Anesthesia Flashcards
1
Q
objectives / characteristics /cardinal features of GA ??
649
A
- analgesia
- amnesia - loss of memory
- loss of consciousness
- loss of autonomic reflex
- skeletal muscle relaxation
2
Q
stages of GA ?
A
- S-1 = Analgesia
- S-2 = excitement
- S-3 = Surgical A
- S-4 = medullary paralysis
549
3
Q
which stage is tried to do short / skipped ??
A
stage-2
violent + combative behavior + rise / irregularity of BP
4
Q
How to short stage - ??
A
before inhalation A
IV - thiopental
649
5
Q
other name / sign
of stages of GA ??
A
Goudels signn
649
6
Q
which A is using recently ??
A
PROPOFOL
650
7
Q
Pre-anesthetic medication drugs name ??
A
- reduce anxiety = BDZ
- reduce analgesia = NSAID + opioids
- reduce bronchial salivary sweating secration = Anti-Muscarinic
- reduce gastric acid secretion = PPI
- Prevent vomiting = Ondansetron + metoclopramide
- prevent allergy = Antihistamine
- prevent infection = antibiotics
- for emptying GIT = Laxatives
651
8
Q
stage of GA ??
A
- Induction
- maintenance
- recovery
652
9
Q
Drugs of Induction stage ??
A
- IV = Thiopental + Propofol + Etomidate
- Inhalation = halothane + sevoflurane
652
10
Q
Drugs in Maintanence stage of GA ??
A
- IV = propofol
- Inhalation = Nitrous oxide + O2 + Halothane + sevoflurane
- Neuromuscular blocker + Opioid
652
11
Q
Drugs in Recovery stage of GA ??
A
- Withdraw of Inhalation
- Reverse muscle relaxation = Neostigmine
- Analgesic = Opioid
- Anti-emetic = Ondansetron + Metoclopramide + Cyclizine
652
12
Q
combination of mutilple drugs for GA is called ??
A
Balanced A
653
13
Q
IV / parental A name ??
A
- BDZ - Dia+Lora=Zepam + Midazolam
- Barbiturates = Thiopental Na + Methohexital
- Opioid = morphine + pethidine + fentanyl
- propofol
- ketamine
- etomidate
654
14
Q
which A drugs in BD ??
A
- Thiopental Na
- ketamine
- propofol
KTP
15
Q
Which A drugs in children??
A
PROPOFOL
654
16
Q
Inhalation A ??
A
- Halothane
- sevoflurane
- enflurane
- desflurane
- Nitrous oxide
- O2
- isoflurane
654
17
Q
why Halothane + Nitrous oxide ??
A
- H = Good analgesia No A
- NO = Good A but No Analgesia
656
18
Q
dissociative A ??
A
ketamine A
655
19
Q
M/A of ketamine ??
661
A
- profound analgesia
- unresponsiveness to coma
- amnesia
- eyes open
- limbs involuntary
- breath spontaneously
- DIssociative A
661
20
Q
Antiodote of Thiopental Na ??
A
No specific Antidote
658
21
Q
cellular M/A of thiopnetal / GA ??
A
- EFfects on synaptic transmission
- action potential generation of propagation
658
22
Q
Molecular M/A of GA ??
A
- Target = Ligand gated ion channels
- inc sensitivity of the GABAa receptors to GABA
658
23
Q
Why Thiopental Na is preferred for Induction ??
A
- lipid solubility
- IV
- Quickly enters into CNS
- Time = 1 minute
658
24
Q
what will happen if Thiopental Na is given in a post-operative patient ??
A
- cardio-respiratory depression
659
24
Mostly used LA ??
LIDOCAINE
| 665
25
Minor surgery which A ??
Local A
| 664
26
Esters of LA ??
* Procaine
* cocaine
* tetracaine
* benzocaine
| 664
27
Amides of LA ??
* Lidocaine
* bupiVacaine
* MepiVacaine
* LevoBupivacaine
| 664
28
Why LA + Adrenaline ??
| 668
* Adrenaline = local vasoconstriction
* dec blood flow
* dec absoprtion of LA
* LA can act on nerve for more time
* Prolongation of action of LA
| 668
29
Relationship of LA & Contact ??
inc contact time of LA = inc duration of action
30
Dose of Lidocaine with/without Adrenaline ??
