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Module 202 Theme 1 > Anaesthetic drugs > Flashcards

Anaesthetic drugs Flashcards

1
Q

What is anaesthesia?

A

A reversible drug induced absence of sensation and awareness

Any lipid soluble agent that causes depression of the brain in a predictable order

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2
Q

State the order in which anaesthetics cause depression to the brain

A

Cortex
Midbrain
Spinal cord
Medulla

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3
Q

What are the effects of ethanol?

A 
Tranquillization
Excitation
Dysarthria
Ataxia
Sedation/hypnosis
Anaesthesia
Coma
Medullary depression
Death
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4
Q

How do anaesthetics work?

A

Stimulation of inhibitory receptors - GABAA, Glycine

Inhibition of excitatory receptors - Nicotinic, Serotonin, Glutamate/NMDA

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5
Q

How doe GABAA anaesthetics work?

A

Pentameric
Single amino acids
Chloride ions
Hyperpolarisation

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6
Q

How do we give anaesthetics?

A

Inhale

Inject

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7
Q

Name some inhalation agents

A 
Oxygen
Nitrous oxide
Ideal properties
Isoflurane
Other volatile agents
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8
Q

State some side effects of oxygen

A 
O2 free radicals
CNS convulsions
Pulmonary oxygen toxicity
Retrolental fibroplasia	
CO2 narcosis
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9
Q

When is oxygen a gas?

A

Above -119 degrees

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10
Q

Describe nitrous oxide

A 
Weak anaesthetic
Good analgesic
Quick onset/offset
Cardiorespiratory depressant
Neuropathy/BM depression
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11
Q

List some physical properties of inhalational agents

A 
Cost
Chemical stability
Non-flammable/explosive
Vaporizable
Environmentally stable
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12
Q

List some chemical properties of inhalational agents

A 
Non irritant
Low blood:gas solubility
High potency - lower MAC
Minimal side effects (pharmacodynamics)
Biotransformation (pharmacokinetics)
Non-toxic
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13
Q

List some older inhalational agents

A

Ether - side effect is nausea and vomiting
Chloroform
Cyclopropane
Methoxyflurane
Halothane - causes kidney problems
Enflurane - lowered threshold for epilepsy and seizures

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14
Q

Describe isoflurane

A 
Inhalational agent 
Halogenated ether
1965
Relatively cheap
Stable and non flammable
Vaporizable BP 49C
Irritable to airway
Relatively potent MAC 1.1%	B:G co 1.4 - works quickly and wears off relatively quickly
Side effects	CVS/RS
0.2% metabolised
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15
Q

Describe sevoflurane

A 
Inhalational agent
Non irritable
Quick onset/offset
MAC 2%
5% metabolised
CVS stability
Emergence phenomena
Expensive
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16
Q

Describe Desflurane

A 
Inhalational agent 
Very quick onset/offset
0.02% metabolised
Moderately expensive
Irritant
Special vaporizer
MAC 6.35%
17
Q

How are inhalational agents delivered to the patient?

A

Machine/vapourizer

18
Q

Describe intravenous agents

A 
Shorter history
Induction agents/iv opiate
Rapid and pleasant
Lipid soluble
Redistribution	- into fat or muscles short acting
Metabolised
CVS/RS depression
19
Q

Describe thiopentone

A 
Thiobarbituate	1933
Powder
Smell of garlic
Antiepileptic
CVS/RS depression
Anaphylaxis/	arterial
Half life 10 hours
20
Q

Describe 2,6-diisopropylphenol (propofol)

A 
Solvent
Redistribution half life 		4 minutes
Elimination half life			4 hours
Minimal accumulation		TIVA
Anti emetic
Anti epileptic
Painful to inject
Abnormal movements
CVS/RS effects
Also used to keep ICU patients asleep
21
Q

Name some other intravenous agents

A

Ketamine
Etomidate
Midazolam

22
Q

What are muscle relaxants?

A 
Dangerous drugs
Muscle paralysis
Facilitate intubation
Maintain paralysis for surgery/ventilation
Depolarising
Non depolarising
Anaesthetists only
23
Q

What are depolarising agents?

A 
Suxamethonium
Post-synaptic membrane
Mimics acetylcholine
Rapid onset offset
Short half life ~ 2min
Plasma cholinesterase
Multiple side effects
24
Q

What are non depolarising blockers?

A 
Competitive with Ach
Ach moiety blocks Na channel with size
Duration is variable
Slower onset
Slower offset
Steroid group		rocuronium
Benzylisoquinoliniums	atracurium
25
Q

Describe N-M blocking agents

A 
Intubation
Surgery
Ventilation
Transfer
Side effects
Reversal

Module 202 Theme 1 (28 decks)

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