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PLE_PHARMA > ANESTHETICS & SKELETAL MM RELAXANT > Flashcards

ANESTHETICS & SKELETAL MM RELAXANT Flashcards

1
Q

Best measure of potency of inhaled anesthetics

A

MAC (Minimum Alveolar Concentration)

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2
Q

Lowest MAC (highest potency)

A

Methoxyflurane

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3
Q

Highest MAC (lowest potency)

A

Nitric Oxide

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4
Q

C/I in patients with asthma (inhalational anest)

A

Desflurane (pungent odor)

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5
Q

Best for asthmatic (bronchodilation) Inhalational Anesth

A

Sevoflurane

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6
Q

Coronary steal syndrome???

A

Coronary steal syndrome: the preferential redistribution
of blood from ischemic areas to non-ischemic areas, is a
theoretical possibility for isoflurane use

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7
Q

Inhalational Anesth that has Highest propensity to cause hepatitis

A

Halothane

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8
Q

Highest POTENCY, Lowest MAC

A

Methoxyflurane

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9
Q

Anesthesia for minor surgery and dental procedures,
Balanced anesthesia for major surgery

A

Nitric Oxide

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10
Q

Not a SOLE anesthetic agent; combined with other
inhaled local anesthetics for a more balanced effect

A

Nitric Oxide

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11
Q

Lowest potency (highest MAC) and least
cardiotoxicity among inhalational anesthetics

A

Nitric Oxide

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12
Q

can
cause airway irritability and hence is unsuitable for
induction (inhalational anesth)

A

DESFLURANE (and ISOFLURANE to a lesser extent)

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13
Q

Genetic disorder of susceptible individuals upon exposure to
volatile anesthetics and succinylcholine

A

Malignant Hyperthermia

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14
Q

most reliable test to
establish susceptibility to malignant hyperthermia

A

Caffeine-Halothane contracture test

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15
Q

Pathophysiology of malignant Hyperthermia

A

Pathophysiology: Mutation in the ryanodine receptor (calcium
release channel in the SR) of the skeletal muscle that results to
uncontrolled release of Ca2+ from the sarcoplasmic reticulum

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16
Q

Tx malignant hyperthermia?

A

Treatment: Dantrolene

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17
Q

Uses: Dissociative anesthesia (analgesia, amnesia, and catatonia
but with retained consciousness)

A

ketamine

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18
Q

IV anesth: potent bronchodilation with minimal respiratory
depression making it ideal for asthmatic patients

A

Ketamine

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19
Q

IV anesth: uses - Pain on injection, Myoclonus, Postoperative nausea and
vomiting, Adrenocortical suppression

A

Etomidate

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20
Q

unlike other IV anesthetics, has minimal
effects on CV and respiratory functions upon induction.
HENCE, it can be used as an induction agent of choice
for unstable patients or those with minimal
cardiopulmonary reserve

A

Etomidate

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21
Q

Interact with μ (mu), δ (delta) and κ (kappa) receptors
for endogenous opioid peptides - what opioid analgesic?

A

Fentanyl

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22
Q

SE fentanyl and antidote?

A

Respiratory depression, NALOXONE

23
Q

MILK OF AMNESIA?

A

Propofol

24
Q

PROPOFOL INFUSION SYNDROME (PRIS)?

A

● Seen in prolonged high dose infusions (>75ug/kg/min) for > 24 hrs
● Cardinal features: metabolic (lactic) acidosis + hyperlipidemia +
rhabdomyolysis + hepatomegaly

25
Q

How will you distinguish whether local anesthetics are esters or amides?

A

ESTERS have only 1 i in their names.
Tetracaine, Procaine, Benzocaine

AMIDES have 2 i’s in their names.
Bupivacaine, Ropivacaine, Lidocaine

26
Q

Half life of local anesthetics?

A

MNEMONICS – Half Life of Local Anesthetics
PROCAINE = shortest half-life (1-2 mins) A PRO finishes the race fastest.
ROPIVACAINE = longest half-life (4.2 hrs) At the end of the long ROPe.

27
Q

MOA local anesthetics?

