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Specialties > Anaesthetics- Principles of Pharmacology > Flashcards

Anaesthetics- Principles of Pharmacology Flashcards

1
Q

What is general anaesthesia?

A

A state of controlled unconsciousness.

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2
Q

How is General anaesthetic administered?

A

Via centrally acting drugs, such as Hypnotics or Analgesia

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3
Q

What does regional anaesthesia do?

A

Produce insensibility in an area or region of the body

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4
Q

How does regional anaesthesia work?

A
  • Nerve and plexus blocks

* Applied to nerves supplying relevant areas

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5
Q

What does local anaesthesia do?

A

• Produces insensibility on the relevant part of the body

Applied directly to the tissue

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6
Q

What is the ASA score used for?

A

To work out if someone is healthy enough for anaesthesia and surgery

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7
Q

What is the triad of anaesthesia?

A
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8
Q

What is the triad of anaesthesia?

A

Hypnosis
Analgesia
Relaxation

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9
Q

What is hypnosis?

A

Unconsciousness.

Done via opiates or general anaesthetic agents (main)

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10
Q

What is analgesia?

A

Pain relief.

Done via opiates, local anaesthetic and general anaesthetics

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11
Q

What is relaxation?

A

Skeletal muscle relaxation.

Done via muscle relaxants (mainly), general anaesthetic agents and local anaesthetic agents

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12
Q

What are the 3 main problems of anaesthetics?

A

Polypharmacy
Muscle relaxation
Separation of relaxation and hypnosis

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13
Q

What is the problem with polypharmacy?

A

Increases chances of drug reactions and allergies

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14
Q

What is the problem with muscles relaxation?

A

Artificial ventilation, patients airways need managed

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15
Q

What is the problem of Separation of relaxation and hypnosis?

A

Awareness

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16
Q

What is the main effect of general anaesthetic agents?

A

Hypnosis/ unconsciousness

17
Q

How do general anaesthetic agents work?

A
  • Interfere with neuronal ion channels

* Hyperpolarise neurones- Less likely to fire

18
Q

How do general anaesthetic inhalation agents work?

A

Dissolve in membranes

Have a direct physical effect

19
Q

How do general anaesthetic IV agents work?

A

Allosteric binding

GABA receptors open chloride channels

20
Q

What type of drugs are used for intravenous anaesthesia?

A

Fat soluble drugs

21
Q

Why are fat soluble drugs used for IV anaesthesia?

A

Rapid onset of unconsciousness

Rapid disappearance of drug from circulation

22
Q

How is the onset of unconsciousness measured?

A

1 arm-brain circulation time

23
Q

What type of drug are inhalation anaesthetics?

A

Halogenated hydrocarbons

24
Q

How are inhalation anaesthetics taken up and excreted?

A

Via the lungs

25
Q

Why are inhalation anaesthetics given in high concentrations?

A

To create a partial pressure gradient between the lungs > blood > brain

26
Q

What does MAC stand for?

A

Minimum alveolar pressure

27
Q

What is MAC?

A

The concentration of inhaled agent that is required to achieve a certain level of anaesthesia

28
Q

What is MAC a measure of?

A

Potency- high number, low potency

29
Q

Is the induction of inhalation slower or faster than IV?

A

Slower

It takes longer to build up effective concentrations

30
Q

Is the duration of inhalation longer or shorter than IV?

A

Longer-prolonged duration

31
Q

What effect does general anaesthetic have on the cardiovascular system?

A

Depress cardiovascular system

32
Q

What are the central effects of general anaesthesia on the CVS?

A
  • Reduce sympathetic outflow
  • Negative iontropic/chronotropic effect on the heart
  • Reduced vasoconstrictor tone->Vasodilation
33
Q

What are the direct effects of general anaesthesia on the CVS?

A
  • Negatively inotropic
  • Vasodilation- Decreased peripheral resistance
  • Venodilation- Decreased venous return and decrease cardiac output
34
Q

What is the effect of general anaesthesia on the respiratory system?

A

All anaesthetic agents are respiratory depressants
• Reduce hypoxic and hypercarbic drive
• Decreased tidal volume & increase rate

Paralyse cilia

Decrease FRC- Lower lung volumes, VQ mismatch

35
Q

What are the indications for using muscle relaxants?

A
  • Ventilation & Intubation
  • When immobility is essential-microscopic surgery, neurosurgery
  • Body cavity surgery
36
Q

What are the problems of muscle relaxants?

A
  • Awareness
  • Incomplete reversal → airway obstruction, ventilatory insufficiency in immediate post op period
  • Apnoea = dependence on airway and ventilatory support
37
Q

What are the effects of local and regional anaesthesia?

A
  • Retain awareness/ consciousness
  • Lack of global effect of G?
  • Derangement of CVS physiology
  • Relative sparing of respiratory function

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