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Neuro & Behavior Pharm > Anesthetics > Flashcards

Anesthetics Flashcards

1
Q

Ester linked or Amide linked:

Procaine, tertracaine, cocaine, benzocaine

A

Ester linked

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2
Q

Ester linked or amide linked:

Lignocaine, Mepivacaine, Bupivacaine, Ropivacaine, Prilocaine, lidocaine

A

Amide linked

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3
Q

These local anesthetics:

  • produce more intense and longer lasting local anesthesia
  • metabolized in liver
  • hypersensitivity reactions less
A

Amides

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4
Q

These local anesthetics:

  • short acting
  • metabolized by plasma esterases
  • hypersensitivity reactions more
A

Esters

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5
Q

What is the mechanism of action of local anesthetics?

A
  • Block conduction by decreasing the large transient increase in the permeability of to Na+
  • increase threshold of excitability
  • impulse conduction slows
  • decrease rate of rise of the action potential
  • ultimately prevent propagation of action potential
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6
Q

Which nerves tend to be blocked first myelinated or unmyelinated?

A

Myelinated

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7
Q

What is the order of sensory function block?

A
  1. Pain
  2. Temperature
  3. Touch
  4. Deep pressure
  5. Motor

Recovery in reverse order

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8
Q

What is the effect of addition of vasoconstrictors with LA?

A
  1. Increase the duration of action of LA
  2. Decrease systemic toxicity of LA
  3. Decrease bleeding in the operative field
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9
Q

What are topical local anesthetics?

A

Cocaine
Lidocaine
Proparacaine
Tetracaine

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10
Q

What are infiltrative local anesthetics?

A

Lidocaine
Procaine
Bupivacaine

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11
Q

What gas is an inhaled local anesthetic?

A

Nitrous Oxide

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12
Q

What volatile liquid is an inhaled anesthetic?

A 
Halothane
Enflurane
Isoflurane
Desflurane 
Sevoflurane
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13
Q

Which inhaled anesthetic:

  • MAC > 100%: Incomplete anesthetic
  • Good Analgesia
  • Rapid onset & recovery
  • Used along with other anesthetic
  • Second Gas effect
A

Nitrous Oxide

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14
Q

Which inhaled anesthetic:

  • Not Pungent (used for induction in children)
  • Bronchidilator
  • Medium rate of onset & recovery
  • Sensitized the heart to epi-induced arrhythmias
  • induces hepatitis
A

Halothane

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15
Q

Which inhaled anesthetic:

  • Most rapid onset of action & recovery of the halogenated GAs
  • Widely used for outpatient surgery
  • irritating to the airway in awake patients & causes coughing, salivation, & bronchospasm
  • Used for maintenance of anesthesia
A

Desflurane

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16
Q

Which inhaled anesthetic:

  • Very low blood: gas partition coefficient with relatively rapid onset of action & recovery
  • Widely used for outpatient surgery
  • Not irritating to the airway
  • Bronchodilator
  • Useful induction agent, particularly in children
A

Sevoflurane

17
Q

Which inhaled anesthetic:

  • medium rate of onset & recovery
  • used for induction and maintenance of anesthesia
A

Isoflurane

18
Q

What are some adverse effects of inhalational GAs?

A

Nephrotoxicity: methoxyflurane, enflurane, and sevoflurane leads to the formation of fluoride ions

Malignant Hyperthermia: volatile agents + muscle relaxants

Enflurane: seizures

19
Q

What are the IV anesthetic barbiturates?

A

Thiopental

Methohexital

20
Q

Which IV anesthetic:

  • can produce unconsciousness and surgical anesthesia in <1 min
  • with single bolus-emergence from GA occurs in ~10 mins
  • cerebral metabolism, oxygen utilization, cerebral blood flow is also decreased
  • can precipitate porphyria
A

Barbiturates

21
Q

What are the IV anesthetic benzodiazepines?

A

Diazepam
Lorazepam
Midalozam

22
Q

Which IV anesthetic:

-Used as premedication: produce anxiolysis, amnesia and sedation prior to induction of GA

A

Benzodiazepines

23
Q

Which benzodiazepine has a more rapid onset, a shorter elimination half-life — inducing agent

A

Midazolam

24
Q

Which IV anesthetic has:

  • a rate of onset of action that is similar to that of the intravenous barbiturates but recovery is more rapid
  • patients subjectively “feel better” in the immediate postoperative period
  • agent of choice for ambulatory surgery
  • effective in producing prolonged sedation in patients in critical care
A

Propofol

25
Q

Which IV anesthetic has the adverse effects:

  • apnea can occur
  • marked decrease in blood pressure during induction
  • pain at the site of injection
  • muscle movements, hypotonus
  • clinical infections may occur
A

Propofol

26
Q

Which IV anesthetic has:

  • rapid induction (~1 min)
  • short duration of action (3-5 min)
  • little effect in CV and respiration
  • maintains cardiovascular stability in patients with coronary artery disease, cardiomyopathy, cerebral vascular disease, or hypovolemia
A

Etomidate

27
Q

Which IV anesthetic has adverse effects :

  • can cause post-op nausea
  • adrenocortical suppression
A

Etomidate

28
Q

What are the opioids used for general anesthetic?

A 
Morphine
Fentanyl 
Sufentanil
Alfentanol
Remifentanil
29
Q

Which IV anesthetic:

  • high doses can cause post-op respiratory depression
  • used for post-op analgesia and premedication
A

Opioids

30
Q

What is Neuroleptanalgesia and what drugs are used for it?

A

State of analgesia and amnesia

Fentanyl + Droperidol (Innovar)

31
Q

What is Neuroleptanesthia and what drugs are used for it?

A

Fentanyl + Droperidol + N2O

32
Q

Which IV opioid is very potent but with a short half-life?

A

Remifentanil

33
Q

Which IV anesthetic:

  • a “dissociative anesthetic” that produces a cataleptic state that includes intense analgesia, amnesia
  • acts by blocking NMDA receptor
  • has emergence phenomena: postoperative disorientation, sensory and perceptual illusions, and vivid dreams
  • increases cerebral blood flow, oxygen consumption, and ICP
  • cardiovascular stimulation: increase heart rate, arterial blood pressure, and cardiac output
A

Ketamine

Neuro & Behavior Pharm (3 decks)

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