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CNS > Anesthetics Pharm and principles, Pain pharm > Flashcards

Anesthetics Pharm and principles, Pain pharm Flashcards

1
Q

What are the major side effects of Halothane?

A

Hepatitis and depression of circulation and respiration

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2
Q

Which inhalation anesthetic do you use for obese patients?

A

Desflurane

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3
Q

What is the MAC?

A

Minimal Alveolar Concentration

- concentration of drug that results in 50% of patients immobile

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4
Q

How does solubility of a drug influence the onset?

A

Lower solubility leads to faster onset

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5
Q

What two of the inhaled anesthetics are the least metabolized?

A

Isoflurane and Desflurane

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6
Q

What produces Compound A?

A

Degradation of Sevoflurane in the CO2 absorber

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7
Q

What is the MOA of Compound A?

A

depress spontaneous and evoke activity of neurons in the brain

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8
Q

What does the Meyer Overton Theory state?

A

Anesthetic potency is determined by lipid solubility

- membrane expansion

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9
Q

Which two inhalation anesthetics are upper airway irritants?

A

Isoflurane and Desflurane

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10
Q

What inhalation anesthetic is used for pediatric mask induction?

A

Sevoflurane

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11
Q

What do you use to treat Malignant Hyperthermia?

A

Dantrolene = older; Ryanodex = newer

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12
Q

What intravenous anesthetic is best for patients with increased ICP?

A

Thiopental

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13
Q

Which intravenous anesthetic is used for burn dressing?

A

Ketamine

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14
Q

Which intravenous anesthetic causes corticoadrenal suppression?

A

Etomidate

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15
Q

What intravenous anesthetic is used in short outpatient cases?

A

Propofol

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16
Q

What is the MOA of Dexmedetomidine?

A

Alpha 2 agonist

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17
Q

Where is Dexmedetomidine metabolized?

A

The liver

18
Q

What is the MOA for local anesthetics?

A

prevent increased permeability of Na ions

- no depolarization to threshold

19
Q

What are the three states of the modulated receptor model?

A
  1. rested closed
  2. activated open
  3. inactivated closed
20
Q

In what state of the receptor model do localized anesthetics have high affinity?

A

inactivated closed state

21
Q

What two groups make up the local anesthetic structure?

A

aromatic ring and tertiary amine

-hydrocarbon chain in middle

22
Q

In what form do local anesthetics cross the nerve membrane?

A

non -ionized form

23
Q

In what form do local anesthetics block the sodium channel?

A

ionized form

24
Q

How does pKa affect time of onset?

A

closer to physiological pKa (7.4) will have faster onset

25
Q

How does tissue acidosis affect use of localized anesthetic?

A

slow onset of nerve blockade and causes poor quality of block

26
Q

How does hydrophobicity affect localized anesthetic ?

A

Higher coefficient means more potency

27
Q

How does vasodilation affect localized anesthetics?

A

increased Vd causes the diffusion of drug from site

28
Q

How does protein binding affect localized anesthetic?

A

increased binding leads to increased duration of action

29
Q

How does addition of epinephrine affect localized anesthetics?

A

causes vasoconstriction and dec absorption–> decreased diffusion away from the site

30
Q

Where are amide localized anesthetics metabolized?

A

in the liver

- more likely to cause toxicity

31
Q

Where are ester localized anesthetics metabolized?

A

in the plasma via PCE

32
Q

How is cardiac toxicity caused by localized anesthetics?

A

blockage of Na fast channels in cardiac membranes

- widens QRS

33
Q

What two localized anesthetics cause severe heart rhythm problems?

A

Bupivacaine and Etidocaine

34
Q

Which specific pathway carries nociceptive, temp, and crude touch?

A

Spinothalamic tract

35
Q

What generates arachidonic acid?

A

Phospholipase A2

36
Q

How long is the trial for an NSAID?

A

One month

37
Q

Which NSAID is commonly used for gout?

A

Indomethacin

38
Q

Tetracaine is an anesthetic that is used for what kinds of procedures?

A

Bronchoscopy, Bronchography, Esophagoscopy

39
Q

Which two alpha 2 agonists are used to treat post op pain?

A

Clonidine and Dexmedetomidine

40
Q

What is the drug of choice for severe pain?

A

Morphine

41
Q

What is fentanyl used for?

A

help ongoing pain and when opioid tolerance is starting to show

CNS (7 decks)

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