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BMB Test 4 > B7-097 CNS Anesthetics > Flashcards

B7-097 CNS Anesthetics Flashcards

1
Q

which stage of anesthesia is from regular respiration to respiratory arrest

A

stage 3

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2
Q

stages of anesthesia are based on the effects of

A

Ether

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3
Q

the less soluble, the […] induction and emergence

A

faster

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4
Q

concentration of anesthetic in the inspired air at equilibrium when there is no response to skin incision in 50% of patients

A

minimum alveolar concentration (MAC)

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5
Q

lower MAC = […] potent

A

more

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6
Q

actual relative potency depends on the anesthetic’s partial pressure in the

A

brain

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7
Q

has analgesic activity but is insufficient potency for surgical anesthesia

A

nitric oxide

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8
Q

-ane

what class?

A

volatile (inhaled) anesthetics

desflurane, isoflurane, sevoflurane

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9
Q

most widely used inhaled anesthetic

A

isoflurane

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10
Q

MOA of the inhaled anesthetic agents

A

depress spontaneous and evoked neuronal activity

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11
Q

why must patients be monitored under anesthesia?

A

causes medullary depression of respiratory and CV function

complete CNS depressants (can lead to coma/death)

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12
Q

adverse reaction to inhaled anesthetics that occurs in individuals with ryanodine receptor mutations

A

malignant hyperthermia

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13
Q

malignant hyperthermia can be treated with

A

dantrolene

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14
Q

which inhalable anesthetic depresses the myocardium?

A

nitrous oxide

also desflurane, minimally

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15
Q

which inhalable anesthetics cause vasodilation and tachycardia? [2]

A

isoflurane
desflurane

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16
Q

which inhalable anesthetic causes vasodilation without tachycardia?

A

sevoflurane

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17
Q

rate of induction of nitrous oxide

A

rapid

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18
Q

rate of induction of isoflurane

A

medium

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19
Q

rate of induction of sevoflurane

A

rapid

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20
Q

rate of induction of desflurane

A

rapid

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21
Q

list the inhaled anesthetics from least potent to most potent (MAC) [4]

A

nitrous oxide
desflurane
sevoflurane
isoflurane

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22
Q

barbituates used as IV anesthetics [2]

A

thiopental
methohexital

long DOA due to accumulation in adipose

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23
Q

no analgesia, in fact causes hyperalgesia

A

IV barbiturates

thiopental, methohexital

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24
Q

cause a profound decrease in respiration at anesthetic doses

A

IV barbituates

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25
Q

IV anesthetic that redistributes to other tissues

can accumulate in adipose leading to long duration of action

A

thiopental

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26
Q

propofol acts at […] receptors

A

GABA-a

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27
Q

similar effects as barbituates, but there is a more rapid recovery due to 10x faster hepatic metabolism

A

propofol

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28
Q

often used for maintenance of anesthesia, as well as induction

A

propofol

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29
Q

most popular fixed anesthetic

often used for OP prodcedures

A

propofol

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30
Q

used for induction, especially in patients at risk of hypotension

A

etomidate

no analgesia

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31
Q

does etomidate have analgesic activity?

A

no

used for induction in patients with hypotension

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32
Q

dissociative anesthesia
causes catatonia, analgesia, and amnesia without loss of consciousness

A

ketamine

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33
Q

ketamine blocks the […] receptor

A

NMDA

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34
Q

IV anesthetic that provides excellent analgesia and amnesia

A

ketamine

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35
Q

associated with “emergence phenomenon” of hallucinations and disorientation

A

ketamine

(can be decreased by benzos, kids tolerate this better)

36
Q

anesthetic use mainly limited to small children

A

ketamine

37
Q

IV anesthetic that causes cardiac stimulation via increased SNS outflow

A

ketamine

38
Q

IV benzodiazepines used for anesthetic [2]

A

midazolam
remimazolam

short-acting 2-4 hours

39
Q

which IV benzodiazepine is faster and shorter acting, allowing it to be used for induction?

A

remimazolam

40
Q

can be used for maintenance of anesthesia with other agents or for conscious sedation

A

IV benzodiazepines

41
Q

IV benzodiazepines have good […] effect

A

amnestic

42
Q

antagonist […] can accelerate recovery when using IV benzodiazepines

A

flumazenil

43
Q

can achieve anesthesia with sufficient dose

provides excellent post-op analgesia

A

fentanyl

useful in patients with compromised CV function

44
Q

nomenclature of ___cur___ indicates they belong to what class?

