anesthesia Flashcards

1
Q

drugs for induction

A

thiopental, propofol, and etomidate

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2
Q

etomidate adverse effects

A

accumulation, decreased CBF, brain metab. rate, ICP, and pulmonary function; decreases adrenal medulla steroid synthesis

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3
Q

thiopental adverse effects

A

increased HR, decreased CBF, brain metab. rate, ICP and plum function;
porphyria
cyp inhibition

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4
Q

propofol adverse effects

A

decreased CBF, brain metab. rate, ICP, and pulm. function; increased HR,
propofol infusion syndrome - cardiac arrest, multi organ system failure

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5
Q

ketamine adverse effects

A

causes dissociative states, increased CBF, ICP, BP, HR, and CO (good thing); bronchodilation (good), hallucinations

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6
Q

IV analgesic that increases cardiac output

A

ketamine

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7
Q

short acting benzos

A

lorazepam and midazolam

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8
Q

long acting benzo

A

diazepam

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9
Q

benzodiazepam antagonist

A

flumazenil

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10
Q

remifentanil

A

ultra rapid acting IV opiate

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11
Q

neurolept analgesia (for awake surgery)

A

droperidol, fentanyl, N2O, and atropine

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12
Q

causes malignant hyperthermia

A

succinylcholine, volatile anesthetic agents

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13
Q

malignant hyperthermia treatment

A

dantrolene, hyperventilate with O2, correct hyperkalemia and acidosis, cool core temp

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14
Q

local anesthetics pharmacology

A

lipophilicity allows them to dissolve through the membrane to get to the inside of the Na channel, hydrophilicity allows them to stay in the membrane so it can bind to the channel without passing all the way through the membrane;
have to cross the membrane in the unionized state

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15
Q

local anesthetic MOA

A

blockade of voltage gated Na channels by binding to the inside of the channel in the activated and inactive states (not closed)

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16
Q

require the most anesthetic

A

large, myelinated fibers and fibers in the center of the nerve (distal fibers)

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17
Q

order of anesthesia of fiber types with local anesthetic

A

Beta, Adelta, C, motor

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18
Q

amide local anesthetics

A

lidocaine, mepivicaine, prilocaine, bupivacaine, ropicacaine, articaine

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19
Q

slow onset amides

A

mepivicaine, bupivicaine and ropivacaine

20
Q

esters

A

procaine, tetracaine, chlorprocaine, cocaine

21
Q

topical anesthetics

A

benzocaine, dibucaine, dyclonine, pramoxine

22
Q

topical anesthetics not for use on mucus membranes

A

dibucaine and pramoxine

23
Q

cause methemoglobinemia

A

benzocaine and prilocaine

24
Q

EMLA

A

lidocaine and prilocaine cream

25
Q

LET

A

lidocaine, epinephrine, and tetracaine liquid; used for peds before stitches

26
Q

lidocaine + ozymetazoline

A

used by ENT to decrease nasal engorgement

27
Q

rapid intubation

A

lidocaine, vecuronium, fentanyl, atropine

28
Q

local anesthetic with most cardiotoxic effects

A

bupivacaine

29
Q

local anesthetic with fast onset

A

prilocaine and chlorprocaine

30
Q

vasoconstrictors to use with local anesthetic

A

epinephrine, phenylephrine, and oxymetazoline (alpha agonists)

31
Q

fast onset inhalation anesthetics

A

sevoflurane and desflurane

32
Q

inhaled anesthetic that causes seizures

A

enflurane

33
Q

inhaled anesthetic that causes arrhythmia

A

halothane

34
Q

inhaled anesthetic that causes muscle relaxation

A

isoflurane

35
Q

N2O adverse effects

A

teratogen, inhibition of B12 synthesis, can cause an increase in pressure resulting in pneumothorax and perforation
second gas effect - accumulation of other drugs
exits system fast and can lead to diffusional hypoxia

36
Q

opoids for anesthesia

A

morphine, fentanyl and remifentanil

37
Q

IV induction drug that does not effect CV function

A

etomidate

38
Q

systemic effects of local anesthetics

A

ringing in ears, numbing of lips and tongue, metallic taste, seizures

39
Q

conversion between grams, mLs, and percents

A

100% = 1g/1mL

40
Q

to reverse anesthesia from local anesthetics

A

phentolamine (alpha-1 blocker)

41
Q

benzodiazepines to use the night before surgery

A

lorazepam and diazepam

42
Q

1st gen antihistamines for use in sedation prior to surgery (drugs and effects)

A

hydroxyzine, diphenhydramine, promethazine; useful for sedation, anxiolysis, bronchodilation, antiemesis, and analgesia; dry secretions

43
Q

to prevent aspiration pneumonitis

A

cimetidine and ranitidine - H2 blockers
bicitra and polycitra - increase pH of current contents
metoclopramide - D2 blocker to increase rate of gastric emptying
water - increases stretch reflex

44
Q

ancillary anesthesia anticholinergics

A

atropine, glycopyrrolate and scopolamine

dry secretions, prevents reflux and bradycardia

45
Q

rapid intubation

A

oxygenate, lidocaine, vecuronium, fentanyl,and atropine

46
Q

Tx for post-anesthesia HTN

A

nitroprusside or trimethaphan

47
Q

Tx for post-anesthesia hypotension

A

dopamine, phenylephrine, or ephedrine