A
  • block voltage-gated Na+ channels, reducing influx of Na+,
    thereby blocking action potentials for nerve conduction
28
Q

Relationship of local anesthesia with electrolytes: Hyperkalemia?
Hypercalcemia?

A

o hyperkalemia enhances local anesthetic activity
o hypercalcemia antagonizes local anesthetic activity

29
Q

Treatment of LAST: LOCAL ANESTHETICS: SYSTEMIC TOXICITY

A

TREATMENT OF LAST
* ANTIDOTE: INTRALIPID (IV lipid emulsion therapy)

30
Q

shortest half-life (local anesth)

A

Procaine

31
Q

Vasoconstrictor; first ever LA discovered

A

Procaien

32
Q

Local anesth: Also an antiarrhythmic (Group 1B, used post-MI and
in digitalis toxicity)

A

Lidocaine

33
Q

Local Anesth: Can cause methemglobinemia

A

Prilocaine

34
Q

Local Anesht: Most cardiotoxic. Ventricular arrhythmias if given IV

A

Bupivacaine

35
Q

Local Anesthetic: Enantiomer of bupivacaine (less cardiotoxic)
Longest half life

A

Robivacaine

36
Q

What are the drugs used in lethal injection?

A
  • Thiopental (5 g)
  • Pancuronium (100 mg)
  • Potassium chloride (100 mEq)
37
Q

Antidote od PHASE 2 of neuromuscular blockade?

A

Cholinesterase inhibitors

38
Q

Depolarizing NMB Prototype drug?

A

Succinylcholine

39
Q

Non depolarizing NMB prototype drugs?

A
  • Short-acting: Mivacurium
  • Intermediate: Tubocurarine,
    Rocuronium, Atracurium
  • Long-acting: Pancuronium
40
Q

MOA of DEPOLARIZING vs NON DEPOLARIZING NMBs?

A

Depolarizing
* AGONIST at Ach
receptors
Non depolarizing
* COMPETITIVE
ANTAGONIST at Ach
receptors

41
Q

SE of Depolarizing NMBs?

A
  • Malignant
    hyperthermia
  • Hyperkalemia
  • Muscle pain and
    amage
42
Q

Reversal agents of non depolarizing NMBs?

A
  • Neostigmine
  • Sugammadex – for
    Rocuronium
43
Q

GABAB agonist. Facilitates spinal inhibition of motor neurons

A

BACLOFEN

44
Q

α2 agonist in the spinal cord, increases presynaptic
inhibition of motor neurons

A

TIZANIDINE

45
Q

Ca Channel blocker - Block RyR1 Ca2+-release
channels in the sarcoplasmic reticulum of the skeletal
muscle

A

DANTROLENE

46
Q

USES OF DANTROLENE?

A

Malignant Hyperthermia, Spasm due to cerebral palsy,
spinal cord injury & multiple sclerosis

47
Q

Any molecule that acts through the opioid receptor: natural
opiates and semisynthetic alkaloids derived from the opium
poppy, pharmacologically similar synthetic surrogates, and
endogenous peptides (enkephalins, endorphins, dynorphins)

A

OPIOIDS

48
Q

MORPHINE SIDE EFFECTS:

A

MNEMONIC for Morphine side effect: MORPHINE = Miosis, Out of it,
Respiratory depression, Pruritus, Hypotension and Headache,
In frequency, Nausea, and Emesis

49
Q

OPIOID OVERDOSE TRIAD?

A

Triad of pupillary constriction, comatose state, and
respiratory depression
* Diagnosis confirmed if intravenous injection of naloxone results
in prompt signs of recovery

50
Q

By half-life: Which opioids have the shortest and longest half-lives?

A

o REMIFENTANIL = shortest half-life (3-4 mins)
o BUPRENORPHINE = longest half-life (4-8 hrs)

51
Q

MEPERIDINE plus MAOi = ???
MEPERIDINE plus SSRI = ???

A

+ MAOi = Hyperpyrexic Coma
* + SSRI = Serotonin Syndrome

52
Q

What drug is used for opioid dependance

A

METHADONE MAINTENANCE THERAPY

53
Q
A

PLE_PHARMA (16 decks)

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