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Pharm II > Anesthetics I > Flashcards

Anesthetics I Flashcards

1
Q

Anesthesia

A

partial or complete loss of sensation with or without loss of consciousness

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2
Q

General Anesthesia:

A

anesthesia that produces complete loss of consciousness. “medically controlled coma”

loss of protective reflexes, cessation of respiration

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3
Q

Analgesia

A

insensitivity to pain

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4
Q

sedation

A

the process of allaying nervous excitement

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5
Q

conscious sedation

A

a minimally depressed level of consciousness during which he patient retains the ability to maintain a patent airway and respond appropriately to physical or verbal commands

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6
Q

Phases of Anesthesia

A

Induction
Maintenance
Recovery

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7
Q

depth of anesthesia

A

Stage 1 - Analgesia
Stage 2 - Excitement
Stage 3 - Surgical Anesthesia
Stage 4 - Medullary paralysis

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8
Q

Most popular agent for the induction of anesthesia

A

PROPOFOL

Usually given with lidocaine to prevent injection pain from venous irritation

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9
Q

Newer version of propofol

A

Fospropofol (Lusedrea)

less venous irritation

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10
Q

Maintenance of anesthesia is done how?

A

inhalation agents

Intravenous agents

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11
Q

Inhalation agents

A

Halogenated hydrocarbons

Nitrogen Oxide

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12
Q

Halogen Adverse Effects

A

Hepatic Toxicity
Decreased Cardiac Output
Malignant Hyperthermia

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13
Q

Malignant Hyperthermia

A

Rare but life threatening
Usually seen in conjucntion with use of succinylocholine
Dantrolene is main treatment choice

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14
Q

Nitrous Oxide

A

Strong analgesic but weak anesthetic

Frequently used as adjunct

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15
Q

MAC - minimal alveolar concentration

A

Concentration needed to suppress movement in response to standard incision

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16
Q

IV Anesthetics

A

Opiods
FENTANYL

Benzodiazepines
MIDLAZOPAM (conscious sedation)

KETAMINE

DEXMEDETOMIDINE

17
Q

Ketamine

A

Dissociative agent
One of few agents which increase cardiac output
May cause post-op hallucinations

18
Q

Neuromuscular blockade agents

A

Nondepolarizing agents
Depolarizing agents

to paralyze patients

19
Q

Neuromuscular blockade agent utilization

A

facilitate endotracheal intubation

relax abdominal musculature to enhance surgical exposure

20
Q

Depolarizing agent

A

Succinylcholine

fast acting short duration

21
Q

Non depolarizing agent

A

Longer duration of action

22
Q

Local anesthetic agents

A

Inhibit sensory nerve conduction via block of sodium ion channels

Pain nerves more sensitive
can block motor nerves at higher doses

23
Q

Chemical types of local anesthetics

A

Esters

Amides

24
Q

Amides

A

Lidocaine
Mepivicaine
Bupivicaine
Ropivacaine

25
Q

popular ester

A

chloroprocaine

26
Q

Duration of action for topical anesthetics

A

Lidocaine 15-30 min
Chloroprocaine 30-40 min
Mepivacaine: 60-90 min
Bupivacaine & Repivacaine: 120 min or more

27
Q

adding epinepherine to topical anesthetics

A

extends duration of action, reduces bleeding

bad news: increases heart rate, increased anxiety

28
Q

Adverse effects of local anesthetics

A 
Allergic reactions
Cardiac Toxicity (bupivacaine)
Systemic effects are variable
     altered CNS function
     Cardiac changes
29
Q

allergy considerations in topical anesthetic

A

True allergy is rare
Allergic to one ester, usually means allergic to all esters
Amides or usually OK in patients allergic to esters
Allergic to one amide DOES NOT mean allergic to all amides

30
Q

Insensitivity to local anesthetics

A

Insensitivity is usually rare

31
Q

Conscious sedation

A

very frequently utilized

especially for endoscopic procedures

32
Q

Elements of conscious sedation

A 
Intravenous access
Patient monitoring
Variable medicaiton "cocktail"
     sedative
     analgesic
     Anesthetic
33
Q

Conscious sedation medications

A

Most common: Benzodiazepine
esp midlazopam (versed)
Next: Fentanyl (short acting opiod)
Sometimes: propofol

34
Q

Conscious sedation dangers

A

respiratory depression

adverse drug reactions

Pharm II (10 decks)

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