Anesthetics

Question 1

Ideal Injectable anesthetics

Answer 1

1. Water and lipid soluble
2. good analgestic
3. muscle relaxant
4. High TI
5. Have pharmacological antagonist

Question 2

Injectable anesthetics: Barbiturates

Answer 2

GABA-BZD-BRB complex, allosteric.
Thiopental+ Methohexital(ultrashort acting 5-8 min) - unconsciousness, good muscle relaxation, no anaglesia , no readministration (accumilates in fat)
*Hexobarbital, pentobarbital, thiamylal

Question 3

Injectible anesthetics: List

Answer 3

1. Barbiturates
2. Propofol
3. Imidazole
4. Steriod anesthetics
5. Ketamine
6. Zoletil

Question 4

Injectible anesthetics: Propofol

Answer 4

GABAa, unconsciousness, muscle relaxation, non anelgestic (+opiods)
*Inc ocular pressure

Question 5

Injectable anesthesics: Imidazole

Answer 5

1. Etomidate; unconsciousness+muscle relaxant+no analgesia , for induction. Briad TI , no CV depression, adrenocortical supression
2. Metomidate: methyl analogue of ethomidate, pigs

Question 6

Injectible anesthetics: Steriods

Answer 6

Alphaxalone + alfadolone = althesin
Unconsciousness, muscle relaxant, no alnalgesia
Broad TI, histamine release

Question 7

Injectible anesthetics: Steriods

Answer 7

Alphaxalone + alfadolone = althesin
Unconsciousness, muscle relaxant, no alnalgesia
Broad TI, histamine release

Question 8

Injectible anesthetics: Ketamine

Answer 8

SC 2 , NMDA receptor antagonist .
* causes CATALEPSY (trance with loss of sensation and body rigidity,) inc. CO, tachycardia, HR, BP, arrhythmia, convulsion

ANALGESTIC, NO MUSCLE RELAXATION
*Metabolized to Norketamine, only in Eq+ca and in combination!!, no im hepatic patients, late pregnancy

Question 9

Injectible anesthetics: Zoletil

Answer 9

Fast, inc. sympathetic tone, pain when given IM,SC

Question 10

Inhalation anesthetics: classification

Answer 10

1. Inorganic anesthetics:

2. Organic anesthesics: non halogenated (e.g diethyl ether) + halogenated (chloroform + halothane)

Question 11

Inhalation anesthetics: pharmacological effect

Answer 11

Narcosis , unconsciousness muscle relaxation, no analgesia ( exc. N2O), bronchodilation

• Remember: low blood:gas partition coefficient is favourable. (Faster onset and recovery)
• Halothane is metabolized in the liver
• Smaller MAC - ED50 , smaller= more potent

Question 12

Inhalation anesthetics: side effects

Answer 12

CV depression , hypotension, local irritation, bronchospasm (not in IV) pre+postnarcotic excitation ,, heoatotoxicoty , nephrotoxicity

Question 13

Inhalation anesthetics: Halothane side effects

Answer 13

BANNED, Most efficacious , intracranial pressure, teratogenic, carcinogenic, hepstotoxic, Arrhythmogenic

Question 14

Inhalation anesthetics: halothaned List

Answer 14

1. Halothane (banned)
2. Isoflurane+ sevoflurane (not in young , pregnant, malignant hyperthermia.)
3. Desflurane (common SE)
4. Methoxyflurane (maintanance, not in reptiles)

Question 15

Local anesthetics: pharmacological Effect

Answer 15

Conduction in nerve fibers (no CNS interaction), produce loss of sensation and even patalysis

Question 16

Local anesthetics: list

Answer 16

1. Esters (decompose in blood): procaine (low utilization), chloroprocaine , oxybuprocaine, tetracaine, benzocaine
2. Amides (decompose in liver): Lidocaine, prilocaine, mepvicacaine, bupivacaine, ropivacaine

Toxicity from low to high:
Mepvicacaine< procaine< Lidocaine< tetracaine< bupivacaine