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PT2 Pain 5-10 > Anesthetics > Flashcards

Anesthetics Flashcards

1
Q

stage 1 of anesthesia

A
  • analgesia

- decreased activity in substantia gelatinosa

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2
Q

stage 2 of anesthesia

A
  • excitaion

- disinhibition (undesirable)

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3
Q

stage 3 of anesthesia

A
  • surgical anesthesia

- decreased spinal reflexes and reticular activating systems activity

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4
Q

stage 4 of anesthesia

A
  • medullary depression

- respiratory and vasomotor depression

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5
Q

two mechanisms of general anesthetics

A
  • enhance inhibitory receptor effects (GABA, Glycine)

- inhibit excitatory receptor effects (neuronal nicotinic, NMDA, K channel)

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6
Q

ED95 MAC value

A

1.3

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7
Q

1 MAC =

A

ED50

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8
Q

MAC

A
  • minimum alveolar concentration

- concentration of inhaled anesthetic at which 50% of patients do not move in response to surgical incision

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9
Q

MAC awake value

A

~0.3

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10
Q

factors that speed induction and emergence

A
  • increased anesthetic inspired concentration
  • decreased anesthetic solubility
  • increased minute ventilation
  • decreased cardiac output
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11
Q

inhalation agents use

A
  • usually maintenance

- sometimes for induction

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12
Q

IV agents use

A
  • usually induction

- sometimes maintenance

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13
Q

context sensitive half-time (CSHT)

A

-time for plasma concentration to decrease by 50% after stopping an infusion targeting a steady state

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14
Q

things that alter CSHT

A
  • duration of infusion
  • redistribution rate
  • fat accumulation
  • metabolism/elimination
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15
Q

nitrous oxide

A
  • inhaled
  • inorganic gas, odorless, colorless
  • MAC >105%
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16
Q

anesthetics that provide analgesia

A
  • ketamine
  • nitrous oxide
  • dexmedetomidine
17
Q

desflurane

A
  • inhaled
  • low solubility so rapid induction/emergence
  • highly volatile
18
Q

isoflurane

A
  • inhaled
  • moderate solubility
  • pungent odor
19
Q

sevoflurane

A
  • inhaled
  • non-pungent odor
  • associated with emergence delirium in some pediatric patients
20
Q

drugs associated with malignant hyperthermia

A

desflurane
isoflurane
sevoflurane

21
Q

treatment for malignant hyperthermia

A

dantrolene

22
Q

barbiturates (thiopental, methohexital, etc)

A
  • IV
  • rapid redistribution with a single dose
  • accumulation with repeated doses
23
Q

etomidate

A
  • IV
  • cardiovascular stability
  • adrenocortical suppression
24
Q

propofol

A
  • IV (number 1 used in US)
  • contraindicated in pts with egg allergy
  • relatively flat CSHT curve (can use for maintenance)
25
Q

ketamine

A
  • IV
  • NMDA receptor antagonist
  • related to PCP
  • dissociative anesthesia (less immobility)
  • preserves lung function
26
Q

dexmedetomidine

A
  • IV
  • central alpha 2a agonist
  • sedation and analgesia
  • poor amnesia
27
Q

benzo to use for sedation

A

midazolam because of its rapid onset and short duration of action

PT2 Pain 5-10 (6 decks)

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