Anaesthetic Drugs Flashcards

1
Q

Which induction agent is an excellent airway reflex suppressor?

A

Propofol

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2
Q

In previous cases of PONV, which induction agent decreases the incidence of PONV?

A

Propofol

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3
Q

What side effects does propofol cause?

A
  • Drop in HR
  • Drop in BP
  • Pain on injection
  • Involuntary movements
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4
Q

Which induction agent is contraindicated in patients with egg/soy allergy?

A

Propofol

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5
Q

What type of drug is thiopentone?

A

Barbiturate

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6
Q

Which drug has anti-epileptic properties?

A

Thiopentone

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7
Q

What side effects does thiopentone cause?

A
  • Rise in HR
  • Drop in BP
  • Rash
  • Bronchospasm
  • Intra-arterial injection - thrombosis and gangrene
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8
Q

In which medical condition is thiopentone contra-indicated in?

A

Porphyria

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9
Q

Which Induction agent has the slowest onset?

A

Ketamine - 90 seconds

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10
Q

What are the benefits of using ketamine?

A

Anterograde amnesia and profound analgesia

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11
Q

Which induction agent has the lowest incidence of hypersensitivity reaction?

A
  • Etomidate
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12
Q

What are the effects of ketamine?

A
  • Rise in HR
  • RIse in BP
  • Bronchodilation
  • N+V
  • Emergence phenomenon - hallucinations
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13
Q

What type of onset does etomidate have?

A

Rapid

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14
Q

What are the unwanted effects of etomidate?

A
  • Pain on injection
  • Spontaneous movements
  • Adreno-cortical suppression
  • High incidence of PONV
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15
Q

When is etomidate contra-indicated?

A
  • Septic shock
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16
Q

Which induction agent would be best for changing a burn dressing?

A

Ketamine

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17
Q

Which induction agent is most appropriate for GA with an LMA?

A

Propofol

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18
Q

Which induction agent would be best for a patient with a history of heart failure requiring GA?

A

Etomidate

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19
Q

Patient requiring emergency laparotomy?

A

Thiopentone

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20
Q

Patient with porphyria requiring for inguinal hernia repair?

A

Propofol

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21
Q

Which maintenance drug has the least effect on organ blood flow?

A

Isoflurane

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22
Q

Which inhalational agent is sweet smelling?

A

Sevoflurane

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23
Q

Which inhalational agent can also be used for induction?

A

Sevoflurane

24
Q

Which inhalational agent has a rapid onset and offset?

A

Desflurane

25
Q

Which inhalational agent is good for long operations?

A

Desflurane

26
Q

Which inhalational agent would be best for an 8 hour finger-reimplantation operation?

A

Desflurane

27
Q

Which inhalational agent would be best for a chubby child with no IV access?

A

Sevoflurane

28
Q

Which inhalational agent would be best for organ retrival from a donor?

A

Isoflurane

29
Q

Which analgesia is short-acting and used intra-operatively?

A

Fentanyl, Remifentanyl, Alfentanyl

30
Q

Which analgesia suppresses the response to laryngoscopy?

A

Fentanyl, Remifentanyl, Alfentany

31
Q

Which analgesia is good for surgical pain?

A

Fentanyl, Remifentanyl, Alfentany

32
Q

Which long acting analgesia is best for intra-op and post-op?

A

Morphine, oxycodone

33
Q

How long does Morphine/oxycodone take to work?

A

Works best at 20mins and lasts 2 hours

34
Q

How do depolarising muscle relaxants work?

A

Compete with Ach for nicotinic receptors with similar action but slowly hydrolysed so can cause muscle contraction

35
Q

What is suxamethonium used for?

A

RSI - rapid onset, rapid offset

36
Q

What are the adverse effects of suxamethonium? Name 5

A
  • Muscle pain
  • Fasciculations
  • Hyperkalaemia
  • Malignant hyperthermia
  • Rise in ICP, IOP and gastric pressure
37
Q

How do non-depolarising muscle relaxants work?

A
  • Block nicotinic receptors therefore muscles relax
38
Q

What are the effects of non-depolarising relaxants?

A
  • Slow onset
  • Variable duration
  • Less side effects
39
Q

Name 2 short acting, 2 intermediate acting and 1 long acting non-depolarising muscle relaxants

A

Short:

  • Atracurium
  • Mivacurium

Mid:

  • Vecuronium
  • Rocuronium

Long:
- Pancuronium

40
Q

How are muscle relaxants reversed?

A

Neostigmine and Glycopyrrolate

41
Q

How does Neostrigmine work?

A

Anti-cholinesterase preventing breakdown of Ach

42
Q

What are the muscarinic effects of Ach?

A

Bradycardia

43
Q

Why is neostigmine combined with glycopyrrolate?

A

Antimuscarinic agent

44
Q

What are the side effects of reversal?

A

N+V

45
Q

Which drugs are used to treat hypotension?

A
  • Ephidrine
  • Phenyephrine
  • Metaraminol
46
Q

What are the effects of Ephedrine?

A
  • Rise in HR and contractility = rise in BP

- Direct and indirect action on alpha and B receptors

47
Q

What are the effects of phenyephrine?

A
  • Vasoconstriction = rise in BP
  • Direct action on alpha receptors
  • Drop in HR
48
Q

What are the effects of metaraminol?

A
  • Vasocontriction = Rise in BP

- Direct and indirect action predominantly on alpha receptors

49
Q

Which drugs are used to treat severe hypotension?

A

Noradrenaline
Adrenaline
Dobutamine

50
Q

What are the effects of adrenaline?

A

Bronchodilator/inotrope
Prolongs anaesthetic action
Administered via central line

51
Q

Which Vaso-active agent is best when the patient has low BP and HR

A

Ephedrine

52
Q

Which Vaso-active agent is best when the patient has low BP and high HR?

A

Phenylephrine

Metaraminol

53
Q

What are the effects of atropine?

A
  • Decreased secretions
  • Reduced gastro-oesophageal sphincter tone
  • Urinary obstruction
  • Tachycardia
  • Confusion in elderly
54
Q

How long does thiopentone take for RSI?

A

15-30 seconds

Lasts for 4-8minutes

55
Q

How long does propofol take in RSI?

A

30 seconds

Lasts for 2-6minutes

56
Q

How long does suxamethonium last in RSI?

A

6 minutes