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SURG > ANESTHESIA > Flashcards

ANESTHESIA Flashcards

1
Q

MC inhalational anesthetic

A

Sevoflurane

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2
Q

MC IV anesthetic

A

Propofol

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3
Q

What does a small MAC mean?

A

More lipid soluble aka more potent. The speed of induction is inversely proportional to solubility

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4
Q

Which anesthetic diffuses into closed spaces?

A

NO2 – avoid in pts with SBO, PTX

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5
Q

Which inhalational anesthetic has the highest degree of cardiac depression and arrhythmias

A

Halothane

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6
Q

Halothane hepatitis

A

Fever, eosinophilia, jaundice, increased LFTs

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7
Q

Which inhalational anesthetic is the least pungent

A

Halothane

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8
Q

Which inhalational anesthetic is good for mask induction

A

Sevoflurane

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9
Q

Which inhalational anesthetic is used in neurosurgery

A

Isoflurane. It lowers brain oxygen consumption and doesnt cause increase in ICP

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10
Q

Which inhalational anesthetic can cause seizures?

A

Enflurane

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11
Q

MCC of intra-op bradycardia

A

Inhalational anesthesia. Tx with atropine

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12
Q

3 types of pts that should not get propofol

A

Egg allergy
Pregos
Parkinsons

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13
Q

Side effects of ketamine

A

Hallucinations
Catecholamine release (increased CO2, tachy)
Increased airway secretions
Increased cerebral blood flow

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14
Q

Ketamine contraindicated in..

A

head injury

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15
Q

Which IV induction agent has fewest cardiac side effects?

A

Etomidate

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16
Q

Sedation agent for intubated patients

A

Dexmedetomidine (Precedex) – good for early extubation protocols

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17
Q

Last muscle to go down and first to recover from paralytics

A

Diaphragm

18
Q

First to go down and last to recover from paralytics

A

Neck muscles and face

19
Q

First sign of malignant hyperthermia

A

Increased end-tidal CO2

20
Q

Succinylcholine – specific electroylte effect

A

Depolarization releases K. Don’t use in severe burns, neuro injury, NM disorders, spinal cord injury, massive trauma, or acute renal failure (all have upregulation of ACh receptors which can release significant amts of K)

21
Q

Most common side effect of pancuronium

A

Tacycardia (no hypotension)

22
Q

Two drugs that can be used to reverse non depolarizing agents

A

Neostigmine
Edrophonium

both block AChase, increasing ACh

23
Q

Max dose of lidocaine

A

4 mg/kg (7 mg/kg with epi)

24
Q

Max dose of bupivacaine

A

2 mg/kg (3 mg/kg with epi)

25
Q

Why are infected tissues difficult to anesthetize

A

Acidosis

26
Q

List length of action for local anesthetics

A

bupivacaine > lidocaine > procaine

27
Q

First sign of local anesthetic OD

A

Perioral paresthesias – CNS sx occur before cardiac

28
Q

Amides

A

All have i in first part of name – lidocaine, bupivacaine, mepivacaine. Rarely cause allergic rxns.

29
Q

Esters

A

Tetracaine, procaine, cocaine. Increased allergic reactions due to PABA analogue

30
Q

Avoid use of narcotics in patients on what kind of drug?

A

MAOIs. Can cause hyperpyrexic coma (srotonin release syndrome – fever, tachy, sz, coma)

31
Q

What causes hypotension with morphine

A

Histamine release

32
Q

Demerol should be avoided in pts with ..

A

Renal failure. It can cause a buildup of normedperidine analogues – > seizures

33
Q

Most potent narcotic

A

Sufentanil

34
Q

Which benzo contraindicated in prego

A

Versed (midazolam) as it can cross placenta

35
Q

Tx for acute hypotension and bradycardia in epidural anesthesia

A

Turn it down.
Fluids
Phenylephrine or atropine

36
Q

Lidocaine in epidural can cause ..

A

Decreased HR, BP

37
Q

Epidural contraindicated in ..

A

HOCM, cyanotic heart dz – sympathetic denervation causes decreased afterload, which worsens these 2 conditions

38
Q

MC complication of epidural and spinal

A

Urinary retention

39
Q

Most post op hospital morality is due to ..

A

Pre-op renal failure (#1) and CHF

40
Q

Which abx prolong neuromuscular blockade

A

Clindamycin

SURG (17 decks)

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