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Pharmacology > Anesthesia > Flashcards

Anesthesia Flashcards

1
Q

2 major types of anesthesia:

A

1) general anesthetics

2) local anesthetics

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2
Q

general anesthesia: goal

A

absence of all perceived sensations

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3
Q

general anesthesia: purpose

A

allow detailed surgical procedures, with minimal harm to patient

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4
Q

anestheia before 1846: unconsciousness from what?

A

strangulation or blow to head

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5
Q

date of anesthesia breakthrough

A

Oct. 17, 1846

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6
Q

anesthesia after 1846: first use of ( )

A

ether

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7
Q

general anesthesia requirements: loss of ( )

A

consciousness; perceived sensations

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8
Q

general anesthesia requirements: amnesia- yes or no?

A

yes

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9
Q

general anesthesia requirements: inhibition of ( )

A

reflexes

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10
Q

general anesthesia requirements: ( )relaxation

A

skeletal muscle

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11
Q

general anesthesia requirements: safe, transient, ( )

A

predictable

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12
Q

stages of general anesthesia:

A

1) analgesia
2) excitement/delirium
3) surgical anesthesia
4) medullary paralysis

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13
Q

types of general anesthetics: inhalation agents

A

1) halogenated liquids
2) nitrous oxide
3) other gases

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14
Q

types of general anesthetics: IV agents

A

1) barbiturates
2) Benzos
3) opioids

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15
Q

choice of anesthetic: often use more than 2 agents to provide what?

A

“balanced” anesthesia

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16
Q

choice of anesthetic: traditional method

A

injected followed by inhaled

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17
Q

inhalation or IV: halothane

A

inhalation

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18
Q

inhalation or IV:

A

thiopental

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19
Q

general anesthetics- mechanism of action: direct effect on ( )

A

lipid bilayer

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20
Q

general anesthetics- mechanism of action: direct effect on ( ) receptors

A

neuronal

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21
Q

general anesthetics- mechanism of action: combo of ( )effects

A

lipid and receptor

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22
Q

anesthetic adjuvants: ( ) patients prior to surgey

A

relax and sedate

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23
Q

anesthetic adjuvants: reduce post-op ( )

A

nausea and vomiting (PONV)

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24
Q

anesthetic adjuvants: reduce other problems related to ( )

A

anesthesia

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25
Q

NMJ blockers: used to ( ) skeletal muscles to facilitate positioning on table, prevent spasms, allow easier mechanical ventilation

A

paralyze

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26
Q

NMJ blockers: depolarizing

A

succinylcholine

27
Q

NMJ blockers: nondepolarizing

A

tubocurarine, rocuronium, others

28
Q

NMJ short duration (minutes to about an hours) but some paitents may lack ( ) which make them remain in paralyzed state at end of surgery

A

metabolizing enzymes

29
Q

NMJ blocker effects can be reversed somewhat with what?

A

cholinesterase inhibitors (neostigmine, edrophonium)
OR
sugammadex (inactivates rocuronium, veruronium)

30
Q

dissocitative anesthesia: patient may remain conscious but ( )

A

indifferent to surroundings

31
Q

dissocitative anesthesia: achieved by use of ( )

A

ketamine
OR
combo of antipsychotic with opioid

32
Q

general anesthetics rehab concerns: use in ( )

A

burn debridement, dressing changes, etc

33
Q

general anesthetics rehab concerns: dealing with residual effects of

A

respiratory hygience, short term confusion/lethargy due to redistribution of anesthesia, possible long term effects on cognition/intellect

34
Q

local anesthesia: goal

A

interrupt nerve conduction at site of application

35
Q

local anesthesia: purpose

A

prevent or relieve pain w/o loss of consciousness or systemic effects

36
Q

typical local anesthetics

A

“-caine” drugs: lidocaine, procaines, bupivicaine, etc.

37
Q

local anesthetics mechanism:bind to ( ) in nerve membrane

A

sodium (Na+)

38
Q

local anesthetics mechanism: inactivate ( ); prevent action potential conduction

A

Na+ channel

39
Q

clinical use and administration: applied to surface of skin

A

topical

40
Q

clinical use and administration: pain relief…minor burns, abrasions

A

topical

41
Q

clinical use and administration: also used prior to IV insertion, injections

A

topical

42
Q

clinical use and administration: movement through skin enhaced by electricity, ultrasound, other cehmicals

A

transdermal

43
Q

clinical use and administration: lidocaine patch

A

transdermal

44
Q

clinical use and administration: injected subQ

A

infiltration

45
Q

clinical use and administration: commonly used before suturing wounds

A

infiltration

46
Q

clinical use and administration: allowed to penetrate into selected area

A

infiltration

47
Q

clinical use and administration: injected close to nerve or nerve plexus

A

peripheral nerve block

48
Q

clinical use and administration: commonly used for dental procedures, other minor surgeries

A

peripheral nerve block

49
Q

clinical use and administration: administration outside of durs

A

epidural

50
Q

clinical use and administration: administration into subarachoid space

A

spinal block

51
Q

clinical use and administration: CRPS

A

sympathetic block

52
Q

clinical use and administration: local anesthetic injected into venous system of affected arm/leg

A

intravenous regional anesthesia (Bier Block)

53
Q

clinical use and administration: tourniquet placed proximally to keep drup in limb

A

intravenous regional anesthesia (Bier block)

54
Q

clinical use and administration: used for some surgical procedures or to treat CRPS/RSDS

A

intravenous regional anesthesia (Bier block)

55
Q

continuous nerve block: small catheter is implanted near ( )

A

peripheral nerve(s) to a specific region

56
Q

continuous nerve block: ( ) dripped slowly/continuously onto nerve

A

local anesthetic

57
Q

continuous nerve block: excellent ( ) pain control

A

post-op

58
Q

differential nerve block: which fibers affected first?

A

smallest, unmyelinated fibers

59
Q

differential nerve block: which fibers affected last?

A

largest myelinated fibers

60
Q

differential nerve block: typical order of functional loss

A

pain, temp, touch, proprioception, motor

61
Q

local anesthetics implications for rehab: transdermal administration for tx of pain via ( )

A

ionto- and phonophoresis

62
Q

local anesthetics implications for rehab: use in ( )

A

RSDS/CRPS; other acute and chronic conditions

63
Q

local anesthetics implications for rehab: be alter for possible ( )

A

absorption into systemic circulation (can cause “local anesthetic systemic toxicity” (LAST)

Pharmacology (6 decks)

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