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ACC > Anaesthetics > Flashcards

Anaesthetics Flashcards

1
Q

What are the 3 components of GA?

A

1) Amnesia
2) Analgesia
3) Akinesis

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2
Q

Define Amnesia

A

Lack of response and recall to noxious stimuli (Unconsciousness)

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3
Q

Define Analgesia

A

Pain relief

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4
Q

Akinesis

A

Immobilisation/Paralysis

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5
Q

2 advantages of using Propofol

A

1) Decreases incidence of PONV

2) Excellent suppression of airway reflexes

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6
Q

3 unwanted effects of Propofol

A

1) Marked drop in HR + BP
2) Pain on injection
3) Involuntary movements

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7
Q

Propofol/ Thiopentone = Lipid or Barbituate?

A 
Propofol = Lipid
Thiopentone = Barbituate
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8
Q

When is Thiopentone most commonly used?

A

For rapid sequence induction (RSI)

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9
Q

2 advantages of Thiopentone?

A

1) Antiepileptic properties

2) Antithrombotic/ protects brain

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10
Q

3 Unwanted effects of Thiopentone?

A

1) Drops BP but increases HR
2) Can cause rash/bronchospasm
3) If intra-arterial injection causes thrombosis and gangrene

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11
Q

Contraindication of Thiopentone

A

Porphyria

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12
Q

What type of anaesthetic is ketamine

A

Dissociative

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13
Q

When is Ketamine most commonly used?

A

Short procedures (The only one used)

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14
Q

5 disadvantages of Ketamine

A

1) Slow onset
2) No muscle relaxation
3) Rise in HR and BP and bronchodilation
4) Nausea and Vomiting
5) Emergence Phenomenon

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15
Q

2 advantages of ketamine

A

Anterograde amnesia (memory loss) and profound analgesia

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16
Q

2 advantages of Etomidate

A

1) Haemodynamic stability

2) Lowest incidence of hypersensitivity reaction

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17
Q

4 unwanted effects of Etomidate

A

1) Pain on injection
2) Spontaneous movements
3) Adreno-cortical suppression
4) High incidence of PONV

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18
Q

5 things to maintain during the operation

A

1) Amnesia
2) Analgesia
3) Muscle relaxation
4) Fluid
5) Blood

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19
Q

How does sevoflurane smell?

A

Sweet

20
Q

What is sevoflurane used for?

A

Inhalational Induction

21
Q

2 Advantages of Desflurane

A

1) Rapid onset and offset

2) Good for long operations

22
Q

Advantage of Isoflurane

A

Least effect on organ blood flow

23
Q

3 short acting opioids

A

Remifentanyl
Alfentanyl
Fentanyl

24
Q

2 long acting opioids

A

Morphine

Oxycodone

25
Q

2 classes of muscle relaxants

A

Depolarising

Non-depolarising

26
Q

How do depolarising muscles relaxants work?

A

Increase the concentration of ACh in the neuromuscular junction - causes spasm of the muscle and then relaxation

27
Q

Example of a depolarising muscle relaxant and when is it used?

A

Suxamethonium

For rapid sequence induction

28
Q

5 adverse effects of suxamethonium

A

1) Muscle pains
2) Fasciculations
3) Hyperkalaemia
4) Malignant Hyperthermia
5) Rise in ICP, IOP and gastric pressure

29
Q

Compare non/depolarising muscle relaxants

A

Non = Slower onset, variable duration and less side effects

30
Q

How do non-depolarising muscle relaxants work?

A

Compete with ACh for nicotinic receptors

31
Q

2 Short acting non-depolarising muscle relaxants

A

Atracurium and Mivacurium

32
Q

2 Intermediate acting non-depolarising muscle relaxants

A

Veruconium and Rocuronium

33
Q

1 long acting non-depolarising muscle relaxant

A

Pancuronium

34
Q

What is used to reverse a non-depolarising muscle relaxant

A

Neostigimine

35
Q

What effect does Epedrine have?

A

Increases BP and HR

36
Q

What effect does Phenylephrine have?

A

Increase BP but decrease HR

37
Q

What effect does Metarminol have?

A

Increase BP but decrease HR

38
Q

3 drugs used in severe hypotension/ICU

A

Noradrenaline
Adrenaline
Dobutamine

39
Q

1st line anti-emetic and class of drug

A

Ondansetron

5HT3 Blocker

40
Q

2nd line anti-emetic and class of drug

A

Cyclizine

Anti-histamine

41
Q

3rd line anti-emetic and class of drug

A

Dexamethasone

Steroid

42
Q

How does neostigimine work?

A

Anti-cholinesterase

Prevents breakdown of ACh

43
Q

Side effect of neostigimine and why?

A

Muscarinic effect of ACh as it builds up again causes bradycardia

44
Q

What is combined with neostigimine and why?

A

Antimuscarinic agent - Glycopyrrolate

Prevents Bradycardia

45
Q

Name 2 reverse muscle relaxants

A

Neostigimine

Sugammadex

46
Q

How does Sugammadex work?

A

1) Binds 1:1 ratio with the steroid muscle relaxants to make a water soluble complex
2) This creates a gradient that moves the drug out of the junction into the plasma
3) Free drug is bound tightly to the sugammadex to continue the concentration gradient

47
Q

Which drugs does sugammadex reverse?

A

Recoronium> Veruconium&raquo_space; Panconium

ACC (3 decks)

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