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Pharmacology & Drugs > Anesthetic Mechanisms > Flashcards

Anesthetic Mechanisms Flashcards

1
Q

What are the drugs used in monitored anesthesia

A

Midazolam for premedication, then propofol for the deeper sedation

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2
Q

What is the mechanism of action of propofol

A

GABAa agonist receptors

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3
Q

What are the general toxicities seen with inhaled anesthetics

A
  • Nausea and vomiting

- Malignant hyperthermia if used with succinyl CoA

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4
Q

What is deep sedation

A

Decreased consciousness, loss of protective reflexes, no patent airway, lock of verbal responsiveness

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5
Q

What are the toxicity seen in the CV with local anesthetics

A

Block cardiac sodium channels and decrease the amount of excitability, conduction, contractility, arteriole dilation, and hypotension

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6
Q

What is conscious sedation

A

Used by dentists where the patient is awake and responsive

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7
Q

What is the method of epidural anesthesia

A

Injection into the epideral space to create a large area

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8
Q

What is the method of block anesthesia

A

Injection into the major nerve trunks, so results in a region distal to the site of injection (such as brachial plexus)

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9
Q

What are the toxicities of local anesthesia at low concentrations

A
  • Sleepiness
  • light headed
  • visual and auditory disruptions
  • restlessness
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10
Q

What are the characteristics of an anesthetic agent that high low blood solubility

A

Reaches high arterial pressure slowly, so it reaches equilibrium slowly, resulting in a slow onset of action

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11
Q

What is the mechanism that most general anesthetics work

A
  • Activation of chloride channels for hyperpolarization (GABA and Glycine)
  • Decreased excitatory channels activity
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12
Q

What is monitored anesthesia

A

Sedation based anesthetic technique for diagnostic and mino therapeutic surgical procedures, where premedication is given, then followed by another for deep sedation

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13
Q

What can be given to help control seizures and what is the mechanism

A

Benzodiazepine, which raising the threshold of seizure activity

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14
Q

What is the mechanism of action for local anesthetics

A

Blocks the voltage gated sodium channels, so there is no spread of the depolarization

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15
Q

What is the method of infiltration anesthesia

A

Direct injection into the tissues near peripheral nerve endings

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16
Q

What are the toxicities seen in high doses of local anesthetic

A
  • Nystagmus
  • Convulsions
  • muscle twitching and fasciculation
17
Q

What is the method of spinal anesthesia

A

Injection into the CSF in the lumbar space in order to produce a great area

18
Q

Where are ester type agents metabolized

A

In the plasma by circulating enzymes

19
Q

Which type of fibers are most susceptible to blockage by a local anesthetic

A

Type C (dorsal root and SNS) > Type B (pregang) > Type A delta

20
Q

What are the characteristics of a gaseous anesthetic

A

High vapor pressure and low boiling point, so they are gas at room temperature

21
Q

Where are amide-type anesthetics metabolized

A

In the liver by CYP450 and excreted in the urine

22
Q

What is the mechanism of action of opioid analgesics in anesthesia

A

Given in combination with benzo

23
Q

Where do inhaled anesthetics tend to accumulate and have an effect first

A

The organs receiving a higher cardiac output, such as the heart, liver, and kidneys, with the muscle tissues taking much longer

24
Q

What are the characteristics of effects for an anesthetia

A
  • Unconscious
  • amnesia
  • analgesia
  • attenuated Autonomic responses
  • immobility
25
Q

What is the response in the CV to inhaled anesthetics

A

They decrease the mean arterial pressure in direct proportion to their alveolar concentration, but increase the right atrial pressure proportionately

26
Q

What is the mechanism of action of dexmedetomidine

A

Alpha 2 adrenergic agonist (hypnotic like state)

27
Q

What are the characteristics of an anesthetic with a low blood solubility

A

Reaches high arterial pressure rapidly, so there is a rapid equilibrium with the brain and subsequent onset of action

28
Q

What is the mechanism of action of benzodiazepines

A

Increased GABAa sensitivity

29
Q

What are the parameters that the efficacy of inhaled anesthetics are based on

A
  • Concentration of anesthetic in air
  • Ventilation rate
  • drug solubility in the air, blood, and CNS
30
Q

What is the blood:gas’s partition

A

Relative affinity of an anesthetic for the blood compared to the inspired gas (aka blood solubility)

31
Q

What is the minimal alveolar concentration (MAC)

A

Amount of an anesthetic to prevent a response to a surgical incision in 50% of patients

32
Q

What is the mechanism of action of ketamine

A

NMDA antagonist

33
Q

What is the reasoning that a blood soluble anaesthetic takes longer to affect the brain

A

Because the gas is soluble in blood, it must fist completely saturate the blood with the gas before it can affect the brain, as opposed to insoluble, which will reach maximum saturation much quicker and therefore affect the brain much faster

34
Q

How can you tell between an amide and ester local anesthetic

A

Amide- will have at least 2 i’s in in

Ester-Will only hav ethe I in -caine

35
Q

How are inhaled anesthetics eliminated, and which are eliminated the quickest

A

They are eliminated via the lungs, and those that are not blood soluble result in much quicker elimination

36
Q

What is the toxic effect of inhaled anesthetics on the respiratory system

A

Respiratory depressants (reduced response to increased CO2 levels)

37
Q

What are the characteristics of volatile inhaled anesthetics

A

Low vapor pressure and high boiling points so they are liquid at room temperature

38
Q

What is the mechanism of action of barbiturates in anesthetics

A

GABAa receptor agonist

39
Q

What is the mechanism of action of etomidate

A

Enchances GABA on GABAa receptors

Pharmacology & Drugs (43 decks)

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