chapter 11 and 16- local and general anesthetic pharmacology Flashcards
what inhaled general anesthetic can be used to treat malignant hyperthermia caused by inhaled general anesthetics
dantrolene
what is a contraindication for enflurane use
seizures and epilepsy
what additional adverse effect can halothane cause (in addition to those of isoflurane and enflurane)
hepatitis and fatal hepatic necrosis
what are some adverse effects seen with nitrous oxide use
expansion of air cavities (pneumothorax, obstructed middle ear, obstructed loop of bowel, intracranial air)
what type of spasms can desflurane cause
laryngeal
what intravenous general anesthetic can be used for sedation of mechanically ventilated patients
propofol
what are some adverse effects seen with propofol
cardiovascular and respiratory depression; injection-site reaction
what are some clinical uses for thiopental besides induction of anesthesia
narcoanalysis, elevated intracranial pressure, seizure
what intravenous general anesthetic can have adverse effect of laryngeal spasm, hemolytic anemia, and radial neuropathy
thiopental
what are some contraindications for thiopental use
acute intermitted porphyria or variegate porphyria
what is an ultra-short acting barbiturate capable of inducing surgical anesthesia within seconds
thiopental
what IV anesthetic can be used for rapid sequence intubation
etomidate
what IV anesthetic can cause myoclonus
etomidate
what does etomidate bind to
interface between the alpha and beta subunits of the GABAa receptor
what IV anesthetic can cause minimal cardiopulmonary depression
etomidate
what IV anesthetic may cause the patient to be awake but is not actually awake, and what is the term to describe this
ketamine: term to describe this is dissociative anesthesia/analgesia
what IV anesthetic can cause increased intracranial pressure, hallucinations, vivid dreams, psychiatric symptoms
ketamine
what is a contraindication for ketamine use
severe hypertension
what does ketamine antagonize
NMDA receptor
how does ketamine increase cardiac output
by increasing sympathetic outflow
what IV anesthetic can be particularly useful in emergency trauma situations
ketamine
what medication can reverse benzodiazepine effects
flumazenil
what medication reverses the action of opioids
naltrexone
what solubility determines onset/offset
solubility of gas for blood
what solubility of gas determine potency
solubility of gas for lipids
what local anesthetics are amides
lidocaine, mepivacaine, bupivacaine
what amide local anesthetic is most cardiotoxic
Bupivacaine
what local anesthetics are esters
procaine, cocaine, benzocaine, tetracaine
how do you treat methemoglobinemia caused by local anesthetics
methylene blue
describe the onset and recovery with propofol
rapid onset and rapid recovery
what side effect can propofol particularly cause in children
acidosis
describe the onset and recovery with etomidate
rapid onset and moderately fast recovery
describe the onset and recovery with ketamine
moderately rapid onset and recovery
describe the onset and recovery of fentanyl, remifentanil, aifentanil
slow onset and recovery
describe the onset and recovery with thiopental
rapid onset and recovery
describe the onset and recovery with midazolam, lorazepam
slow onset and recovery
describe the onset and recovery with sevoflurane
rapid onset and recovery
describe the rate of onset and recovery with osoflurane
medium rate of onset and recovery
what inhaled anesthetic is most likely to cause hepatotoxicity
halothane
what inhaled anesthetic is most likely to cause nephrotoxicity
methoxyflurane
what type of procedures is thiopental best for
short surgical procedures
what is midazolam used most for
endoscopy; used adjectively with gaseous anesthetics and narcotics
what is the order of loss with local anesthetics
pain, temperature, touch, pressure (in order from first to last)
what local anesthetic is most likely to adversely cause severe cardiovascular toxicity
bupivacaine
what local anesthetic is most likely to adversely cause methemoglobinemia
benzocaine
what local anesthetic is most likely to adverse cause arrhythmias
cocaine
What is the mechanism of action of ester-linked local anesthetic
Inhibit voltage-gated sodium channels in excitable cell membranes
What ester linked local anesthetic is given epidurally before delivery (pregnancy delivery)
2-chloroprocaine
What ester linked local anesthetic can cause contact dermatitis
Procaine, 2-chloroprocaine
What ester linked local anesthetic can cause drug-induced keratoconjunctivitis
Tetracaine
Who should you avoid large doses of tetracaine in
Patients with heart block
What ester linked local anesthetic can be used for diagnosis of horners syndrome pupil
Cocaine
What local anesthetic is also a class 1 antiarrhythmic medication
Lidocaine
What may need to be co-administered with lidocaine in order to prolong duration of action
Epinephrine
What local anesthetic is most commonly used for dental infiltration anesthesia
Prilocaine
What local anesthetic is used for infiltration, regional, epidural, and spinal anesthesia as well as sympathetic nerve block
Bupivacaine
What is the primary use for articaine
Dentristry
What are some adverse effects of articaine
Infection at site of injection (especially lumbar puncture sites); shock
What general anesthetic is often used in pediatrics due to its non-irritating smell
Halothane
