Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Surgery > Anaesthetics > Flashcards

Anaesthetics Flashcards

1
Q

What are the 3 phases of anaesthesia

A

Induction
Maintenance
Emergence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the three principles of anaesthesia

A

Sedation
Analgesia
Muscle relaxants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which drugs are used to induce anaesthesia

A

Propofol - acts as a sodium channel blocker and GABA potentiator
Inhalation agents - isoflurane, sevoflurane, desflurane - thought to agonise GABA receptors (inhibitory) and antagonise NMDA receptors (excitatory)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which patients should propofol not be used in

A

Patients with allergies to egg or soya

Patients with cardiovascular instability - etomidate or ketamine instead

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the adverse effects of propofol

A

Causes vasodilation therefore drop in BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

If propofol caused the BP to drop too much what cm. be Guam to reverse this?

A

Vasopressin
Noradrenaline
Atropine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the side effects of inhalation agents

A

Malignant hyperthermia - RARE - reversed with dantrolene
Raise intracranial pressure
Respiratory depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some examples of muscle relaxants

A

Suxamethonium

Atracurium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does suxamethonium work

A

Depolarises the neurotransmitter blocker at the nicotinic receptors on The motor end plate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some complications of suxamethonium

A

Malignant hyperthermia - dantrolene and cooling blankets
Hyperkalaemia - rapid release of potassium into ECF - arrhythmia and cardiac arrest due to persistently open acetylcholine channels, more likely in burns patients
Suxamethonium apnoea - fresh frozen plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the MOA of atracurium

A

Non depolarising neuromuscular blocker

Antagonist of acetylcholine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the side effects of atracurium

A

Leads to a rapid release of histamine in the area - vasodilation
Can lead to hypotension and tachycardia
Neostigmine can be used to reverse it - acetylcholinesterase inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Where does Morphine act

A

At mu-opioid receptors in the CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the complications of morphine

A

Respiratory depression
Can accumulate to toxic levels in renal failure patients due to morphine-6 glucuronride (when broken down in the liver) still having a potent effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the side effects of morphine

A 
Nausea and vomiting - can give an anti emetic 
Constipation 
urinary retention 
Pruritus
Bradycardia 
Hypotension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which patients should have reduced doses of morphine

A

Elderly
Hepatic impairment
Renal failure

17
Q

What are the contraindications for morphine

A

Head injury - cannot assess pupils

Acute respiratory depression

18
Q

How is an overdose of morphine be treated

A

Naloxone

19
Q

What is fentanyl

A

Synthetic opioid acts at mu-opioid receptors

80-100 times stronger than morphine

20
Q

What are the side effects of fentanyl

A 
Dry mouth 
Emetic action 
Dizziness 
Constipation/diarrhoea 
Sweating 
Weakness
Confusion
21
Q

What are the complications of fentanyl

A

Respiratory depression - more likely to be more prolonged than with morphine

22
Q

Give examples of antiemetic and where they act

A

Metoclopramide, domperidone - D2 antagonist
Ondansetron - 5HT receptor
Cyclizine - anticholinergic h1 receptor antagonist
Hycosine - antimuscarinic
Dexamethasone - unknown antiemetic effect

23
Q

Where in the body is vomiting regulated

A

Vomiting centre and CTZ (chemoreceptors trigger zone) in the medulla

24
Q

Which receptors does the CTZ express

A

5ht3 receptors and D2 receptors

25
Q

Where’s does the CTZ receive input from

A

Vestibular system in the inner ear - motion

26
Q

What does the vomiting centre control

A

Visceral and somatic functions in vomiting

27
Q

Where does the vomiting centre receive input from

A

CTZ
Muscarinic receptors
Histiminergic receptors

28
Q

Which drugs can cause N&V

A 
Abx - erythromycin
Digoxin 
Opioids 
Antiparkinsonian drugs - Ldopa 
Cytotoxic agents (chemo)
29
Q

What are the complications of intubation

A

Oropharyngeal injury
Broken teeth
Oesophageal intubation

30
Q

What are the complications of anaesthesia

A

Loss of sensation - urinary retention, pressure sores, nerve palsies
Loss of muscle power - corneal abrasion, no cough reflex - atelectasis, chest infection
Malignant hyperpyrexia
Anaphylaxis

31
Q

What are the advantages of using an epidural

A

Able to top it up
Side effects decreased because its localised
1st line for major bowel resection
Long acting agents can be used e.g. Bupivacaine

32
Q

What are the complications of using an epidural

A

May pierce the dura - leakage of CSF - headache
Haematoma
Abscess
Infection - meningitis and encephalitis
Respiratory depression
Neurogenic shock - drop in BP (vasodilation blood pools in legs)

33
Q

What is the pain ladder

A
  1. Non opioids and adjuvants - paracetamol and NSAIDs
  2. weak opioids and adjuvants - codeine, dihydrocodeine, tramadol
  3. Opioids - morphine, fentanyl, oxycodone
34
Q

Which anaesthetic has proven anti-emetic properties

A

Propofol

Surgery (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions