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PHARMA 2.0 > CNS 3 - Anesthetics > Flashcards

CNS 3 - Anesthetics Flashcards

0
Q

This is described as having INCREASE tolerance to pain AND DECREASE perception to pain

A

ANALGESIA

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1
Q

Give the factors affecting the extent of anesthetic drug effects

A

Specific Drug. Dosage. Clinical situation

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2
Q

Described as having no recall of events

A

Amnesia

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3
Q

Alcohol effect to the heart.

A

Depression of myocardial contractility

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4
Q

Smooth muscle effect of alcohol

A

Vasodilation.

Direct smooth muscle relaxation

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5
Q

Thiamine deficiency associated with alcoholism causes what

A

Wernicke-Korsakoff syndrome

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6
Q

What organs are affected with acute alcohol consumption?

A

CNS.
Heart.
Smooth muscle

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7
Q

What organs are affected during chronic alcohol consumption?

A 
Liver and GIT 
Blood
Fetal alcohol syndrome 
Immune system
Increased risk of cancer
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8
Q

Binge drinking causes what heart problem?

A

Arrythmias

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9
Q

What anemia can be derived from chronic alcoholism?

A

IDA. Anemia from decreased folate synthesis

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10
Q

What common infection is associated with chronic alcoholism?

A

Lung infection

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11
Q

Gynecomastia is associated with alcoholism. True or false

A

True

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12
Q

Alcohol increases estradiol. True or false.

A

True

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13
Q

What drug has decreased metabolism due to acute alcohol consumption?

A

TCAs
Sedative-hypnotics
Phenothiazine - alpha 1

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14
Q

Activation of CYP2E1 is triggered with acute or chronic alcoholism.

A

Chronic

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15
Q

Alcohol has what effect on anti depressants.

A

Additive effect

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16
Q

Alcohol does what on OHA and vasodilator effects

A

Potentiates

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17
Q

What cancers are commonly associated with alcoholism?

A

Stomach, mouth, pharynx, larynx, esophagus, liver, breast

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18
Q

What electrolyte must be monitored during hypoglycemia and ketosis?

A

Phosphate level

K and Magnesium

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19
Q

What must be given to all cases of alcoholism?

A

Thiamine

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20
Q

What can be used for detoxification on alcohol withdrawal?

A

BDZ

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21
Q

What must be prevented in patients having alcohol withdrawal?

A

SAD

Seizure
Arrythmia
Delirium

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22
Q

Among anxiolytics used in alcohol withdrawal which can be used in patients who have compromises liver function.

A

Short acting. Lorazepam.

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23
Q

Preferred BDZs for alcohol withdrawal.

A

Long acting. Diazepam. Chlordiazepoxide

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24
Q

With what kind of drugs can concentration effect can be seen

A

Low MAC and more soluble

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25
Q

The more soluble (mod to high) the drug is in blood there is a significant increase in arterial tension. True or false.

A

True

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26
Q

Low blood coefficient with increase rr will lead to a slight increase in arterial tension

A

True

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27
Q

Opiod administration slows the onset of anesthesia

A

True

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28
Q

Increased pulmonary flow increases arterial tension specially for more soluble drugs.

A

False. Inversely

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29
Q

High AV difference fastens onset

A

False. Indirectly proportional

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30
Q

Anesthetics accumulate in tissue over time but more slowly to where

A

Muscle and Skin

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31
Q

Is AV difference synonymous with increase extraction fraction in tissues thus decrease uptake to the brain

A

True

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32
Q

Frequently abused by dentists

A

Nitrous oxide

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33
Q

Rarely results to hepatitis

A

Halothane

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34
Q

Pungent that leads to coughing and systemic effects

A

Desflurane

Mabaho si Ate Dess.

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35
Q

Reacts with silica or co2 absorbents

A

Sevoflurane

S - ilica

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36
Q

What compound is formed with the combination of silica and sevoflurane. It effect?

A

Olefinic compound or compound A. Nephrotoxic

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37
Q

Is it true that anesthetics shortens labor?

