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

25
thiopental is a
barbituate
26
what is used in perioperative sedative in procedures not require full anaesthesia
medazolam
27
__ is a measure of solubility in blood
blood;gas partition coefficient
28
lower blood gas partition coefficient means
lower solubility = faster onset/ offset due to faster equlibrium within alveoli
29
oil gas partition coefficient is a measure of
solubility in fat
30
higher oil gas partition means
higher potency + decreased speed of recovery
31
isoflurane onset/offset
medium
32
desflurane onset offset
faster
33
sevoflurane onset/offset
fast
34
lower blood sol = ___ onset/offset = ____ sol in fat = ___ potency
faster higher higher
35
N2O potency
low- must be combined with other agents
36
nitrous oxide on/off
fast
37
what is used for dental procedures and to reduce pain during childbirth
nitrous oxide
38
balanced anaesthesia
provide unconciousness, amnesia, analgesia, relaxation
39
vecuronium
neuromuscular blocking agent
40
BZs can be used as a
sedative/ anxiolytic premed
41
parenteral injection
injection near peripheral nerve endings into epidural or subarachnoid spaces around spinal cord
42
bier block
an IV injection distal to where circulation is cut off
43
local anesthetics contain
aromatic residue, ester or amide link to basic amine side chain
44
local anesthetics are usually ___ provided as ___
weak bases | salts
45
the greater the pKa, the ___ the rate of anesthesia onset
slower
46
local anesthetic MOA
block Na+ channels increase excitation threshold block conduction
47
how do local anesthetics enter channel
uncharged form through membrane reionizes enters channel from inside
48
access of receptor to LA limited by
activation state of channel
49
low pH = ____ action of LA
decreased | ionized = can't pass through
50
block of LA is
use dependent
51
most susceptible nerve fibers to LA have
smaller diameter higher firing frequency longer action potential duration/ wider spike width
52
sensory fibers (pain) are ___ have ____ firing rates, and ___ AP durations
thin high long
53
local anesthetics don't want systemic absorption due to
toxic effects
54
LA effects on cardiovascular
cardiac depression by inhibiting Na+ | hypotension by inhibiting SNS
55
LA effect on CNS
CNS depression
56
______ are added to local anesthetics to limit systemic absorption
vasoconstrictors
57
epinephrine added to local anesthetics counteracts tendency of local anesthetics to cause
vasodilation
58
procaine and lidocaine are
nonaddictive local anesthetics