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Pharm 2 > Anesthesia > Flashcards

Anesthesia Flashcards

1
Q

weak bases that block the voltage gated Na channels of excitable membranes

A

local anesthetics

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2
Q

local anesthetics affect smaller and myelinated fibers (C fibers) first and build to A. order that sensation is lost in

A

pain, cold, warmth, touch, deep pressure, motor

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3
Q

indications: skin irritation, hemorrhoids, mouth/gum irritation, poison ivy, sore throat, gag reflex suppression

A

topical benzocaine

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4
Q

contra: “Benzocaine (Orajel®, Dermoplast®)
Gels, sprays, liquids, and lozenges”

A

Oral formulations are not for children <2 years old

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5
Q

max doses for “Benzocaine (Orajel®, Dermoplast®)
Gels, sprays, liquids, and lozenges”

A

4 doses/day

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6
Q

local anesthetic FDA warning

A

FDA label warning about methemoglobinemia (oxidized iron in hemoglobin (confusion, discolored lips / nail beds/ skin, HA, SOB) on all OTC products

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7
Q

group: “Benzocaine (Orajel®, Dermoplast®)
Gels, sprays, liquids, and lozenges”
Cocaine
“Tetracaine
topical or inj”

A

esters

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8
Q

group: “Lidocaine(Icy Hot®,Salonpas®, Xylocaine®) max dose = 4mg/kg (NTE 300mg)
spray, patch, ointment, lotion, jelly, gel, mouthwash”
Bupivacaine (Marcaine®)

A

amides

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9
Q

indications: Great for nose and throat procedures/injuries (sometimes eye) applied topically

A

cocaine

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10
Q

lidocaine max dose

A

4mg/kg NTE 300mg

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11
Q

MOA: metabolised in liver. Quickest onset (1-5 min) and shortest duration (20-60 min). Bleeds less and lasts longer if combined w/ epi (120-240 min) due to vasoconstriction

A

lidocaine

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12
Q

lidocaine contra

A

AVOID epinephrine injection locally to digits in those with known PAD

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13
Q

LAST order of symptom presentation

A

drowsiness, paresthesias in mouth/tongue, tinnitus / auditory hallucination, muscular spasm, seizures, coma, resp arrest, cardiac arrest

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14
Q

how to make lidocaine injection sting less

A

warm to room temp, add Na bicarb

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15
Q

LAST treatment

A

IV lipid emulsion, secure airway, anticonvulsant

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16
Q

Bupivacaine (Marcaine®)
contra

A

Contraindicated for local infiltration in pregnant women

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17
Q

higher risk of cardiotoxicity if systemically absorbed: lidocaine or marcaine?

A

marcaine

18
Q

effect of epi and Na bicarb on marcaine

A

nothing

19
Q

AEs: nerve damage, bleeding from accidental arterial puncture, injection of LA into vessel (systemic toxicity)

A

Peripheral Nerve Blocks

20
Q

Single injection of anesthetic drug into CSF (subarachnoid space)

A

Spinal block

21
Q

Tiny catheter placed into epidural space and anesthetic can be slowly infused in

A

Epidural block

22
Q

AEs: hypotension (in 50%), bradycardia, post-dural puncture HA, urinary retention

A

Neuraxial anesthesia (spinal and epidural)

23
Q

dissociative sedative, analgesic, amnestic

A

ketamine

24
Q

AEs: minimal cardiorespiratory depression. Does not inhibit protective reflexes. Symp stimulation, tachycardia, HTN (rare). Emergence reactions common (+/- n/v). Prolonged effect in elderly

A

ketamine

25
Q

AEs: minimal hypotension and histamine release.

A

fentanyl

26
Q

sedative, amnestic. No analgesia. Rapid onset and neuro recovery.

A

Propofol

27
Q

AEs: resp depression, hypotension, inj site pain.

A

Propofol

28
Q

special pop concern for propofol

A

Elderly: reduce dose by 20%, give slowly

29
Q

sedative. No analgesia. Does not change BP, cardiac output or heart rate

A

Etomidate

30
Q

Etomidate
indication

A

hemodynamically unstable pts

31
Q

AEs: myoclonus, injection site pain, n/v

A

Etomidate

32
Q

Etomidate
special pop concerns

A

lower dose in elderly, liver dz

33
Q

sedative, anxiolytic. No analgesia. Slow onset.

A

midazolam (Versed)

34
Q

midazolam (Versed)
special pop concerns

A

Prolonged effect in elderly, obese, liver dz

35
Q

Block transmission of acetylcholine between motor nerve endings and skeletal muscle. Causes skeletal muscle paralysis. No sedation

A

Neuromuscular Blockers

36
Q

indication:
Emergency / Surgical Procedures: Used w/ a sedative (induction agent); Facilitate endotracheal intubation; Facilitate muscle relaxation during surgery

A

Neuromuscular Blockers

37
Q

pseudocholinesterase enzyme breaks down ___

A

“Depolarizing Blocker:
Succinylcholine (Anectine®) IV”

38
Q

AEs: CV: bradycardia, hypotension (use atropine), arrythmias. Myalgia. Increased introcular and intragastric pressure. Malignant hyperthermia (rare; treat w/ dantrolene IV, autosomal dominant)

A

“Depolarizing Blocker:
Succinylcholine (Anectine®) IV”

39
Q

who is at risk of low pseudocholinesterase enzyme

A

enzyme deficiency aquired in elderly, renal failure, malnutrition, liver failure, pregnancy

40
Q

class that has AEs: “All: resp depression, prolonged paralysis.
Panc: muscle weakness, elevated HR and BP
Roc: mild hypotension
Cisat: mild hypotension, flushing”

A

“Non-depolarizing Blockers:
Rocuronium (Zemuron®)
vecuronium
Cisatracurium (Nimbex®)
Pancuronium (Pavulon®)”

41
Q

how to reverse “Non-depolarizing Blockers:
Rocuronium (Zemuron®)
vecuronium
Cisatracurium (Nimbex®)
Pancuronium (Pavulon®)”

A

reverse w/ neostigmine

42
Q

treatment for malignant hyperthermia

A

dantrolene IV

Pharm 2 (29 decks)

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