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Pharmacology > Anesthetics > Flashcards

Anesthetics Flashcards

1
Q

What are the inhaled general anesthetics?

A
  1. nitrous oxide
  2. isoflurane
  3. enflurane
  4. desflurane
  5. sevoflurane
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2
Q

What are the intravenous general anesthetics?

A
  1. propofol
  2. etomidate
  3. ketamine
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3
Q

What are the adjuncts for general anesthetics?

A
  1. midazolam
  2. Fentanyl
  3. Dexmedetomidine
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4
Q

Why are general anesthetics a very dangerous group of drugs?

A

narrow therapeutic index and extremely fast acting.

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5
Q

What term is used to describe general anesthetics?

A

controlled death

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6
Q

When was the first successful demonstration of the ability of a patient to be anaesthetized? what was used?

A

1846 by william morton.

diethyl ether vapor

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7
Q

What are the three requirements for a patient to achieve an anesthetic state?

A
  1. amnesia (depress activity in hippocampus)
  2. immobility - inhibit conscious or nerve reflex
  3. attenuation of autonomic
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8
Q

What dose the term balanced anesthesia mean?

A

use of multiple classes of drugs to achieve the desired depth of anesthesia

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9
Q

What drugs are used for pre-op sedation?

A

barbiturates, diazepam, midazolam.

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10
Q

What drug is used for pre-op to reduce risk of bradyarrhythmia?

A

atropine

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11
Q

What drug is used for pre-op to prevent vomiting?

A

ondansetron

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12
Q

What drug is used for pre-op reduction of regurgitation?

A

ranitidine

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13
Q

What drugs are used to induce anesthesia and why?

A

intravenous GA because they are faster acting than inhaled GA

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14
Q

What drugs are used for maintenance of anesthesia?

A

inhaled GA, can be fine tuned to the dose.

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15
Q

What drug is used in addition to other inhaled GA to allow for lower amounts of other GA used?

A

nitrous oxide

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16
Q

What drug is given to reduce dose of GA and block noxious stimulus reflex?

A

fentanyl

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17
Q

What drug is used as an neuromuscular junction blocking agent for endotracheal intubation?

A

succinylcholine

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18
Q

What rebound effect do GAs have?

A

tachycardia and hypertension

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19
Q

What does emergence excitement mean?

A

a condition where the half conscious patient exhibits restlessness, crying, moaning, and extreme thrashing.

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20
Q

What drug can be given post-op to reduce shivering threshold?

A

meperidine.

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21
Q

All inhaled GAs are what, except for nitrous oxide which is a gas.

A

volatile liquids

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22
Q

What determines the rate of aesthetic induction/recovery?

A

rate of GA diffusion from lung - blood- CNS

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23
Q

The faster the effects of inhaled GA wear off post-surgery….

A

the faster the patient can start to recover and spend less time in recovery room.

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24
Q

Drugs with poor water soluility come to equilibrium?

A

rapidly, thus rapid recovery

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25
Q

Drugs with high solubility come to equilibrium?

A

slowly, thus slow recovery

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26
Q

What measures the water solubility?

A

blood/gas partition coefficient

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27
Q

What is used to measure potency?

A

MAC minimum alveolar concentration.

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28
Q

MAC is defined as?

A

concentration of inhaled GA needed for 50% of patients to NOT respond to pain.

29
Q

What is the rule of thumb when comparing solubility to potency?

A

The greater the Lipid solubility, the greater the potency.

30
Q

The speed of induction _________ related to blood solubility while potency is ________ to lipid solubility.

A

Inversely

Proportional

31
Q

How do GAs inhibit neuronal acitivity?

A
  1. neuronal hyperpolarization
  2. inhibit excitatory synapses (NMDA)
  3. enhance inhibitory synpases (GABA)
32
Q

What are the components of the machines used for inhaled GAs?

A

oxygen, vaporizer, ventilator, CO2 absorber (soda lime)

33
Q

How is depth of anesthesia measured?

