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HLSC 220 - Pharmacotherapeutics for Healthcare Professionals > Chapter 30 - General Anaesthetics > Flashcards

Chapter 30 - General Anaesthetics Flashcards

1
Q

What do general anaesthetics do?

A

-produce unconsciousness
-lack of pain response

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2
Q

How are general anaesthetics administered?

A

-inhalation
-intravenous

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3
Q

What is balanced anaesthesia?

A

a technique used to compensate for an ideal anesthetic that uses a combo of drugs

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4
Q

Goals of Balanced Anaesthesia:

A

-smooth induction
-rapid analgesia
-muscle relaxation

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5
Q

What inhaled drugs make up balanced anaesthesia?

A

-propofol
-NM blocking agents
-opioids
-nitrous oxide

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6
Q

Transmission is enhanced at ____________ synapses

A

inhibitory

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7
Q

Transmission is depressed at ______________ synapses

A

excitatory

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8
Q

All agents used today enhance activation of GABA receptors except…

A

nitrous oxide

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9
Q

What is the minimum alveolar concentration (MAC)?

A

the minimum concentration of drug in the alveolar air that will produce immobility in 50% of patients exposed to pain

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10
Q

Low MAC = _______ anaesthetic potency

A

high

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11
Q

Uptake of Inhaled Anaesthetics

A

in the lungs, greater concentration = more rapid uptake

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12
Q

What determines distribution of inhaled anaesthetics?

A

regional blood flow

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13
Q

What are the areas of fastest uptake?

A

-brain
-kidney
-heart

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14
Q

How are inhaled anaesthetics eliminated?

A

in expired breath via lungs

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15
Q

What are the adverse effects of inhaled anaesthetics?

A

-respiratory and cardiac depression
-dysrhythmias (sensitization to catecholamines)
-malignant hyperthermia
-aspiration of gastric contents (USE ET TUBE!!!)
-hepatotoxicity

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16
Q

Why are pre-anaesthetic medications given?

A

given to reduce anxiety, produce pre-op amnesia, relieve post-op pain

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17
Q

What are pre-anaesthetic benzodiazepines used for?

A

reduce anxiety and produce amnesia

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18
Q

What are pre-anaesthetic opioids used for?

A

pain and cough reduction

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19
Q

What are pre-anaesthetic clonidine used for?

A

used for hypertension

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20
Q

What are pre-anaesthetic anti-cholinergics used for?

A

decrease risk of bradycardia

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21
Q

What are some neuromuscular blocking agents?

A

succinylcholine and pancuronium

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22
Q

What are neuromuscular blocking agents used for?

A

reduce amount of anaesthesia needed and prevent skeletal muscle contraction

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23
Q

What medications are given post-anaesthesia?

A

-analgesics
-antiemetics
-muscarinic antagonists

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24
Q

What are post-anaesthetic analgesics used for?

A

pain relief (mild - acetaminophen and severe - opioids)

25
Q

What are post-anaesthetic antiemetics?

A

-ondansetron
-promethazine
-droperidol

26
Q

What are post-anaesthetic muscarinic antagonists used for?

A

bethanechol - abdominal distension and urinary retention

27
Q

Properties of sevoflurance

A

rapid induction and recovery

28
Q

Nitrous oxide aka

A

laughing gas

29
Q

What is the prototype of the volatile inhalation anaesthetics?

A

isoflurane

30
Q

Properties of isoflurane:

A

-rapid action
-depth can be raised or lowered easily
-weak analgesic
-inadequate muscle relaxation for surgery

31
Q

Isoflurane induction is produced with __________

A

propofol

32
Q

What drug must be added to isoflurane to improve muscle relaxation for surgery?

A

pancuronium

33
Q

What are the adverse effects of isoflurance?

A

-hypotension
-respiratory depression
-nausea
-vomiting
-decreased urine output

34
Q

Nitrous oxide has a _____ anaesthetic potency and a _____ analgesic potency

A

low; high

35
Q

What is nitrous oxide never used as?

A

a primary anaesthetic

36
Q

___% nitrous oxide gives equal pain relief to morphine

A

20

37
Q

What are the side effects of nitrous oxide?

A

nausea and vomiting

38
Q

Name the IV anaesthetics:

A

-short-acting barbiturates
-benzodiazepines
-propofol
-etomidate
-ketamine

39
Q

The neuroleptic-opioid combination is…

A

droperidol and fentanyl

40
Q

Thiopental properties:

A

-rapid onset
-slow recovery
-CV and respiratory depression
-pain with injection

41
Q

Etomidate properties:

A

-rapid onset
-fast recovery
-excitatory effects during induction
-adrenocortical suppression
-less CV and resp depression
-injection site pain

42
Q

Propofol properties:

A

-rapid onset
-very rapid recovery
-CV and resp depression
-injection pain

43
Q

What is the most common induction agent?

A

Propofol

44
Q

Ketamine properties:

A

-slow onset
-post-anaesthetic effects
-psychomimetic effects
-N&V
-no injection pain

45
Q

What is the primary use of benzodiazepines?

A

IV induction of anaesthesia

46
Q

Properties of diazepam?

A

-loc in 1 min
-little muscle relaxation

47
Q

Properties of Midazolam:

A

-unconsciousness in 80s
-dangerous cardiorespiratory effects

48
Q

When does unconsciousness develop and last with propofol?

A

develops in 60s and lasts 3-5 mins

49
Q

What is propofol used for?

A

induction and maintenance of analgesia

50
Q

What are the adverse effects of propofol?

A

-respiratory depression
-hypotension
-risk of bacterial infection
-abuse

51
Q

What is etomidate?

A

a potent hypnotic agent

52
Q

What is etomidate used for?

A

induction

53
Q

What are adverse effects of repeated etomidate use?

A

-hypotension
-oliguria
-electrolyte disturbances
-N&V

54
Q

What is the preferred drug for patients with CV disorders?

A

etomidate

55
Q

What are the effects of Ketamine?

A

-dissociative anaesthesia
-sedation
-immobility
-analgesia
-amnesia

56
Q

What are the adverse effects of ketamine?

A

-hallucinations
-disturbing dreams
-delirium

57
Q

What is ketamine used for?

A

young children with minor procedures

58
Q

What environment should ketamine be used in?

A

a soothing environment

HLSC 220 - Pharmacotherapeutics for Healthcare Professionals (18 decks)

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