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LECOM pharmacology notecards > chapter 11 and 16- local and general anesthetic pharmacology > Flashcards

chapter 11 and 16- local and general anesthetic pharmacology Flashcards

1
Q

what inhaled general anesthetic can be used to treat malignant hyperthermia caused by inhaled general anesthetics

A

dantrolene

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2
Q

what is a contraindication for enflurane use

A

seizures and epilepsy

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3
Q

what additional adverse effect can halothane cause (in addition to those of isoflurane and enflurane)

A

hepatitis and fatal hepatic necrosis

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4
Q

what are some adverse effects seen with nitrous oxide use

A

expansion of air cavities (pneumothorax, obstructed middle ear, obstructed loop of bowel, intracranial air)

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5
Q

what type of spasms can desflurane cause

A

laryngeal

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6
Q

what intravenous general anesthetic can be used for sedation of mechanically ventilated patients

A

propofol

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7
Q

what are some adverse effects seen with propofol

A

cardiovascular and respiratory depression; injection-site reaction

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8
Q

what are some clinical uses for thiopental besides induction of anesthesia

A

narcoanalysis, elevated intracranial pressure, seizure

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9
Q

what intravenous general anesthetic can have adverse effect of laryngeal spasm, hemolytic anemia, and radial neuropathy

A

thiopental

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10
Q

what are some contraindications for thiopental use

A

acute intermitted porphyria or variegate porphyria

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11
Q

what is an ultra-short acting barbiturate capable of inducing surgical anesthesia within seconds

A

thiopental

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12
Q

what IV anesthetic can be used for rapid sequence intubation

A

etomidate

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13
Q

what IV anesthetic can cause myoclonus

A

etomidate

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14
Q

what does etomidate bind to

A

interface between the alpha and beta subunits of the GABAa receptor

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15
Q

what IV anesthetic can cause minimal cardiopulmonary depression

A

etomidate

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16
Q

what IV anesthetic may cause the patient to be awake but is not actually awake, and what is the term to describe this

A

ketamine: term to describe this is dissociative anesthesia/analgesia

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17
Q

what IV anesthetic can cause increased intracranial pressure, hallucinations, vivid dreams, psychiatric symptoms

A

ketamine

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18
Q

what is a contraindication for ketamine use

A

severe hypertension

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19
Q

what does ketamine antagonize

A

NMDA receptor

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20
Q

how does ketamine increase cardiac output

A

by increasing sympathetic outflow

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21
Q

what IV anesthetic can be particularly useful in emergency trauma situations

A

ketamine

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22
Q

what medication can reverse benzodiazepine effects

A

flumazenil

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23
Q

what medication reverses the action of opioids

A

naltrexone

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24
Q

what solubility determines onset/offset

A

solubility of gas for blood

25
Q

what solubility of gas determine potency

A

solubility of gas for lipids

26
Q

what local anesthetics are amides

A

lidocaine, mepivacaine, bupivacaine

27
Q

what amide local anesthetic is most cardiotoxic

A

Bupivacaine

28
Q

what local anesthetics are esters

A

procaine, cocaine, benzocaine, tetracaine

29
Q

how do you treat methemoglobinemia caused by local anesthetics

A

methylene blue

30
Q

describe the onset and recovery with propofol

A

rapid onset and rapid recovery

31
Q

what side effect can propofol particularly cause in children

A

acidosis

32
Q

describe the onset and recovery with etomidate

A

rapid onset and moderately fast recovery

33
Q

describe the onset and recovery with ketamine

A

moderately rapid onset and recovery

34
Q

describe the onset and recovery of fentanyl, remifentanil, aifentanil

A

slow onset and recovery

35
Q

describe the onset and recovery with thiopental

A

rapid onset and recovery

36
Q

describe the onset and recovery with midazolam, lorazepam

A

slow onset and recovery

37
Q

describe the onset and recovery with sevoflurane

A

rapid onset and recovery

38
Q

describe the rate of onset and recovery with osoflurane

A

medium rate of onset and recovery

39
Q

what inhaled anesthetic is most likely to cause hepatotoxicity

A

halothane

40
Q

what inhaled anesthetic is most likely to cause nephrotoxicity

A

methoxyflurane

41
Q

what type of procedures is thiopental best for

A

short surgical procedures

42
Q

what is midazolam used most for

A

endoscopy; used adjectively with gaseous anesthetics and narcotics

43
Q

what is the order of loss with local anesthetics

A

pain, temperature, touch, pressure (in order from first to last)

44
Q

what local anesthetic is most likely to adversely cause severe cardiovascular toxicity

A

bupivacaine

45
Q

what local anesthetic is most likely to adversely cause methemoglobinemia

A

benzocaine

46
Q

what local anesthetic is most likely to adverse cause arrhythmias

A

cocaine

47
Q

What is the mechanism of action of ester-linked local anesthetic

A

Inhibit voltage-gated sodium channels in excitable cell membranes

48
Q

What ester linked local anesthetic is given epidurally before delivery (pregnancy delivery)

A

2-chloroprocaine

49
Q

What ester linked local anesthetic can cause contact dermatitis

A

Procaine, 2-chloroprocaine

50
Q

What ester linked local anesthetic can cause drug-induced keratoconjunctivitis

A

Tetracaine

51
Q

Who should you avoid large doses of tetracaine in

A

Patients with heart block

52
Q

What ester linked local anesthetic can be used for diagnosis of horners syndrome pupil

A

Cocaine

53
Q

What local anesthetic is also a class 1 antiarrhythmic medication

A

Lidocaine

54
Q

What may need to be co-administered with lidocaine in order to prolong duration of action

A

Epinephrine

55
Q

What local anesthetic is most commonly used for dental infiltration anesthesia

A

Prilocaine

56
Q

What local anesthetic is used for infiltration, regional, epidural, and spinal anesthesia as well as sympathetic nerve block

A

Bupivacaine

57
Q

What is the primary use for articaine

A

Dentristry

58
Q

What are some adverse effects of articaine

A

Infection at site of injection (especially lumbar puncture sites); shock

59
Q

What general anesthetic is often used in pediatrics due to its non-irritating smell

A

Halothane

LECOM pharmacology notecards (22 decks)

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