A

competitive nicotinic antagonists

45
Q

competitive nicotinic antagonists [4]

A

d-tubocurarine
atracurium
rocuronium
parcuronium

46
Q

depolarizing nicotinic agonist

A

succinylcholine

47
Q

depolarizing nicotinic agonist with very short duration of action

less than 8 min

A

succinylcholine

48
Q

competitive neuromuscular blocking agents are nicotinic […]

A

antagonists

49
Q

depolarizing neuromuscular blocking agents are nicotinic […]

A

agonists

50
Q

[competitive/depolarizing] neuromuscular blocking agents cause partial persistent depolarization

A

depolarizing

51
Q

[competitive/depolarizing] neuromuscular blocking agents cause fasiculations

A

depolarizing

52
Q

[competitive/depolarizing] neostigmine causes reversal of the block

A

competitive

53
Q

many paralytics cause […] release, leading to hypotension and bronchospasm

A

histamine

(esp. d-tubocurarine)

54
Q

paralytic that can cause muscle pain due to fasciculations

A

succinylcholine

55
Q

reversal agents for neuromuscular blocking agents [2]

A

neostigmine (cholinesterase inhibitor)
sugammadex (SRBA)

56
Q

encapsulates rocuronium and renders it unavailable for binding at NMJ

A

sugammadex

57
Q

increase the potency and duration of competitive antagonist neuromuscular blocking agents [2]

A

antibiotics
inhalable anesthetics

58
Q

produce readily reversible anesthesia

A

inhaled anesthetics

59
Q

do fixed or inhaled anesthetics produce rapid, smooth induction?

A

fixed

however, slow elimination

60
Q

produces a relatively slow induction and emergence and is hepatotoxic
no longer used in USA

A

halothane

61
Q

etomidate is a […] anesthetic

A

fixed

62
Q

not sufficiently potent to produce surgical anesthesia or muscle relaxation,
hematoxic

A

nitrous oxide

63
Q

inhaled anesthetic that produces rapid induction and emergence, good muscle relaxation, and has potential renal toxicity

A

sevoflurane

64
Q

medium rate of induction and emergence, has no known organ toxicities, and produces moderate skeletal muscle relaxation

A

isoflurane

65
Q

definition of MAC

A

percentage of anesthetic in the inspired air when there is no response to a skin incision in 50% of patients

66
Q

MAC is […] proportional to potency

A

inversely

67
Q

hallucinations and other emergence phenomena are associated with

A

ketamine

(disturbing to adults, but don’t bother small children)

68
Q

thiopental accumulates in […] tissue

A

adipose

causes long duration of action

69
Q

non-competitive antagonist at NMDA receptor

A

ketamine

70
Q

inhaled anesthetic that can cause myocardial depression

A

nitrous oxide

also desflurane, minimally

71
Q

primarily used for induction and balanced anesthesia in patients at risk for hypotension

A

etomidate

no analgesia

72
Q

barbiturate that is less lipophilic and does not penetrate the BBB rapidly enough to be used for induction

A

phenobarbital

73
Q

widely used because its hepatic metabolism is roughly 10x faster than IV barbiturates, leading to a more rapid recovery and lower likelihood of accumulation in adipose

A

propofol

74
Q

which barbiturate is most likely to be used as an induction agent

A

thiopental

75
Q

often used as a carrier gas

A

nitrous oxide

76
Q

the lower the MAC, the […] the agent

A

more potent

77
Q

has the greatest influence on induction and emergence

A

oswald coefficient

(blood:gas partition coefficient)

78
Q

the less soluble the agent in blood, the […] the rate of induction

A

more rapid

(blood:gas partition coefficient)

oswald coefficient

79
Q

the potency and duration of […] is increased when used in combination with inhaled anesthetics

A

nicotinic antagonists

80
Q

causes fasciculations because it is a nicotinic agonist

A

succinylcholine

81
Q

short duration of action (less than 8 min) makes it suitable for short procedures like ECT

A

succinylcholine

82
Q

reversal agent for nicotinic antagonists

A

neostigmine

83
Q

reversal agent for rocuronium

A

sugammadex

84
Q

hypotension and brochospasm are most likely due to […] release

A

histamine

(atracurium and morphine cause histamine release)

85
Q

are mixed anesthetics used to maintain anesthesia?

A

no, make it difficult to control

BMB Test 4 (14 decks)

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