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DT2 E2 > 14. Anesthesia > Flashcards

14. Anesthesia Flashcards

1
Q

Stages of anesthesia?

wc one does anesthesiologist minimize?

A

Stage 1: analgesia

Stage 2: Excitement (keep to minimum)

Stage 3: surgical anesthesia (regular respiration, eye movements cease, relx muscles)

Stage 4:medullary parlaysis

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2
Q

MOA of Benzos? Antagonist to tx OD?

A

Inc frequency of channel opening. Flumazenil

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3
Q

hw is cocaine metabolized? lidocaine?

A

cocaine = local ester anesthetic –> plasma esterases. Lidocaine = amide –> liver amidases

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4
Q

Drug used for epidural anesthesia?

A

Bupicacaine

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5
Q

wt determines duration of action of local anesthetics?

A

diffusion/absorption

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6
Q

local anesthetics: MOA? wc form has higher affinity?

A

Bind Na channel, inhibiting conduction.

Ionized have higher affinity.

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7
Q

Dissociate anesthetic used?

MOA?

wt reduces utility?

A

Ketamine

blocks NMDA receptor

Recovery has hallucinations

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8
Q

wc inhaled anesthetic does not cause malignant hyperthermia? 2 AEs? hw to prevent one?

A

Nitrous Oxide (N2O) megaloblastic anemia dec respiration –> administer 30% O2

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9
Q

wc local anesthetic causes vasoconstriction?

A

Cocaine only

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10
Q

3 Local anesthetic used in mucous membranes and cornea?

A

tetracaine, lidocaine and cocaine

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11
Q

How does solubility affect rate of induction of anesthetics?

A

Decreased solubility will increase rate of induction

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12
Q

inhaled anesthetic to use that does not induce arrhythmas, sensitize heart or decrease cardiac output?

A

Isoflurane

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13
Q

why are opioids used for anesthesia? wt type of procedures are they used for?

A

Analgesia

used in cardiac surgery

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14
Q

why Anticholinergics use for anesthesia? 2 used?

A

prevent secretions and prevent vagal effects.

Scopalamine - prevent salivaiton

Atropine – prevent reflex bradycardia

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15
Q

hw do the following affect inhalation anesthetic rate of induction, inc solubility in blood? inc concentration? inc alveolar ventilation? inc cardiac output?

A

inc solubility decreases rate of induction time inc concentration increases rate of induction inc alveolar ventilaiton increases ROI inc cardiac output decreases ROI

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16
Q

Inhaled anestheric that produces toxic compound A? other thing released by drug?

A

Sevoflurane. also releases Fl

17
Q

Effect of vasoconstrictors on local anesthesia?

2 vasoconstrictors?

2 MOA?

Benefit?

when to not use?

A

Prolong local anesthesia

Epinephrine, phenylephrine

slow absorption and dec drug plasma concentration

less side effects

dont use in end areteries (fingers toes

18
Q

why do local anesthetics cause hypersensitivity rxns?

A

ester anesthetics get into systemic circulation and are metbaolized to PABA

19
Q

wt is infiltration anesthesia?

use?

wt double duration?

A

injected into tissues

dental procedues

epinephrine doubles duration

20
Q

Local anesthetic used on skin?

A

Benzocaine

21
Q

wt is second gas effect? drug often used?

A

when a rapidly absorbed gas increases the rate of uptake of a 2nd gas. NO used

22
Q

Propofol:

Use?

Advantage?

Major AE? pt populaiton w more pronounced AE?

Drug increasing AE?

Drug causing serious effects in pediatric patients?

Drug precipitating seizures?

A

Induction and maintenance of anesthesia.

Rapid Recovery.

CV effects AE. (more in elderly)

Opiates increase AE and sedation.

Fentanyl causes serious bradycardia in peds.

Alfentanil –> seizures.

23
Q

age MAC is calculated? effect of infancy on MAC? old age? hyperthyroidism? hypothyroidism? sedatives? amphetamines? red hair?

A

35-40 y/o infancy - inc old age - dec hyperthyroidism - inc hypothyroidism - dec sedatives - dec amphetamines - inc red hair - inc

24
Q

?name of barbiturate we need to know? What causes recovery? contraindication?

A

Thiopental.

Recovery is due to redistribution from the brain into less vascular regions (skin and muscle)

CI: Porphyria

25
Q

wc anesthetic is actually a weak anesthetic but a strong analgesia?

A

Nitrous Oxide

26
Q

df MAC?

A

Minimum alveolar concentration – inspired concentration of anesthetic producing anesthesia in 1/2 of subjects

27
Q

wc anesthetics are in LET mixture

A

Lidocaine

Epinephrine

Tetracaine

DT2 E2 (25 decks)

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