Drugs 101

Question 1

What is anesthesia

Answer 1

the absence or abolition of sensation/ NOT pain

Question 2

What are the 3 components of general anesthesia

Answer 2

unconsciousness, analgesia, muscle relaxation

Question 3

Why do we give more than one drug?

Answer 3

no one drug provides optimal general anesthesia, so combination will help

Question 4

Anesthesia is?

Answer 4

amnesia- induction, anxiolytics
analgesia- pain meds
skeletal muscle relaxation- vec, curare, succs

Question 5

Why give meds pre op

Answer 5

given before had will reduce the amount that are needed to be given

Question 6

Why do we give histamine receptor blockers

Answer 6

decrease dangers of asipration

Question 7

What is useful about giving opioids pre-op

Answer 7

lowers the doses for MAC

Question 8

Why do we pre-oxygenate

Answer 8

it lowers the danger of low blood O2, while not ventilating the patient

Question 9

When pre-oxygenating what is the lowest you can have your flow?

Answer 9

5 liters

Question 10

when will you not give propofol

Answer 10

in critically ill patients, low MET, and ASA greater than 4

Question 11

Etomidate

Answer 11

may cause pain with injection
severe respiratory depressant
they may shake when they are going to sleep
It will not cause a drop in BP

Question 12

Succinylcholine

Answer 12

Do not give with kidney failure, muscle diesease, or hx of MH

Question 13

non-depolarizers

Answer 13

in addition to duration, they will vary in speed and onset and effects on vital signs

Question 14

Cisatracurium

Answer 14

shart acting non-depol
requires no kidney function to be broken down
minimal effects on BP and heart
useful in liver failure patients
can be given as an infusion.

Question 15

Vecuronium

Answer 15

short acting,
no effect on vitals
generic
longer duration with kidney and liver failure
sometime infusion
has to be mixed

Question 16

Rocuronium

Answer 16

shortest acitng non-depol
expensive
no mixing
substitue for succs in RSI

Question 17

ISoflurane

Answer 17

ether
cheap
potent
airway irritant
slightly soluble- so does not come off fast
not for inhalation induction
may increase hear rate
no toxic compounds produced

Question 18

desflurane

Answer 18

ether
requires a special vaporizer
irritant
quickest off and on
not absorbed by fat so it is the best for bariatric surgeries, 
EXPENSIVe
cost minimized by gas flows

Question 19

sevofllurane

Answer 19

smells great
inhalation induction
requires 2L of gas flow to reduce risk of compund A
expensive

Question 20

Nitrous oxide

Answer 20

analgesic gas
lowers MAC
reduces doses of opioids
increased PONV
contraindicated for many surgeries
works quick
has be replaced by air now more often
rots bone marrow with abuse

Question 21

Air

Answer 21

pure o2 is harmful
may lower some cost
minimal benefit of pure ox

Question 22

opioids

Answer 22

used in place of the term narcotics

acts in the brain, spinal cord, and periphery

Question 23

morhpine

Answer 23

all natural from poppy opium
provides- analgesia, euphoria, respiratory depression, nausea, itiching
used for post op pain

Question 24

fentanyl

Answer 24

70-100X stronger, 
synthetic
respiratory depressant
reduces MAC
addictive

Question 25

sufentanil

Answer 25

most potent infusion big resp. depresent

Question 26

remifentanil

Answer 26

``` shortest acting given by infusion respiratory depressant reduces doeses of other anesthtics usefull for neuro cases ```

Question 27

ketamine

Answer 27

``` induction agent and analgesic hallucinogenic may raise BP post op delirium gives post op analgesia ```

Question 28

How do relaxant reversals work

Answer 28

inhibit acetylcholinesterase, which breaks down acetylcholinine, so greater amounts accumlate the allows contration to return

Question 29

atropine

Answer 29

now is used in ACLS

Question 30

glycopryrrolate

Answer 30

doesn't alter the brain, does not cross, BBB, like atropine, onset is slower than atropine

Question 31

ephedrine

Answer 31

``` rasies BP andn HR short duration Directly and indirectly alpha beta directly indirect by cause release of catacholamines ```

Question 32

epinephrine

Answer 32

raises glucose levels

Question 33

steroids

Answer 33

they help fight stress rasies glucose lowers resistace to infection lower ability of tissue to heal

Question 34

when does analgesia, amnesia and relzation end?

Answer 34

analgesia- ends due to opioid metablism exhaling gases amnesia- ending occurs by exhaling anesthetic gases, metabolizing midazolam relazation- ens by metabolixm and use of anticholinesterase drugs

Question 35

Transport time

Answer 35

Monitor the sicker patients | Always use O2