Anesthetics Flashcards
Induction
drug
done via IV
Propofol
Maintenance
drug
sustain anesthesia
nitrous oxide and halogenated hydrocarbons
Drugs given via inhalation
nitrous oxide
Halothane, Enflurane
Drugs given via IV
Propofel
Benzodiazepines
Ketamine
Targets of Benzodiazepines, Etomidate, and Propofol
GABA Cl channels
Targets of Barbituates and Propofel
Glycine Cl channels
Minimum Alveolar Concentration
MAC
conc of drug that prevents a pain response in 50% of patients
more lipid soluble = lower MAC = greater potency
lower in elderly and in presence of opiates or sedatives
Partial Pressure
moves gas into lungs to blood to brain
Halothane
no longer used because it caused fulminant hepatic necrosis
Enflurane SE
decreases heart force and causes seizures
Propofel
for induction and maintenance
acts at GABA receptors
Ketamine
induction
NMDA antagonist
Local Anesthetics are an acid or base?
weak base
LA should not be used where?
injected into infected tissue
Lipophilic
needed for anesthetic to bind
increases potency and duration and toxicity
Hydrophilic
ionizable
Drugs used for LA
Esters
Amides
Examples of Esters
Procaine
Tetracaine
Examples of Amides
Bupivacaine
Lidocaine
Esters are used for….
topical LA
Amides are used for….
injectable LA
More extracellular Ca causes….
antagonizes LA effects
Increasing extracellular K causes
enhances LA effects
Which nerve fibers are easiest to block?
small; myelinated
Cocaine
constricts blood vessels, prevents own absorption
Metabolize Esters
Esterase
Metabolize Amides
P450 system in liver
Bupivacaine SE
cardiovascular toxicity
Tetracaine Use
spinal and ophthalmic anesthesia
rapid onset, long duration
Cocaine cannot be used in….
angle closure glaucoma patients
Bupivacaine
long acting
blocks peripheral nerve and epidural
Lidocaine
used in cataract surgery
used for infiltration, peripheral and central nerve blocks, and as antiarrhythmic
