anesthesia Flashcards
drugs for induction
thiopental, propofol, and etomidate
etomidate adverse effects
accumulation, decreased CBF, brain metab. rate, ICP, and pulmonary function; decreases adrenal medulla steroid synthesis
thiopental adverse effects
increased HR, decreased CBF, brain metab. rate, ICP and plum function;
porphyria
cyp inhibition
propofol adverse effects
decreased CBF, brain metab. rate, ICP, and pulm. function; increased HR,
propofol infusion syndrome - cardiac arrest, multi organ system failure
ketamine adverse effects
causes dissociative states, increased CBF, ICP, BP, HR, and CO (good thing); bronchodilation (good), hallucinations
IV analgesic that increases cardiac output
ketamine
short acting benzos
lorazepam and midazolam
long acting benzo
diazepam
benzodiazepam antagonist
flumazenil
remifentanil
ultra rapid acting IV opiate
neurolept analgesia (for awake surgery)
droperidol, fentanyl, N2O, and atropine
causes malignant hyperthermia
succinylcholine, volatile anesthetic agents
malignant hyperthermia treatment
dantrolene, hyperventilate with O2, correct hyperkalemia and acidosis, cool core temp
local anesthetics pharmacology
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
local anesthetic MOA
blockade of voltage gated Na channels by binding to the inside of the channel in the activated and inactive states (not closed)
require the most anesthetic
large, myelinated fibers and fibers in the center of the nerve (distal fibers)
order of anesthesia of fiber types with local anesthetic
Beta, Adelta, C, motor
amide local anesthetics
lidocaine, mepivicaine, prilocaine, bupivacaine, ropicacaine, articaine