Anaesthetics Flashcards
Name 4 classes of anaesthetics
- General anaesthetics
- Neuromuscular blockers
- Other agents used in anaesthesia
- Drugs for local anaesthesia
Name 2 classes of general anaesthetics
- IV general anaesthetics
- Inhaled anaesthetics
Name 4 IV general anaesthetics
- Ketamine
- Midazolam
- propOFol
- Thiopental
Name 2 inhaled anaesthetics
- Methoxyflurane
- Nitrous oxide
Name 2 classes of neuromuscular blockers
- Non-depolarising neuromuscular blockers
- Depolarising neuromuscular blockers
Name 5 non-depolarising neuromuscular blockers
- Atracurium
- Cisatracurium
- Mivacurium
- Rocuronium
- Vecuronium
Name 1 depolarising neuromuscular blocker
Suxamethonium
Name 4 classes of drugs used as adjuncts to anaesthesia
- Alpha2 and imidazoline agonists
- Opioids
- Anticholinergics
- Drugs for reversing neuromuscular blockade
Name 2 alpha2 and imidazoline agonists
- Clonidine
- Dexmedetomidine
Name 2 opioids used in anaesthesia
- Alfentanil
- Remifentanil
Name 2 anticholinergics used in anaesthesia
- Atropine
- Glycopyrronium
Name 1 drug used for reversing neuromuscular blockade
Sugammadex
Name 7 local anaesthetics
- Bupivacaine
- Cocaine
- Levobupivacaine
- Lidocaine
- Prilocaine
- Ropivacaine
- Tetracaine
In which patient cohort is ketamine particularly useful?
Opioid-tolerant patients.
Name 12 opioid analgesics
- Alfentanil
- Buprenorphine
- Codeine
- Fentanyl
- Hydromorphone
- Methadone
- Morphine
- Oxycodone ± Naloxone
- Pethidine
- Remifentanil
- Tapentadol
- Tramadol
What is the opioid of choice in surgery?
Morphine
Why is morphine the opioid of choice for surgery?
As it has the best retention in the cerebrospinal fluid.
What must you always consider (besides age) when determining the dose when initiating an opioid?
Renal function
Why must you consider renal function when initiating an opioid?
As renally-cleared opioids will accumulate in poor renal function.
What should you consider if you see oxycodone and tramadol concurrently charted?
Check if there has been APS involvement.
What is the common approach to pain management by the Acute Pain Service?
They will commonly start a patient on paracetamol and oxycodone, then add tramadol if pain is still not sufficiently controlled
What is the rationale for the Acute Pain Service adding tramadol to a patient already on Oxycodone?
Tramadol has a slightly different mechanism to oxycodone.
What should you do if you see IV opioids charted on the ward?
Chase this with the team to have it removed (IV opioids can’t be given on the wards) and check to see if anything else should be charted in its place.
What is generally a requirement for a patient to be charted opioids as an inpatient?
They must be on regular paracetamol.
How must Targin be ordered by a ward?
A ward can send a distribution form for Targin but they must specify the patient details as they must have past history for pharmacy to be able to supply it.
What is an example of an off-label use of oxybutynin?
To control sweating.
How is clonidine used in surgery?
Clonidine may be used to manage anxiety (for example about pain) in the recovery room.
