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Stuff and Thangs > Anesthesia II > Flashcards

Anesthesia II Flashcards

1
Q

What is the triad of anesthesia?

A

Sedation
Loss of Pain
Muscle weakness

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2
Q

Class 1 ASA?

A

Normal healthy

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3
Q

Class 2 ASA

A

Mild systemic disease

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4
Q

Class 3 ASA

A

Severe systemic disease
(Uncontrolled diabetes, etc)
Not incaacitating

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5
Q

Class 4 ASA

A

incapacatating systemic disease threatening life

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6
Q

Stage 1 of anesthesia is known as?

A 
This is known as the amnesia stage!
Three planes:
1:Preanalgesia, memory and sensation intact
2: Partial amnesia and analgesia
3: Total amnesia and analgesia
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7
Q

What is stage 2 of anesthesia?

A

Stage 2 is delerium

Unconsciousness, mydriasis, irregular breathing, involuntary movements

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8
Q

What is stage 3 of anesthesia known as?

A

Known as surgical anesthesia!
Broken into 3 planes
1: Sleeping with faint lid reflex and eye focused centrally/ regular breathing.

2: Partial intercostal paralysis, tachycardia, hypotension, hypotonia
3: Complete intercostal paralysis and respiratory arrest

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9
Q

What is stage 4 of anesthesia known as?

A

This is the medullary paralysis and is not good!

Plane 1: Reversible
Plane 2: irreversable

Causes respiratory and cardiac failure

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10
Q

What are the major first signs of malignant hyperthermia?

A

TACHYCARDIA

Sweating, muscle rigidity etc.

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11
Q

What is the treatment for malignant hyperthermia?

A

Sodium Dantrolene 2.5 mg/kg

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12
Q

Which two medications can put a patient at risk for malignant hyperthermia?

A

Halothane

Succinylcholine

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13
Q

Inhalated agents with increased risk of spontaneous abortion?

A

Diethyl Ether

Chloroform

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14
Q

Does halothane effect the liver or the kidneys?

A

LIVER
H FOR HEPATIC

Also may trigger malignant hyperthermia, myocardial depression, and arythmias.

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15
Q

What is good about halothane?

A 
Most potent inhalation
Lowest MAC
Rapid smooth induction and recovery
Pleasant smell
Non-irritating/emetic/and safe in asthmatics.
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16
Q

What are the pros and cons of Isoflurane?

A

Rapid induction, good muscle relaxant, heart rhythm safe, and compatible with epinephrine.

Cons: post op shivering, possible delayed hepatic damage.

17
Q

Which inhalation agent is known to cause seizures?

A

Enflurane!!

It is also nephrotoxic and hepatotoxic

18
Q

Which inhalation agents are nephrotoxic?

A

Enflurane (hepato and nephro)
and
Methoxyflurane.

19
Q

The higher the MAC for an agent the …

A

The least potent the agent.

MAC = The lowest possible dose to limit movement in 50% of patients.

20
Q

What is the dose per kg for lidocaine?

A

4.5 mg/kg

21
Q

What is the dose per kg for lidocaine with epi?

A

7 mg/kg

22
Q

What is the dose per kg for marcaine?

A

2 mg/kg

23
Q

How many mg/mL of epinephrine is in 1:1000?

A

In a solution of 1:1000 there is 1 mg/mL of epinephrine.

24
Q

What type of local is contraindicated with the use of halothane?

A

Should not use epinephrine halothane sensitizes the heart

25
Q

What is clark’s rule?

A

Pediatric local dosing.

weight of child in lbs / 150 x ( adult dose)

26
Q

Why are intravenous anesthetics used before inhalation agents?

A

Intravenous agents do not cause as much muscle relaxation/breathing supression.

Its best to initiate with IV and then follow up with inhalation products.

27
Q

Why is ketamine so nephrotoxic?

A

It is one of the few intravenous agents that is not bound to albumin.
Thus it is cleared by the kidneys instead of the liver!

28
Q

Why is the recovery from diprivan (propofol) quicker than any other induction agent?

A

Because propofol is quickly cleared by the liver at a rapid rate.

29
Q

What is the moa of ketamine?

A

NMDA antagonist

30
Q

What trifecta does ketamine provide patients?

A

Hypnotic
Analgesia
Amnesia

Also hallucinogenic with dissociative amnesia.

31
Q

Why is ketamine useful in trauma cases?

A

Has no effect on the heart!

Prevents any drops in blood pressure!

32
Q

Safest anesthetic for people with cardiac issues and asthma?

A

Etomidate

33
Q

Antidote for benzodiazepines?

A

Flumazenil 0.2 mg/kg

34
Q

Another name for versed?

A

Midazolam

Sedative, hypnotic, amnesia.

35
Q

Whats the differnce between versed and valium?

A

Both are benzos but…
Versed (midazolam) allows hypnotic effects.

Valium allows for anti anxiety effects!

36
Q

What drug can reverse narcotic overdose?

A

Naloxone!

37
Q

What drug can reverse opiod antagonists?

A

Narcan

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