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CNS I > Clinical Anesthesia > Flashcards

Clinical Anesthesia Flashcards

1. Describe the rationale for the use of combinations of anesthetic agents to achieve safe and effective surgical anesthesia. 2. Provide examples of different combinations of anesthetic agents that could be used to achieve safe and effective anesthesia 3. Describe the mechanisms of common drug interactions and list the resulting effects in the use of combinations of anesthetic agents.

1
Q

General goals of anesthesia

A

analgesia
amnesia
unconciousness
supression of responses to surgery

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2
Q

responses to surgery needed to be supressed

A

motor, CV, pain, hormonal

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3
Q

midazolam given for

A

preop sedation

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4
Q

fentanyl given for

A

preop sedation, anesthetic maintainance

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5
Q

propofol given for

A

anesthetic induction

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6
Q

cis-atracurium given for

A

muscle relaxant

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7
Q

isoflurane given for

A

anesthetic maintenance

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8
Q

furosemide and dexamethasone given for

A

reduction of ICP

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9
Q

phenytoin given for

A

prevention of postop seizures

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10
Q

neostigine and glycopyrrolate given for

A

reversal of NMB

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11
Q

ondansetron given for

A

post op nausea

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12
Q

rationale for using multiple drugs

A

max benefit, minimize problems

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13
Q

advantages for use of multiple drugs

A

allows selection of best drug for desired targeted effect, smaller doses

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14
Q

possible number of interactions with 7 drugs

A

21

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15
Q

define pharmacokinetic interaction

A

when precense of one drug alters the serum concentration of the 2nd drug

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16
Q

define pharmacodynamic interaction

A

precense of one drug alters concentration vs effect relationships for a 2nd drug

17
Q

dehine pharmaceutcal drug

A

when precense of one drug causes another or both to precipitate or become less soluble

18
Q

benzo/opoid combo used for

A

preop sedation (beneficial at low doses)

19
Q

type of benzo/opioid interaction

A

dynamic and kinetic interaction

20
Q

preop sedation/induction agent interaction type

A

dynamic and synergistic as well as mutual interaction

21
Q

define 2nd gas effect

A

uptake of 2nd gas reduces lung volume and increases concentration and uptake of 2nd gas

22
Q

combo of inhaled agent and muscle relaxant NOT TO BE USED

A

N2O and NDBD

23
Q

type of interaction in inhaled agent and NDBD

A

dynamic synergistic (increases effect of NDBD)

24
Q

labeltol/hydralazine combo good fir

A

decreases BP without increasding HR (good for coronary disease)

25
Q

type of reaction of labeltol/hydralazine

A

dynamic

26
Q

most common drugs causing n/v

A

N2O and opioids

27
Q

risk factors for post op N/V

A

nonsmoker, female, previous history, long general anesthetic

28
Q

drugs to treat post op n/v

A

ondansetroon and droperidol

29
Q

MOST effective combo for post op n/v

A

5HT3 blockers and steroids

30
Q

result of etomindate/Sch interactin

A

pHdifferences can lead to precipitate

31
Q

result of phenytoin/cis-atracurium interaction

A

pharmadynamic antagonism of NdBd

32
Q

type of case when phenytoin/cis-atracurium interaction can be particularly bad

A

neurosurgical case

33
Q

way to monitor phenytoin/cis-atracurium interaction

A

tittration with nerve stimulator

34
Q

drugs that can negatively interact with ephedrine

A

non selective MAO inhibitors, meth, cocaine,

CNS I (36 decks)

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