A

By computers that analyze patient EEG. BIS bispectral index, where 100 is awake and 0 is deep coma.

34
Q

What is used to induce analgesia in dentist offices?

A

Nitrous oxide

35
Q

What is nitrous oxide solubility in water? in lipids?

A

Low water solubility - Fast acting

Low lipid solubility - low potency

36
Q

What is diethyl ether solubility in water? in lipids?

A

High water solubility - slow acting

High lipid solubility - very potent

37
Q

What drug can result in spontaneous combustion on the operating table?

A

cyclopropane

38
Q

This drug has no pungent odor and can cause hepatitis.

A

Halothane.
High water solubility - slow acting
High lipid solubility - potent

39
Q

This drug has a sweet odor and can produce electrical seizures.

A

Enflurane

40
Q

If a blood:gas partition coefficient is = 1.8 what does this mean?

A

The drug is soluble in water/blood and therefore is slow acting.

41
Q

This drug is eliminated unchanged via the lungs.

A

Isoflurane, Desflurane, Sevoflurane

42
Q

This drug is the preferred GA for neurosurgery. It produces vasodilation in cerebral vasculature, but does what in the brain?

A

Isoflurane

Decrease metabolic rate in brain

43
Q

This drug is an irritating gas and must be use IV to induce anesthesia.

A

Desflurane

44
Q

What can interact with sevoflurane?

A

Baralyme CO2 absorber that can cause heat, and burn airways.

45
Q

What drug is preferred for patients prone to myocardial ischemia?

A

Sevoflurane

46
Q

What drug reacts with soda lime to produce Compound A causing short term renal damage?

A

Sevoflurane

47
Q

This drug must be used with caution in patients with high triglyceride levels due to low water solubility?

A

Propofol

48
Q

This drug is the most common induction agent of anesthesia.

A

Propofol

49
Q

This drug can be used for patient prone to vomiting due to its anti-emetic properties.

A

Propofol

50
Q

This drug is used for patients at risk for hypotension.

A

Etomidate, Ketamine

51
Q

This drug is used for induction and maintenance of anesthesia.

A

Etomidate

52
Q

This drug can cause nausea and vomiting and inhibits adrenal gland enzymes.

A

Etomidate

53
Q

This drug produces profound analgesia.

A

Ketamine

54
Q

This drug is used in battlefields and in veterinary medicine.

A

Ketamine

55
Q

This drug causes a modest decrease in ventilation rate and is potent bronchodilator.

A

Ketamine

56
Q

These drugs are used for pre-op sedation and amnesia.

A

Midazolam>diazepam>lorazepam

57
Q

Which of the benzodiazepines is water soluble, no injection pain, and preferred?

A

Midazolam

58
Q

What drug is used to minimize vascular reflex to noxious, painful stimuli?

A

Fentanyl

59
Q

This drug is used in hostage/terrorist action to incapacitate individuals.

A

Fentanyl

60
Q

This drug is used to reduce post-op shivering.

A

Meperidine

61
Q

This drug is an alpha2 agonist used in critically ill adults for sedation.

A

dexmedetomidine

62
Q

This drug does not change the ventilation rate.

A

dexmedetomidine

63
Q

This drug is useful in non-intubated patients.

A

dexmedetomidine

64
Q

How do GAs cause hypothermia?

A

Cause vasodilation that faclitates body heat loss.

65
Q

What is the treatment for hypothermia?

A

Warming methods, such as heating of air, heated beds, water-filled garments.

66
Q

What is malignant hyperthermia?

A

Core body temperature rises over 42C due to uncontrolled muscle activity.

67
Q

What specifically causes malignant hyperthermia?

A

ryanodine calcium channels do not close resulting in uncontrolled muscle contractions leading to heat generation.
Fatigued myocytes lyse releasing potassium resulting in fatal cardiac events.

68
Q

This drug is a ryanodine receptor inhibitor, used to treat spasms and spastic disorders.

A

dantrolene

Pharmacology (13 decks)

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