16 - GENERAL ANAESTHETICS Flashcards
GA DRUGS
Thre are two tyepes, the administered Iv and those which are administered inhaled.
Intravenous anaesthetics
They have a very raid action (20s- few minuts). They are used to induce or to mantain anaest hesia (“total iv anaesthesia”- TIVA).
`Propofol
Its combined with muscle relaxants or analgesic drugs. This is an example of Iv anaesthetic.
OPIODS
- Opioids. Frequently used in cardiac surgery (stable cardiovascular function or
bradycardia).
Problem: insufficient capacity to depress neuroendocrine function, “stress response”
characterized by an increase in somatotropin, catecholamines, antidiuretic hormone
and cortisol leading to hypertension and effects on the myocardium.
Fentanyl (shorter action compared to morphine, high liposolubility, elimination due to
hepatic metabolism, half-life: 3.5h)
Alfentanyl (half-life : 1.5-2h)
Sufentanyl (half-life: 3h)
Remifentanyl (last generation, ultrarapid action, elimination independent of hepatic
metabolism, half-life: 10min)
15
Use: severe nervous insomnia, certain types of epilepsy, certain psicological
disorders, seizures, anaesthesia - Barbiturates
BDZ increase
BARBITURATES
Iv anaesthetics- GA
Fentanyl
a
Afentanyl
b
Sufentanyl
c
Remifentanyl
d
Thiopental
e
Benzodiazepines
f
Ketamine
g
Etomidate (corticosteroid)
h
Droperidol (dehidrobenzioperidol, neuroleptics)
i
Inhalational anaesthetics- names
Nitrous oxide Halothane Enflurane Isoflurane Desflurane Sevoflurane
Halothane
Example of inhalational anaesthetic. It is 100 times more soluble in fat than in water, so after equilibrium is achieved the amount in the fat is 95% of the total amount present in the organism . This fact is going to cause hangover effect. So it is high liposoluble, leading to hangover effect.
Enflurane
a
Isoflurane
b
