24 Pharmacology: Local and General Anesthetics Flashcards
1
Q
General Anesthesia
- What are the 4 steps in using this?
- Which step is unwanted?
A
2
Q
IV General Anesthetics
- What are the indications for this?
- Why are they used with inhaled anesthetics?
A
3
Q
Amide-Linked Local Anesthetics
- How do these drugs come to ester-linked ones in terms of half-life and duration of action?
- How are they solubilized in the liver?
- How are they eliminated?
- What happens when a patient has impaired hepatic blood flow?
A
4
Q
Adjunct Agents: Benzo’s
- Midazolam
- What is this drug used for?
- Can it produce surgical anesthesia?
- What does it do to GABAA activity?
- What ADRs does this drug have?
- How do you reverse the effects of this drug?
A
5
Q
Keeping doses low
- Why would one use a vasoconstrictor with a local anesthetic?
- What vasoconstrictor is preferred?
- Why would local toxicity occur from using a vasoconstrictor?
A
6
Q
Adjunct Agents: Opioids
- When are these drugs used?
- What receptors do they act on as an agonist? What does this inhibit?
- What ARS do they have?
- What is their reversal agent?
A
7
Q
Factors that determine fiber susceptibility: Firing Frequency
- Anesthetic drugs have a higher affinity for a binding site when a channel has a _______ conformation.
- How do rapid firing neurons differ from slow-firing neurons in terms of suseptibliting to blockades?
A
8
Q
IV General Anesthetics
- What organs do these drugs favor?
- 4 compartment model
- What group is associated with IV General Anesthetics?
- How is recovery from these drugs mediated?
- What role does metabolism play for IV General Anesthetics?
A
9
Q
ADRs Local Anesthetics
- What serum concentrations are associated with CNS adverse side effects of lidocaine?
- What type of motor neurons are directly blocked by local anesthetics?
- What happens to the urinary bladder of patients?
A
10
Q
Keeping doses low
- What can be administered to lower the pH of a target tissue?
- What effect does this have on the membrane of the target of cells in the target tissue?
A
11
Q
Local Anesthetics
- What channel must be open in order for local anesthetics to access desired binding sites?
A
12
Q
IV General Anesthetics
- What are the 4 drug types to remember for this?
A
13
Q
Local Anesthetics
- List the 3 main indications for Local Anesthetics
- List the 5 general adverse side effects for Local Anesthetics
A
14
Q
ADRS of local anesthetics
- What can these drugs do the cardiac function in terms of
- chronotropic
- entropy
- What dysrhythmias can occur?
- What drugs are actually cardioprotective at low doses?
- What drug is very lipophilic and has a high affinity for cardiac tissue?
- How can cardiotoxicity be revered?
A
15
Q
Factors that determine fiber susceptibility: Diameter
- What kind of neurons rely the most on passive propagation of action potentials?
- What does this mean in terms of “skipping” a blocked node?
- What are the notable fibers that are among the smallest and desired fibers to be blocked in a clinical setting?
A
16
Q
ADRS of Local Anesthetics
- What can toxic levels of these drugs do to the vasculature?
- What drug is known to cause cardiovascular collapse?
- What drug will actually cause vasoconstriction?
A
17
Q
Propofol
- Why does propofol have a more rapid recovery than other drugs like barbiturates?
- Does it have cause analgesia?
- What are the 3 know mechanism of this drug?
A
18
Q
Etomidate
- What is this drug used for?
- Does it have analgesia
- What is the mechanism of action and receptor type it binds to?
- Unique features
- What is notable about the body systems it DOES not affect?
- ADRS
- What are the 4 main ADRs for this drug?
A
19
Q
Barbituates: Propofol
- Whare is a unique feature of this drug?
- What is the prodrug for it?
- How is it converted into propofol?
- What are the ADRs for this drug?
A
20
Q
Factors that determine fiber susceptibility
- What are the 4 factors that affect this?
- What fibers are unmyelinated?
- Which have the highest sensitivity to being blocked? Which have the lowest?
A
21
Q
Barbiturates
- What are the 2 drugs that were used for induction and maintenance, but have been replaced propofol?
- Do they have analgesic effects?
- What receptors do they act on?
- What are the ADRs for these drugs?
A
22
Q
ADRS of Local Anesthetics
- Why do systemic effects occur?
- What dose can toxic effects occur at?
- What are 3 ways to minimize the ADRs of these drugs?
A
23
Q
Factors that determine fiber susceptibility: Fiber Position
- What fibers in a nerve bundle are exposed to higher drug concentrations?
- Relative to the spinal cord, the effects of administration of a local anesthetics depends on what?
- Where does an epidural go?
- Where does a spinal block go?
- Where does a caudal block go?
A
24
Q
Ester-Linked Local Anesthetics
- Are these fast or short-acting?
- How fast are they eliminated?
- What are they broken down by?
- How are they excreted?
A
25
Q
Factors that determine fiber susceptibility: Myelination
- If controlling for diameter, what is notable about myelinated fibers and node blocks?
- What kind of channels are concentrated at the noted of these fibers?
- What does this mean in terms of the number of channels needed to be blocked in order to achieve full blocking effect?
A
26
Q
ADRS of Local Anesthetics
- What can happen to the blood of patients who take lidocaine or procaine?
- Why do patients become allergic to procaine or benzocaine?
- What drug is associated to cardiac arrest in pregnant women?
A
27
Q
Ketamine
- What is this drug used for?
- What is the mechanism of action and receptor it acts on?
- Unique Features
- What are the 4 unique features of this drug?
- ADRS
- What weird ADRs does this drug have?
A
28
Q
Adjunct Agents: Dexmedetomidine
- What receptor does this drug act on?
- What are the results of this?
- Does it minimally depress the cardiac or respiratory systems?
- What ADRs does it have?
A
