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PHARM 203 > 16/17- anaesthetics > Flashcards

16/17- anaesthetics Flashcards

1
Q

anesthesia

A

loss of all sensation/ consciousness and reflexes

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2
Q

does anesthetic make you loose autonomic reflexes

A

yes- both motor and autonomic

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3
Q

analgesia

A

loss of painful sensation

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4
Q

exerts effects on CNS = loss of all sensation and consciouness

A

general anesthetic

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5
Q

blocks peripheral nerve condition + all sensation

A

local anesthetic

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6
Q

do local anesthetics result in loss of consciousness

A

no

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7
Q

selectively blocks sensation of pain without blocking other modalities

A

analgesic

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8
Q

what has a more rapid onset of anesthesia

A

IV

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9
Q

what is used for anesthesia induction

A

IV

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10
Q

what is used for maintenance anesthesia

A

inhalation

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11
Q

what has faster elimination, IV or inhalation

A

inhalation

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12
Q

inhalation agents are

A

small, lipid soluble molecules

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13
Q

increased lipophilicity = ___ potency

A

increased

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14
Q

anesthetics bind to

A

hydrophobic pockets of specific membrane proteins

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15
Q

general anesthetics affect ____ and ____ rather than axonal conduction

A

synaptic transmission

neuronal excitability

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16
Q

targets of general anesthetics

A

GABAa receptors
2 pore domain K+ channels
nMDA receptors

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17
Q

____ and ____ reduce/ block NMDA (not PCP)

A

nitrous oxide

ketamine

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18
Q

almost all GA potentiate action of GABA at

A

GABAa receptors = Cl- entry = hyperpolarization

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19
Q

propofol and fospropofol onset offset

A

fast on

very fast off

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20
Q

thiopental onset offset

A

fast on, slow off

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21
Q

etomidate on off

A

fast on

fairly fast off

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22
Q

ketamine onset

A

slow

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23
Q

midazolam onset offset

A

slow, slow

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24
Q

what has long enough duration for short operations

A

ketamine

25
Q

thiopental is a

A

barbituate

26
Q

what is used in perioperative sedative in procedures not require full anaesthesia

A

medazolam

27
Q

__ is a measure of solubility in blood

A

blood;gas partition coefficient

28
Q

lower blood gas partition coefficient means

A

lower solubility = faster onset/ offset due to faster equlibrium within alveoli

29
Q

oil gas partition coefficient is a measure of

A

solubility in fat

30
Q

higher oil gas partition means

A

higher potency + decreased speed of recovery

31
Q

isoflurane onset/offset

A

medium

32
Q

desflurane onset offset

A

faster

33
Q

sevoflurane onset/offset

A

fast

34
Q

lower blood sol = ___ onset/offset = ____ sol in fat = ___ potency

A

faster
higher
higher

35
Q

N2O potency

A

low- must be combined with other agents

36
Q

nitrous oxide on/off

A

fast

37
Q

what is used for dental procedures and to reduce pain during childbirth

A

nitrous oxide

38
Q

balanced anaesthesia

A

provide unconciousness, amnesia, analgesia, relaxation

39
Q

vecuronium

A

neuromuscular blocking agent

40
Q

BZs can be used as a

A

sedative/ anxiolytic premed

41
Q

parenteral injection

A

injection near peripheral nerve endings into epidural or subarachnoid spaces around spinal cord

42
Q

bier block

A

an IV injection distal to where circulation is cut off

43
Q

local anesthetics contain

A

aromatic residue, ester or amide link to basic amine side chain

44
Q

local anesthetics are usually ___ provided as ___

A

weak bases

salts

45
Q

the greater the pKa, the ___ the rate of anesthesia onset

A

slower

46
Q

local anesthetic MOA

A

block Na+ channels
increase excitation threshold
block conduction

47
Q

how do local anesthetics enter channel

A

uncharged form through membrane
reionizes
enters channel from inside

48
Q

access of receptor to LA limited by

A

activation state of channel

49
Q

low pH = ____ action of LA

A

decreased

ionized = can’t pass through

50
Q

block of LA is

A

use dependent

51
Q

most susceptible nerve fibers to LA have

A

smaller diameter
higher firing frequency
longer action potential duration/ wider spike width

52
Q

sensory fibers (pain) are ___ have ____ firing rates, and ___ AP durations

A

thin
high
long

53
Q

local anesthetics don’t want systemic absorption due to

A

toxic effects

54
Q

LA effects on cardiovascular

A

cardiac depression by inhibiting Na+

hypotension by inhibiting SNS

55
Q

LA effect on CNS

A

CNS depression

56
Q

______ are added to local anesthetics to limit systemic absorption

A

vasoconstrictors

57
Q

epinephrine added to local anesthetics counteracts tendency of local anesthetics to cause

A

vasodilation

58
Q

procaine and lidocaine are

A

nonaddictive local anesthetics

PHARM 203 (21 decks)

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