11, General Anesthesia Flashcards
What are the stages of General Anesthesia?
1- Analgesia
2- Excitement
3- Surgical
4- Medullary depression
What drugs are used as Intravenous/ induction anesthetic agents?
Benzodiazepines
Barbiturates
Etomidate
Propofol
Ketamine
What is the only IV anesthetic that will inhibit NMDA?
Ketamine
What are the Benzodiazepines?
Midazolam
Lorazepam
Diazepam
What anesthetics can cause anterograde amnesia?
Benzodiazepines
What is the antidote for Benzodiazepines?
Flumazenil
What drug is a barbiturate?
Thiopental
What does Thiopental do?
Enhance actions of GABA
Depress brainstem
What are side effects of Thiopental?
Nausea, Vomit
Profound respiratory depressant
Dose Dependent Inc in BP
What anesthetic can be used in a pt with a head trauma?
Thiopental
What does Etomidate do?
Inc affinity of GABA for its receptor
What types of patients are Etomidate good for?
Elderly
Limited cardiac reserve pt
Pt at risk for HYPOtension
Why is Etomidate good?
Minimal effect on heart, respiration
What drug has a greater margin of safety than barbiturates?
Etomidate
What does Propofol do?
Enhance action of GABA
What is special about Propofol?
Rapid onset
Rapid recovery
Anti- emetic
What are Propofol side effects?
HYPOtension
Cardiac depression
Impair baroreflex
What does Ketamine do?
NMDA antagonist
What drug produces “Dissociative Amnesia”?
Ketamine
How can Ketamine be administered?
IM
Oral
Rectal
What are Ketamine side effects?
HYPERtension
Inc: HR CO Cerebral blood flow Intracranial pressure
Post op:
Hallucination
Excitation
Vivid Dream
What patients are Ketamine best for?
pt w/ Asthma
Child undergoing short painful surgery
What are the inhalation anesthetics?
Nitrous Oxide (non hal)
Volatile inhaled anesthetics (halogenated)
- Desflurane
- Sevoflurane
- Isoflurane
What does Nitrous Oxide do?
NMDA antagonist
How is Nitrous Oxide primarily used?
Adjunct to other anesthetics
What are the side effects of Nitrous Oxide?
When used with Halogenated:
BP, CO INC
When used with Opioids:
BP, CO DEC
What is special about Nitrous Oxide?
Doesn’t trigger Malignant Hyperthermia
What is special about Sevoflurane?
Doesn’t produce Tachycardia
What are side effects of the volatile inhalation anesthetics? (halogenated)
drop in BP
Bronchodilators, Relax SKM
Respiratory depressants
Elimination is ventilation
Can trigger malignant hyperthermia
Affects pregnancy in women
If your pt gets malignant hyperthermia, what drug is given?
Dantrolene
What anesthetics do not decrease BP during induction of anesthesia?
Ketamine
Etomidate
What anesthetics are NMDA antagonists?
Nitrous Oxide
Ketamine