* L only = 4.5 mg/kg
* L + Adrenaline = 7 mg/kg
| 664
31
in 70kg person dose of L ??
* Only L = 70*4.5 = 315mg
* L+A = 70*7 = 490 mg
| 664
32
caessarian delivery which LA ??
Spinal LA
| 667
33
Painless vaginal delievry which LA ??
Epidural LA
| 667
34
M/A of LA ??
667
35
LA form in market ??
Ample - Liquid - Ionized form
36
contraindications of Adrenaline in LA ??
Donot apply in arteries containing end arteries = gangrene - ischemia + necrosis
| 668
37
which surgical OT by LA ??
* Abscess drainage
* circumcision
* cesarean section
* orthopedic procedure
* vascular surgeries
| 670
37
most important A/E of LA ??
Tongue numbness + metallic taste
| 669
38
others A/E of LA ??
* Sleepiness
* light-Headedness
* nystagmus
* muscular twitching
* tonic clonic convulsions
* depression of CNS
* Cardiac arrest
* arrythmia
| 669
39
Indications of Ketamine ??
* useful for Pt who are at risk of hypotension + bronchospasm
* popular alternative of opioid as minimize respiratory depression
* multiple routes can apply
* combined with propofol
| 661
40
advantages of Lidocaine ??
✅ ↑ Potency 🔥 (crosses nerve membrane easily)
✅ ↑ Duration of Action ⏳ (binds to lipophilic tissue → slow release)
✅ ↑ Nerve Penetration 🎯 (better blockade of deep nerves)
✅ ↓ Systemic Absorption 🚫 (stays local, less toxicity)
✅ Better Protein Binding 🛡️ (prolonged effect)
41
which drugs are used as route of administration for LA ??
Spinal & epidural LA
42
Which A used with gasegaseous GA ??
O2
43
In which stage of GA surgery is proceded ??
surgical A
## Footnote
Prof
44
why we give Atropine before A ??
Dec secretion
| 651 PROF
45
Which receptor is blocked by Lidocaine ??
voltage gated Na channel in afferent neurons
46
indication of Bupivacaine ??
cesarian section
47
indication of Thiopental Na ??
658
induction of GA stage
6.59PM
9.4.2025
48
most popular IV GA ??
PROPOFOL
| 659
49
Which NMJ blocker used in Maintenance stage of anesthesia ?
Non-depolarizing blockers like Vecuronium, Rocuronium, Atracurium, or Cisatracurium are used during the maintenance stage of anesthesia to keep muscles relaxed.
50
lidocaine other indication <
dental extarction
OT in legs + Forarms
51
which anesthetics in circumcision ?
lidocaine
52
obsterics ?
epidural
53
function of clorazepate
**Clorazepate** is a **benzodiazepine** used for:
- **Anxiety relief**
- **Seizure control (epilepsy)**
- **Sedation**
- **Muscle relaxation**
- **Alcohol withdrawal symptoms**
🧠 It works by enhancing **GABA**, a calming chemical in the brain.
⚠️ Can cause **drowsiness** and **dependence** if used long-term.
54
if we want to prolong the action of lidocaine and increase its dose ? will it be effective ?
Without Epinephrine With Epinephrine
Max dose 4.5 mg/kg 7 mg/kg
Action duration Shorter Longer
Bleeding control Less Better
📈 Does it allow higher dosing?
✅ Yes.
Without epinephrine: max dose = 4.5 mg/kg
With epinephrine: max dose = 7 mg/kg
55
metabolism of LA ?
"Amides have 'i' in the name — metabolized in liver"
(e.g., lidocaine, bupivacaine)
🧪 1. Ester-type Anesthetics
Examples: Procaine, Tetracaine, Benzocaine
✅ Metabolism:
Rapidly broken down by plasma pseudocholinesterase (plasma esterase)
Metabolized in the blood, not the liver
Forms PABA (para-aminobenzoic acid) → can cause allergic reactions
📌 Fast metabolism, short duration
🧪 2. Amide-type Anesthetics
Examples: Lidocaine, Bupivacaine, Mepivacaine, Prilocaine
✅ Metabolism:
Metabolized in the liver by CYP450 enzymes
Depends on liver function and hepatic blood flow
📌 Slower metabolism, longer duration
