Anesthetics

Question 1

Part of induction period with depression of RAS and dorsal horn cells

Answer 1

Stage 1

Question 2

Part of induction where Begins with loss of consciousness, and Depression of cortex

Answer 2

Stage 2

Question 3

What are some problems with stage 2

Answer 3

Depression of cortex which results in less inhibition of subcortical areas causes Disinhibition can produce several dangerous events:
Hyperreflexia: violent muscular contractions, Irregular respiration, and Vomiting

Question 4

muscular relaxation with low RR and BP

Answer 4

stage 3

Question 5

begins with cessation of respiration depression of pons

Answer 5

stage 4 medullary paralysis

Question 6

as… of adminstration GA increases, recovery takes longer

Answer 6

duration

Question 7

theory that looked at lipid solubility with GA

Answer 7

Myer Overton

Question 8

What was basis of GA and lipid membrane theory

Answer 8

GA disrupts lipid membrane causes closure Na channels so less excitation. Issue is that there’s not enough GA per lipid

Question 9

what are purposes of pre anesthetic medicine

Answer 9

relieve anxiety, prevent secretions, counteract brady, elevate gastric pH (cimetidine)

Question 10

This GA is used in dentistry but doesn’t relax skeletal muscle and peripheral neuropathy

Answer 10

NO2

Question 11

volatile liquid GA with respiratory irritation

Answer 11

isoflurane

Question 12

volatile liquid that yields fluroride toxicity, and seizures

Answer 12

enflurane

Question 13

this volatile liquid has low B/G solubulity

Answer 13

sevoflurane

Question 14

IV injection: usual
Primary site of action: RAS

rapid redistribution from brain to other tissues
Uses
Induction of general anesthesia
As sole GA for short procedures without significant pain

Answer 14

thiopental

Question 15

What are disadvantages of thiopental?

Answer 15

lack of control, poor analgesia, respiratory depressant, poor muscle relaxation

Question 16

Rapid-acting hypnotic; high lipid solubility, but Not an analgesic.

Minimal effects on HR, cardiac output, peripheral circulation, respiration

Biotransformation: Rapid metabolism in the liver; primarily excreted by kidneys

Answer 16

Etomidate

Question 17

ADRs of etomidate

Answer 17

myoclonus, hypotension, tachy, tachyapnea

Question 18

Some degree of analgesic actvity
Uses
Continuous sedation: pts intubated or ventilation / Dx procedures, e.g., colonoscopy
Induction of general anesthesia
Maintenance of general anesthesia in ‘balanced anesthesia’

Answer 18

Propofol

Question 19

ADRs Propofol

Answer 19

clonic movement, confusion, hypersalivation, bronchospasm

Question 20

MOA of ketamine

Answer 20

antagonist of NMDA

Question 21

ADRs of ketamine

Answer 21

Prolonged retention in body
- nightmares

Question 22

How do CNS depressants, cigarrettes, and antibiotics affect GAs?

Answer 22

depressants can increase effect, unless chronically used will decrease. Cigarettes are inducers. Aminogylcosides/lincosamides/polymixins are additive to paralysis