Anesthesia

Question 1

Anesthetics must be …… soluble to cross BBB

Answer 1

Lipid

Also helpful to have low solubility in the blood so they don’t get stuck there when its time for them to work or its time to get them out.

Question 2

Inhaled anesthetic with fastest onset of action

Answer 2

Nitrous Oxide

Question 3

Slowest inhaled anesthetic

Answer 3

Halothane

Question 4

Halothane toxicity

Answer 4

Hepatic

Question 5

General side effects of all

Answer 5

myocardial depression, resp depression, nausea

Question 6

IV drug with VERY FAST induction

Answer 6

Propofol…milk of amnesia.

Question 7

Dissociative anesthetic?

Answer 7

Ketamine, Eyes are open but they are not conscious

Question 8

What does Ketamine do to cerebral blood flow

Answer 8

Increases it….KNOW

Question 9

How does GABA work

Answer 9

binds GABA receptor, induces chloride channel to open. When chloride channel opens, the postsynaptic membrane is stabilized and it becomes extremely hard for another action potential to occur

Question 10

Barbiturates do what>

Answer 10

Keep GABA chloride channels open longer

Question 11

Benzodiazepines work how

Answer 11

Increase how frequently the GABA chloride channels open. Not as dangerous

Question 12

Benzo overdose

Answer 12

FLUMAZENIL

Question 13

Morphine is an example of

Answer 13

opioid

Question 14

Three opioid receptors

Answer 14

Mu, Delta, Kappa

Question 15

opioid overdose

Answer 15

Nals………Naloxone, Naltrexone

Question 16

So in anethsisa you want amnesia, analgesia, and paralysis

Answer 16

The benzos can give you the amnesia what gives you complete paralysis……Neuromuscular blockers

Question 17

Two categories of NM blockers

Answer 17

Depolarizing and Non

THe one depolarizer is : Succinycholine. Ach agonist that produces sustained depolarization. Muscle wil contract initially and then block any other Ach binding. You will see fasciculations first.

The Non- depolarizers work by competing with Ach for binding sites. Can be over come by giving Neostigmine, and Achesterase inhibitor that leads to increase in Ach which can overcome the receptor blockade.

Question 18

Neostigmine works how

Answer 18

Achesterase inhibitor…inc Ach

Question 19

Phase I block of Succinylcholine

Answer 19

No antidote

Question 20

Phase II block of succinylcholine

Answer 20

Can be antagonized by neostigmine

Question 21

Succinylcholine Toxicity

Answer 21

MALIGNANT HYPERTHERMIA

Question 22

How do you treat malignant hyperthermia

Answer 22

Cool , sedate, GIVE DANTROLENE

Question 23

How does Dantrolene work

Answer 23

Prevents sarcoplasmic reticulum from releasing calcium

Question 24

Local anesthetics don’t work well where

Answer 24

acidic tissue (infected) so you give more

Question 25

Order of events with local anesthetic

Answer 25

Small myelinated first

Lose pain, temp, touch, pressure in order

Question 26

Give what with local anesthetic

Answer 26

vasoconstrictor (epinephrine) to prevent systematization

Question 27

IV most commonly used for conscious sedation

Answer 27

Medazolam

Question 28

Anesthetic with high triglyceride content

Answer 28

Propofol