A

No. Prolonged. Since it relaxes uterine muscles

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38
Q

Halothane is also associated with HYPOTENSION. True or false?

A

True

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39
Q

This drug sensitized the myocardium to catecholamines thus leading to arrythmia

A

Halothane

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40
Q

A complication arising from combination of halothane and nm blockin agents such as succinylcholine

A

Malignant hyperthermia

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41
Q

The pathophysiology lies with increase calcium release from RYR1 receptor

A

Malignant hyperthermia

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42
Q

What do u give for OD of depolarizing agent (succi)

A

Pseudocholinesterase

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43
Q

What do u give for nondepolarizing nm blocker OD

A

AChE inhibitors

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44
Q

During anesthesia, wof increasing icp and pco2 sinc patient may have no s/sx

A

True

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45
Q

Which has a faster onset. Inhaled or intravenous

A

IV, even with rapid inhaled anesth

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46
Q

IV agents are commonly used for induction.

A

True

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47
Q

Is propofol adequate as sole anesthetic when combined with nitrous oxide for opd procedures?

A

True

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48
Q

What makes IV drugs good for OPD procedures?

A

Short / rapid recovery

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49
Q

A barbiturate that is mainly used for induction

A

Thipental

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50
Q

Why is thiopental not used for maintenance?

A

It is short acting and decreases respi and cardiac fxn and has increase context sensitive half time

51
Q

What iv anesth is desired for patients with brain injury

A

Thiopental

52
Q

Its ok to use thiopental for patients with porphyria

A

False

53
Q

Methohexital

Thiamylal

A

Same effect

Same structure

54
Q

Preferred over thiopental and for patients udergoing ECT

A

Methohexital. Even shorter elimination

55
Q

Propofol has rapid recovery same as sevo and desflu

A

True

56
Q

This are use as preop meds

A

Bdz

57
Q

Give the flow of redistribution ng thiopental

A

Blood
Brain and viscera
Lean tissues
Fat

58
Q

Bdz of choice for parenteral adminiatration

A

Midazolam. Water soluble

59
Q

Are non soluble iv bdz that causes pain and irritation

A

Diaz and loraz

60
Q

Used in lovectomy

A

Midaz

61
Q

Which drug has anterograde amnesia

A

Midazolam

62
Q

Antidote for bdz

A

Flumazenil

63
Q

Only IV anesth that has both anesthesia and analgesia

A

Ketamine

64
Q

Manifests catatonia with or without loss of consciousness.

A

Ketamine

65
Q

What is the diff between ketamine and thiopental in terms of cerebral blood flow

A

Ketamine increases CBF thus must not be used for px with brain injuy

66
Q

Inhibits reuptake of NE leading to emergence rxns

A

Ketamine

67
Q

Propofol and BDZs offset ketamine

A

True

68
Q

Iv anesth that has VERY RAPID onset and recovery

A

Propofol

Rapid - thio
More rapid - metho

69
Q

Can be used as an induction and maintenance for OPD sx

A

Propofol

70
Q

Doc for ambulatory surgery

A

Propofol

71
Q

Ketamine, Etomidate and Propofol all doesnt increase context half time. Why is propofol desired among them?

A

Ketamine - CV effect
Etomidate - adrenocortical suppression
Propofol - anti emetic pa nga eh pero not for kiddos

72
Q

What drug is usually combined in LARGE DOSES with BDZ

A

Opiod analgesics

73
Q

Opiods are also good for patients with ciculatory reserve

A

True

74
Q

Give two drugs used for patients with limited cardiac reserve

A

Opiod

Etomidate

75
Q

This opiod is used to minimize ventilatory depression

A

Remifetanyl

76
Q

What opiod with IV use causes chest wall rigidity?

A

Fentanyl

77
Q

When you combine fentanyl with droperidol and NO what happens?

