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Neuro > Anaesthesia > Flashcards

Anaesthesia Flashcards

1
Q

gases used for inhalational anesthesia

A

nitrous oxide

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2
Q

liquids used for inhalation anesthesia

A 
halothane
enflurane
isoflurane
desflurane
sevoflurane
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3
Q

define conscious sedation

A

protective relfexes mantained

independent mainatinence of airways/O2/ventillation

response to physical or verbal stimuli

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4
Q

deep or unconsious sedation

A

profound effects with loss of one or more of the conscious sedation criteria

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5
Q

define general anesthesia

A

sensory, mental. reflex, and motor blockade

concurrent loss of all protective reflexes

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6
Q

general anesthetic advantage

A

capable fo producing reversible depression of neuronal function, producing loss of abaility to precieve and other sensations

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7
Q

maintainence of airway under general anesthesia

A

PEEP pressure needs to be applied

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8
Q

dosing of general anesthesia

A

inhalation or intravenous

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9
Q

MAC=

A

minimum alveolar concentration

concentration in the inspired gas required to render half a group of patients unconscious -unresponsive to painful stimuli

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10
Q

oil gas patition coefficient

A

describes the lipid solublity of a drug

the higher the number the more lipid soluble

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11
Q

MOQ for anesthetic agents

A

reinforcements of GABA and GLYCINE

resinforcement of two pore K channels

inhibition of glutamate excitatory signalling

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12
Q

other than CNS, where do general anesthetics work?

A

modulate ascending pathways to CNS and descending pathways to peripheral tissues

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13
Q

describe the mixture of a typical inhalation anesthetic

A

70% N2O
25% O2
5% Halothane

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14
Q

REFLEX RESPONSE TO HYPERCAPNIA IS BLOCKED BY ALL EXCEPT

A

N2O

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15
Q

WHEN USED ALONE DOES N2O HAVE CV EFFECTS

A

NO BUT IT IS OFTEN GIVEN IN CONJUNCTION WITH OTHERS that do

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16
Q

N2O given with opioids suggests

A

a sympathomimetic action since no significant CV effects

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17
Q

anesthetics that provide analgesia

A

N2O

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18
Q

does not inhibit preotective reflexes if used alone

A

N2O

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19
Q

pro arrythmogenic anesthetic

A

halothane-sensitizes myocardium to ciruclating cetacholamiens

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20
Q

bad about liver damage

A

halothane

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21
Q

proepileptic potentials

A

enflurane

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22
Q

cause muscle relaxation

A

enflurane and isoflurane

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23
Q

copmplications from N2o

A

second gas effect
diffusional hypoxia
N2O solubility

bowel surgery, pneumothorax, middle ear-rupture air drum

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24
Q

Amide type

A 
lidocaine
mepivicaine
prolicaine
bupivicaine
ropivicaine
articaine
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25
Q

ester-type

A

procaine
chlorprocaine
tetracaine
cocaine

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26
Q

topical use only

A

benzocaine
dyclonine
dibucaine
pramoxine

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27
Q

EMLA,LET

A

VASOCONSTRICTORS: EPI, PHENYLEPHRINE, OXYMETAZOLE

REVERSAL AGENTS: PHENTOLAMINE

28
Q

ONLY local anesthetic with vasoconstrictor effects

A

cocaine

29
Q

ideal agent for local anesthesia

A

lipophillic and hydrophobic

low toxicity
short onset
completely reversible
active by topical injection infiltration

30
Q

Local anesthetic MOA

A

inhibit voltage gated sodium channels involved in process of neuronal conduction

31
Q

ap seen in local anesthetic

A

never reaches threshold

32
Q

reason for differences in onset of action of local anesthetics in different fiber types

A

local anesthetic reaching a critical concentration along the length of the nerve more rapidly, when successive nodes are closer spaced.

33
Q

list the onset of actions in the different fiber types based on myelination

A 
Aalpha
Abeta
Agamma
Adelta
B fibers
C fibers-postganglionic
C fibers-sensory
34
Q

order of onset of block

A

B fibers

c fibers postgang, C fibers sensory, Adelta

Agamma

a beta

a alpha

35
Q

do local anesthetics work on ascending or descending fibers

A

no, only at the axon segments

36
Q

pH of most local anesthetics

A

weak bases wit a pKa of 8

37
Q

thiopene ring rather than benzene ring for lipophillicity

A

articaine

38
Q

amide metabolism may be affected by

A

cardiovascular status, liver disease, toxemia of pregnancy, cimetidine, volatile anesthetics, beta blockers

39
Q

ester metabolism by esterases may be affected by

A

liver disease, pregnancy, chemo, atypical enzyme activity

40
Q

vasoconstrictors used in conjunciton with local anesthetics

A

epinephrine

levonordefin

41
Q

complications of vasoconstrcitors coadministered

A

pallor, undrest, sweating, fatigue, palpitations, N/V

42
Q

epinephrine interactions with

A 
beta blockers
tcas
halothane
HTN
heart block
cerbral vascular insufficency
43
Q

highest chance of allergic reactions

A

procaine-conversion to paraaminobenzoic acid

also some sulphites may produce an allergy

thus in asthamtics use preservitive free

44
Q

short acting local anesthetics

<1 hour

A

procaine-slow onset-1

chlorprocaine-rapid onset-4

45
Q

intermediate acting local anesthetics

2-3 hours

A

articaine-rapid
lidocaine-rapid
pilocaine-rapid
mepivicaine

46
Q

long acting local anesthetics
*potency of 16
2 hours-8 hours

A

bupivicaine-slow
ropivicaine-slow
tetracaine-slow

47
Q

procaine has the same potency as

A

mepivicaine

48
Q

protein binging determines

A

duration of effect for local anesth

49
Q

chemical linkages determine

A

metabolism for local anesth

50
Q

dissociation constant determines

A

time of onset

51
Q

lipid solubility

A

potency

52
Q

toxic metab of these drugs cause methemogolinemia

A

prilocaine

benxocaine

53
Q

bupivicaine is special in that is has a certain toxicity

A

longer duration

potent cardio toxic than lidocaine/mepivicaine

prolonged activity >24 hours useful for postoperative analgesis

but cauting wiht lip trauma=no solid foods

54
Q

local anesthetic with reduced cardiotoxicity a greater safety margin

A

ropivicaine

55
Q

topical local anesthetics for mouth, pharynx, larynx, trachea, esophagus

A

benzocaine

dyclonine

56
Q

topical local anesthetics for SKIN AND NOT MUCOUS MEMBRANES

A

dibucaine

pramoxine

57
Q

EMLA=

A

eutectic
mixture of
local
anesthetics

58
Q

LET=

A

lidocaine-epinephrine-tetracaine

or tetracaine-phelynephrine

59
Q

widely widely used in pediatric

A

LET

60
Q

EMLA made of

A
  1. 5% lidocaine

2. 5% prilocaine

61
Q

Lidocaine-oxymetazoline

A

(alpha 1/2 adrenergic agonist)*

62
Q

method of EMLA delivery

A

applied to the skin and covered with an occlusive dressing for an hour to permit anesthesia of surface tissues before grafting

63
Q

used by ENTs to see engorged nasal passages

A

lidocaine-oxymetazoline

64
Q

nerve block occurs

A

not in the spinal cord itself but in the fibers exiting the cord at that anatomical level

65
Q

baricity

A

density compared to csf

Neuro (19 decks)

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