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3b_Boards - SketchyPharm > (6) Neuro & Psych: Anesthetics & Analgesics (2.1-2.3) > Flashcards

(6) Neuro & Psych: Anesthetics & Analgesics (2.1-2.3) Flashcards

1
Q

Indication(s) : Propofol

A

(1) Induction
(2) Maintenance
* (“Propo-fall-asleep”)*

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2
Q

Name 2 anesthetics which potentiate Cl- current through the GABAA receptor complex

A

(1) Propofol
(2) Etomidate

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3
Q

Which IV anesthetic produces the most profound hypotension?

A

Propofol

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4
Q

Indication(s) : Etomidate

A

Induction

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5
Q

Which induction anesthetic has minimal effect on cardiac function?

A

Etomidate

(Minimal changes to HR, BP, and contractility ∴ preferred for patients with heart disease)

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6
Q

Indication(s): Ketamine

A

Induction

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7
Q

MOA: Ketamine

A

NMDA receptor antagonist

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8
Q

Which IV anesthetic causes “dissociative anesthesia”?

A

Ketamine

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9
Q

Adverse Effects (2) : Ketamine

A

(1) “I’m trippppinnn balllz man” (e.g. vivid colorful dreams, hallucinations, out of body experiences)
(2) Cardiovascular stimulation

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10
Q

Name a drug class used in conscious sedation

A

Benzodiazepines

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11
Q

What aspect of anesthesia can barbituates be used for?

A

Induction

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12
Q

Name 5 IV anesthetics

A

(1) Propofol
(2) Etomidate
(3) Ketamine
(4) Benzodiazepines
(5) Barbituates

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13
Q

Are volatile anesthetics gaseous at room temperature?

A

No

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14
Q

Suffix: Volatile anesthetics

A

“-ane”

(They’re all fluorinated)

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15
Q

What is the relationship between an inhaled anesthetic’s solubility in blood and its rate of onset?

A

Rate of onset ∝ 1/Solubility

(The fat kid passed out before the skinnier kid)

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16
Q

What is the relationship between an inhaled anesthetic’s blood: gas partition coefficient and its duration of action?

A

Blood: gas partition coefficient ∝ Duration of action

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17
Q

When does the arterial tension curve for N2O plateau relative to Halothane?

A

Earlier

(Because it’s less soluble)

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18
Q

What value is used in place of ED50 for inhaled anesthetics?

A

MAC

(Minimum alveolar concentration to render 50% of people unresponsive)

19
Q

When discussing inhaled anesthetics, what is the relationship between potency and MAC?

A

Potency ∝ 1/MAC

20
Q

Adverse Effects (4) : Inhaled anesthetics

A

(1) Cardiac depression
(2) Malignant hyperthermia
(3) Respiratory depression
(4) ↓ Cerebral vascular resistant ⇒ Edema
* (Note: N2O is an exception, it does NOT cause respiratory depression or malignant hyperthermia)*

21
Q

What distinguishes Halothane’s adverse effects from the other inhaled anesthetics

A

Massive liver necrosis

(Also sensitizes heart to catecholamines ∴ contraindicated with pheochromocytoma)

22
Q

What distinguishes Enflurane’s adverse effects from the other inhaled anesthetics

A

(1) Nephrotoxicity
(2) Seizures

23
Q

Name an NMJ antagonist which can cause malignant hyperthermia

A

Succinylcholine

24
Q

What protein is defective in malignant hyperthermia?

A

Ryanodine receptor

25
Q

MOA: Malignant hyperthermia

A

Defective ryanodine receptor

⇒ Unregulated ↑ Ca2+ release from SR

⇒ ↑ ATP dependent reuptake of calcium

⇒ Heat

26
Q

Other than hyperthermia, what is a symptom of malignant hyperthermia?

A

Rhabdomyolysis

27
Q

Treatment: Malignant hyperthermia

A

Dantrolene

28
Q

MOA: Dantrolene

A

Inhibits ryanodine receptor

29
Q

Which opioid receptor mediates most of the clinical and adverse effects of opiates?

30
Q

What ion channels are affected secondary to μ-opiate receptor stimulation?

A

(1) Open post-synaptic K+ channels
(2) Close pre-synaptic Ca2+ channels
* (Stimulation of κ receptor in dorsal horn also ⇒ ↓ Substance P)*

31
Q

MOA: Tramadol

A

(1) Weak μ-agonist
(2) NET/SERT Inhibitor

32
Q

MOA: Loperamide

A

Locally active μ agonist

(Does not cross BBB ⇒ Only slows GI motility)

33
Q

Indication: Diphenoxylate

34
Q

MOA: Dextromethorphan

A

(1) μ agonist
(2) NMDA antagonist

35
Q

Adverse Effects (6) : Opiates

A

(1) CNS depression
(2) Respiratory depression
(3) Miosis
(4) Constipation
(5) Biliary colic
(6) Opiate induced hyperalgesia

36
Q

Name 2 effects of opiates to which tolerance does not develop

A

(1) Miosis
(2) Constipation

37
Q

What phrase summarizes the symptoms of opiate withdrawal?

A

“Anxious, hot, and moist”

38
Q

Name a long-acting full μ-agonist used to attenuate withdrawal symptoms

39
Q

Name a long-acting partial μ-agonist used to attenuate withdrawal symptoms

A

Buprenorphine

40
Q

MOA: Nalbuphine

A

Partial μ agonist

41
Q

What μ-opioid antagonist is used to reverse acute opioid toxicity?

A

Naloxone

(Naloxone is a shorter word than Naltrexone ∴ shorter acting)

42
Q

Which μ-opioid antagonist is used to help maintain abstinence in heroin addicts?

A

Naltrexone

43
Q

Indications (3) : Naltrexone (unrelated to heroin)

A

(1) Alcohol addiction
(2) Nicotine addiction
(3) Weight loss

3b_Boards - SketchyPharm (32 decks)

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