Anaesthetics Flashcards
What are the two types of anaesthetics?
IV
Inhaled
What are the two main types of Inhaled Anaesthetics?
Volatile Liquid
Nitrous Oxide
Give some names of Volatile Liquids used in anaesthetics.
Isoflurane
Desflurane
What are Volatile liquids (-flurane) used in?
Induction and maintenance of anaesthesia
What are some risks associated with Volatile Liquids -fluranes
Myocardial suppression and hyperthermia
What is Nitrous oxide used in?
Induction and maintenance of anaesthesia.
Often pre IV to relax
When should NO be used in caution?
Patients with a Pneumothorax as can diffuse into space increasing the pressure.
Give the main IV anaesthetic agents.
Propofol
Thiopental
Etomidate
Ketamine
What is the most frequently used IV anaesthetic.
Propofol
What is Propofol mode of action?
GABAa inducer
What is a negative in regards to propofol
Very painful on injection
Causes hypotension
If you are inducing a patient who has a history of severe post anaesthetic nausea what anaesthetic is most commonly used?
Propofol - Anti emetic effects
What is Thiopentals MOA
GABAa
Describe Thiopental and how this impacts its affect.
Highly lipid soluble so acts very quickly on the brain.
Used in Rapid Sequence Induction
What is Thiopental associated with?
Laryngospasm
If you have an surgery booked with a patient who is hypotensive what anaesthetic could you use?
Etomidate - less hypotensive affects
What is Etomidate’s MOA
GABAa
What are some risks associated with Etomidate?
Primary Adrenal Suppresion and Myoclonus
If you’ve got an acute emergency surgery for a poltrauma patient who is haemo-dynamically unstable. What is your anaesthetic of choice?
Ketamine
What are some issues with Ketamine?
Disorientation and Hallucination
Ketamine MOA
NMDA antagonist
What three things are required in surgery?
Anaesthetic
Paralytic
Pain Killers
What are the two types of Paralytic drugs?
Depolarizing
Non Depolarizing
You’ve got an acute patient requiring immediate intubation what paralytic would you use? Why?
Depolarizing - Suxamethonium
Rapid acting
What do depolarising paralytics work on?
Nicotinic ACh receptors - Agonist
If you see a patient who has been injected with a paralytic experience fasciculations what is the likely medication?
Depolarising
Suxamethonium
What are some risks associated with Suxamethonium?
Hyperthermia and Hyperkalaemia
Fasciculations - anaesthetise first.
When should suxamethonium be avoided?
Penetrating eye injuries
Acute angle Glaucome
Why are non depolarising IV paralytics more commonly used for routine surgery?
Depolarising - no control when paralytic action stops. Withdrawal can happen randomly. Short half life
Non depolarising - longer half life and can be reversed quickly
Give some examples of non depolarising IV paralytics.
Vecuronium.
Pancuronium
Rocuronium
-curonium
What can be used to revere the paralysis caused by Non Depolarising Paralytics?
Neostigmine
What are some issues with Non Depolarising - curonium - paralytics?
Can cause hypotension
What Cardio Drugs should be stopped on the day of surgery?
ACE
ARB
Diuretics. Unless for HF
If you decided to stop Antiplatelets prior to surgery how long should they be stopped for?
Aspirin and Clopidogrel 7 days
What do Non Depolarising Paralytics work on?
Nicotinic ACh Antagonists
A patient presents with apnoea post general anaesthesia. What is the likely culprit?
Suxamethonium - apnoea is linked to a deficiency in the enzyme needed to break it down.
Which condition causes you to have an increased sensitivity to non depolarising anaesthetics.
Myasthenia Gravis
Non depolarising anaesthetic works by.
Antagonistic binding of ACh receptors
Depolarising anaesthetics work by.
Agonistic binding of ACh
In rapid sequence induction what is the muscle relaxant of choice?
Suxamethonium
What is the management of malignant hyperthermia?
IV Dantrolene
Major side affect associated with etomidate?
Adrenal Suppression
