Anesthesia: Lichtblau Flashcards
What drug is it most common to see malignant hyperthermia with?
Halothane
Describe Halothane.
Vapor, Potent, Slower onset than NO because Halothane is more soluble in the blood, Cheap, Doesn’t irritate airway.
May see sensitization to catecholamines, High metabolism (undesirable, can lead to “halothane hepatitis” hepatotoxicity)
What make something more potent?
More lipid soluble
What makes it more rapid?
Less soluble in blood
Describe Isofulrane
Vapor, Induction in less than 10 minutes, Potent, no sensitization of myocardium to catecholamines, less renal and hepatotoxicity than Halothane.
Terrible smell. Potential for malignant hyperthermia.
Which general anesthetic needs a special vaporizer because its boiling point is near the temp of the OR?
Desflurane
Which general anesthetic is considered “almost perfect” and why?
Sevoflurane. It has rapid onset, it is potent, it has low blood solubility to it reaches equilibrium quickly. It is also quickly redistributed so it has rapid recovery time.
What is the only gas inhalation anesthetic? Tell me about it.
Nitrous oxide. It has low blood solubility so it has a rapid onset.
There is no chance for malignant hyperthermia and it does not sensitize the heart. It has a potential for diffusion hypoxia if it is rapidly discontinued due to rapid transfer from blood to alveoli (displaces the air).
Tell me about propofal.
Rapid induction, anti-emetic, short acting, injection site pain.
most significant respiratory effect is apnea (breathing repeatedly starts and stops)
Which drug is extremely lipid soluble, is a Barbiturate, and has an anesthetic dose between 50 and 75 % of the LD50 so it must be used with caution?
Thiopental
Describe Midazolam.
(Lichtblau’s fav drug)
A benzodiazepine, purely a muscle relaxant, only an induction agent, Less CV and respiratory depression. Actually not an anesthetic.
Describe Ketamine.
Dissociative anesthetic. Patient’s eyes stay open so they appear awake. Airway reflexes and respiration maintained. Patient unaware of environment, doesn’t feel pain. *Ideal for patients with unstable CV function.
NMDA Receptor Antagonist
*One problem: Hallucinations, nightmares, abuse
Fentanyl
Analgesic prior to surgery. Maintain respiration artificially, may be depressed post-op.
Why are Fentanyl and Sufentanyl good for patients with compromised myocardial function?
Hemodynamic stability
What drug class do Fentanyl and Sufentanyl belong to?
Opioids
