA antagonist

Question 25

How is Nitrous Oxide primarily used?

Answer 25

Adjunct to other anesthetics

Question 26

What are the side effects of Nitrous Oxide?

Answer 26

When used with Halogenated: BP, CO INC When used with Opioids: BP, CO DEC

Question 27

What is special about Nitrous Oxide?

Answer 27

Doesn't trigger Malignant Hyperthermia

Question 28

What is special about Sevoflurane?

Answer 28

Doesn't produce Tachycardia

Question 29

What are side effects of the volatile inhalation anesthetics? (halogenated)

Answer 29

drop in BP Bronchodilators, Relax SKM Respiratory depressants Elimination is ventilation Can trigger malignant hyperthermia Affects pregnancy in women

Question 30

If your pt gets malignant hyperthermia, what drug is given?

Answer 30

Dantrolene

Question 31

What anesthetics do not decrease BP during induction of anesthesia?

Answer 31

Ketamine Etomidate

Question 32

What anesthetics are NMDA antagonists?

Answer 32

Nitrous Oxide Ketamine