A

Neuroleptanesthesia

78
Q

What mainly cause neurolept rxn

A

Droperidol

79
Q

It mainly blocks ur NMDA RECEPTOR and Glutamic acid

A

Ketamine

80
Q

Can cause central excitatory activity

A

Methohexital

81
Q

Etomidate is not ideal for combination with opiods

A

False

82
Q

Carboxylated imidazole derivative

A

Etomidate

83
Q

Aside from being used in px with cardiac reserve, this drug also has minimal cv and respi depression

A

Etomidate

84
Q

Despite having m cv and respi effect this drug is not used for maintenance because it causes adrenocortical suppression

A

Etomidate

85
Q

Etomidate causes pain on injection, myoclonus and postop n and v

A

True

86
Q

This class of anesth effectively and reversibly blocks impulse conduction along NERVE axons

A

Local anesth

87
Q

For LA to be effective it must be injected in alkaline area

A

True

88
Q

Ionized form facilitates penetration trough membranes

A

False. Non ionized

89
Q

Non ionized facilitates the membrane activation

A

False. Ionize

90
Q

Esters have how many I

A

ISA LANG

Procaine
Cocaine
Tetracaine
Benzocaine

91
Q

Amides have how many I

A

DALAWA

Lidocaine
Mepivacaine
Prilocaine
Bupivacaine

92
Q

Among the Amides which is the fastest

A

PRILOCAINE - mabilis sa PRI (free)

93
Q

MOA is the blockade of voltage gated sodium channel

A

LA

94
Q

Resting form of channels

A

Im resting in HEAVEN

M close H open

95
Q

The larger the nerve fiber the more sensitive it is

A

False. Smaller sensiive

96
Q

In terms of firin freq, who is most sensitive

A

High firing

97
Q

Between sensory and motor which has high firing rate?

A

Sensory - high and long AP (B, C)

Motor - low and short (A - dbga)

98
Q

Some LA have nm blocking property

A

Lidocaine in low dose. Antiarrythmic

99
Q

All LA are vasodilators except?

A

Cocaine - VC

100
Q

VC drugs are also effective in longg acting drug such as bupovacaine and ropivacaine

A

No! Only for short acting

101
Q

Shortest LA

A

Procaine

102
Q

What causes allergy in La

A

Paba detivatives of esters

103
Q

LA binds to the internal or external sodium channel. The toxins?

A

Internal. External

104
Q

From puffer fish

A

Tetrodotoxin

105
Q

From dinoflagellates

A

Saxitoxin

106
Q

Both tetro and saxi binds to cardiac and nerve cell? Thus decreasimg conduction

A

Trie

107
Q

This toxin from eel and frogs keep channels open causing flaccid paralysis

A

True

Ciguatoxin
Batrachotoxin

108
Q

2 types of non depo

A

Steroid - onium

Isoquinolone - urium

109
Q

This non depo is implicates with malignant hyper

A

Tubo

Halogenated Plus NM

110
Q

Why is tubo called an arrow poison

A

Releases histamine and blocks depo

111
Q

Pancuronium

A

Steroid
Increase BP

Log acting

112
Q

Antracurium

A

Isoquinolone

Intermediate acting

113
Q

Undergoes exhaustive methylation

A

Hoffman elimination producing luadanosine

114
Q

Shortest of all non depo

A

Mivacurium

115
Q

NON DEPO - MAP

A

Histamine
Hoffman
BP

116
Q

Reverses non depo.

A

Ache in

117
Q

Describe the two phases of nicotinic receptor agonist

A

Phase 1 - brief stimulation - fasci
Phase 2 - depo - flaccid

NOT REVERSED BU ACHE INH

GIVE PSEUDOCHOLINESTERASES

118
Q

Effect of succinylcholine in low doses and high

A

Low - decrease

High - high

119
Q

scc must not be given to pts with?

A

Burn, glaucoma, hyperkalemia, muscle pain and malignant hyperthermia

120
Q

Doc or malignant hyp

A

Dantrolene

121
Q

Acts on GABA a receptor

A

Bdz

122
Q

Acts on gaba a synapse

A

Diazepam

123
Q

Acts on gaba b receptor

A

Baclofen

124
Q

Severe spasticity -
Acute and chronic spasticity -
Cord transection

A

Baclofen -
Bdz -
Diazepam

PHARMA 2.0 (3 decks)

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