Anesthetics and Skeletal muscle blockers Flashcards
All inhaled anesthetics are bronchodilators except:
Desflurane
Used as GA
Desflurane not used in people with?
Asthma
Act as pulmonary irritant, will worsen bronchospasm
All local anesthetics vasoDILATE except:
Cocaine
Laughing gas used in minor surgeries and dental procedures?
Nitrous (joyOUS) oxide - rapid onset
High MAC, low potency
Low PC, rapid onset, least cardiotoxic
Type of anemia caused by Nitrous oxide?
Megaloblastic
Most hepatotoxic inhalational anesthesia? Other AE?
Halothane
Cause malignant hyperthermia with succinylcholine
Antidote for malignant hyperthermia? (massive SR release of Ca due to defective RYR, trismus of the jaw)
Dantrolene
To decrease body temp rapidly
Inhalational GA with the LOWEST MAC and HIGHEST potency?
Methoxyflurane
stays in blood longer, very SLOW recovery
Cause renal insufficiency
Ultrashort acting barbiturate used as IV GA for anesthesia induction and increased ICP?
Thiopental
TAYO AGAD
Short acting BZD also used as IV GA is? Antidote for toxicity?
Midazolam
Antidote: Flumazenil
Dissociative anesthesia (no loss of consciousness but with analgesia) preferred in trauma patients with unstable vital signs?
Ketamine CV stimulation (inc BP and HR)
Ketamine AE? Therefore need pretreatment with?
Emergence delirium
Give BZDs first
IV GA with no analgesic properties, used if with limited cardiac reserve or respi reserve?
Etomidate
“Eto may date, pareserve na tayo”
How is neuroleptanesthesia achieved? Used in endoscopic, bronchoscopic and ophthalmic procedures
“Friend drop the ox”
Fentanyl
Droperidol
Nitrous oxide
Antidote for opioid (fentanyl) overdose?
Naloxone
IV GA also known as “Milk of Amnesia”?
Propofol - for OPD sedation
Common AE of propofol?
Dec BP, dec HR
Priapism
Local anesthetic with shortest half life?
Longest half life?
PRO finishes fast - Procaine - Ester
end of the ROPE - Ropivacaine - Amide
Hyper K or Ca enhances local anesthesia effect?
Hyper K enhances
Hyper Ca antagonizes
Local topical anesthesia used with care in patients with sunburn?
Benzocaine
Burn the Benz
Toxic dose of Lidocaine?
5mg/kg (1% in 10mL solution)
Group 1B antiarrhythmic used for ventricular arrhythmias POST-MI
Amide local anesthetic used in dental procedures that cause methemoglobinemia?
Prilocaine “Pri dental checkup!”
Antidote: Methylene blue
METhemoglobinemia = METhylene blue
Give two cardiotoxic local anesthetics
Bupivacaine
Ropivacaine
“HeartBuRoken”
Treatment of anesthesia induced cardiotoxicity?
Intralipid
Fat emulsion used in TPN
Nondepolarizing NMB prevent action of ACh at the end plate. These effects can be reversed by?
Neostigmine
Cholinesterase inhibitor
Nondepolarizing NMB with most rapid onset?
Reversed by what novel drug?
Rocuronium (60-120 seconds only)
Reversed by Sugammadex
Long acting NMB that cause RECURARIZATION (drug eliminated but still with active metabolites) and is contraindicated in patients with MI?
Tubocurarine
AE: Resp paralysis, ganglion block
Intermediate acting ND NMB used during intubation and GA that cause seizures, bronchospasm, histamine release?
Atracurium
Atracurium undergoes what type of elimination?
Hoffman elimination (Rapid spontaneous breakdown to form laudanosine)
Intermediate acting ND NMB that is eliminated in bile?
Vecuronium
VILE = Vecuronium
Long acting ND NMB used in euthanasia and lethal injection?
Pancuronium
Drugs used in lethal injection?
ToPaK!
- Thiopental
- Pancuronium
- KCl
The only DEPOLARIZING NMB?
Succinylcholine
NMB metabolized by PSEUDOcholinesterase?
Eliminated in bile?
Excreted renally?
PseudoCholi - Mivacurium and Succinylcholine
Bile - Vecuronium
Renal - Pancuronium, tubocurarine
