Blocking Drugs - 2 Flashcards
What are the 6 inhaled anesthetics?
Desflurane
Enflurane
Halothane
Isoflurane
Sevoflurane
Nitrous oxide
Facilitate GABA-mediated inhibition: block brain NMDA and ACh-N receptors
MOA of which drug?
All inhaled anesthetics
inhaled anesthetics increase ___________.
inhaled anesthetics increase cerebral blood flow.
Which two drugs decrease cardiac output?
All others cause vasodilation
enflurane & halothane
all inhaled anesthetics decrease ________.
all inhaled anesthetics decrease respiratory functions.
Which drug causes lung irritation?
desiflurane
Rate of onset and recovery vary by blood: gas partition coefficient
recovery mainly due to redistribution from brain to other tissues
P-kinetics of which drug?
inhaled anesthetics
What are the toxicities of inhaled anesthetics?
extensions of effects on brain, heart/vasculature, lungs.
What are the drug interactions of inhaled anesthetics?
additive CNS depression with many agents, especially opioids and sedative-hypnotics
What plays an important role in the practice of modern anesthesia?
IV non-opioid anesthetics
Used to facilitate rapid induction of anesthesia and have replaced inhalation as the preferred method of anesthesia induction in most settings except for pediatric anesthesia
Which drugs?
IV Anesthetics
Provide sedation during monitored anesthesia care and for patients in intensive care (ICU) settings.
Which drug?
IV Anesthetics
Not ideal anesthetic drugs in the sense of producing all and only the five desired effects (unconsciousness, amnesia, analgesia, inhibition of autonomic reflexes, and skeletal muscle relaxation)
Which drug?
IV Anesthetics
What 4 drugs facilitate GABA-mediated inhibition of Gaba-A receptors?
Barbiturates, benzodiazepines, etomidate, and propofol
facilitate GABA-mediated inhibition at GABAA receptors
MOA of which drug?
Thiopental, Thioamylal, Methohexital
Pharmacologic effects of Thiopental, Thioamylal, Methohexital (Barbiturates)
Circulatory and respiratory depression
decrease intracranial pressure
High lipid solubility—fast onset and short duration due to redistribution
PK of which drug?
Barbiturates:
Thiopental, Thioamylal, Methohexital
Extensions of CNS depressant actions
additive CNS depression with many drugs
Toxicities and Interactions of which drug?
Barbiturates:
Thiopental, Thioamylal, Methohexital
Slower onset, but longer duration than barbiturates
Which drug?
Midazolam
Postoperative respiratory depression reversed by flumazenil
Toxicities and Interactions of which drug?
Midazolam
Blocks excitation by glutamate at NMDA receptors
MOA of which drug?
Ketamine
What are the pharmacologic effects of ketamine?
analgesia, amnesia and catatonia but consciousness retained
CV stimulation
PK of ketamine?
Moderate duration of action—hepatic metabolism
Pharmacologic effects of Etomidate
Minimal effects on CV and respiratory functions
PK of Etomidate
Short duration due to redistribution
What are the 4 opioids?
Fentanyl
Alfentanil
Remifentanil
Morphine
Interact with μ, κ, and δ opioid receptors
MOA of which drug?
Opioids:
Fentanyl
Alfentanil
Remifentanil
Morphine
Pharmacologic Effects of Opioids
Marked analgesia, respiratory depression
PK of opioids
Alfentanil and remifentanil: fast onset (induction)
What are the 2 phenols?
Propofol
Fospropofol
Vasodilation and hypotension • negative inotropy. Fospropofol water-soluble
Pharmacologic effects of which drug?
Propofol, Fospropofol
PK of Phenols (Propofol, Fospropofal)
Fast onset and fast recovery due to inactivation
