drugs for local anesthesia

Question 1

what is general anesthesia

Answer 1

loss of sensation throughout the entire body, accompanied by LOC

Question 2

what kind of anesthesia ; loss of sensation throughout the entire body, accompanied by LOC

Answer 2

general

Question 3

what is local anesthesia

Answer 3

person is awake, loss of sensation limited to a body region, with no LOC

Question 4

regional anesthesia

Answer 4

this is the loss of sensation to a larger body area with no LOC

Question 5

ROA for regional anesthesia

Answer 5

epidural, spinal

Question 6

roa for local anesthesia

Answer 6

topical, nerve block, infiltration

Question 7

how can we improve the duration of action of local anesthetics

Answer 7

by adminstering the anesthetic with epinephrine, this causes vasodialation limiting blood flow to the area so the drug stays where it belongs

Question 8

procaines and lidocaine

Answer 8

esters and amines

Question 9

esters - procaines and lidocaine

Answer 9

rapidly metabolized in the blood stream, short half life

pka of 8.6-8.9

Question 10

amides - procaines and lidocaine

Answer 10

metabolized in the liver, longer half life, pka ranges from 7.5-8

Question 11

regional anesthesia in labour - how is it usually administered

Answer 11

nerve blocks, epidural or intrathecal injection, edidural adminsitratio of opiods

Question 12

how do opiods work - what aspects of pain to they attnuate to

Answer 12

they attenuate to both the emotional and sensory aspects of pain

Question 13

eipdural injection of anesthsia, where do we administer

Answer 13

it is the injection of a drug into a highly vascularized area, this is the fat filled space

Question 14

what is injected into a highly vascularized area aka; faT FILLED SPACE

Answer 14

this is the epidural injection

Question 15

what anesthetic causes the client to become bed bound

Answer 15

local anesthetic

Question 16

intrathecal regional anesthesia

Answer 16

injection is directly into the CSF

Question 17

what anesthesia is injected into the CSF space

Answer 17

intrathecal

Question 18

what anesthesia is typically adminstered during labour?

Answer 18

intrathecal

Question 19

what is the easiest administered anesthesia?

Answer 19

intrathecal

Question 20

what is administered in the space just above the coccyx

Answer 20

intrathecal

Question 21

what can be administered in the CSF or epidural space?

Answer 21

opiods or regional anesthesia

Question 22

how do opioids and regional anesthesia work?

Answer 22

they bind to the presynaptic receptors, inhibiting the release of pain signalling NT in the spinal cord
then the bind to the post synaptic receptors in the brain-decreasing neuronal excitability
this will inhibit the pain receptors that are descending from the central nervous system

Question 23

inhibiting the release of pain signalling NT in the spinal cord
then the bind to the post synaptic receptors in the brain-decreasing neuronal excitability
this will inhibit the pain receptors that are descending from the central nervous system

Answer 23

this is how opiod and regional anesthesia work

Question 24

what anesthesia allows for no blockade on the motor neurons

Answer 24

opioid and regional anesthesia

Question 25

adverse effects of opiod regional analgesia

Answer 25

pruitis, itchy, nausea, vomiting, respiratory depression

Question 26

adverse effects of epidural and spinal anesthesia

Answer 26

backache infection, inadequate anesthesia, arachinoidititis, spinal headache, CSF leak

Question 27

how is a spinal headache treated

Answer 27

treated with a blood patch, you draw the pt blood, apply to the area to resolve the CSF

Question 28

what is spinal headache

Answer 28

this is a CSF leak, that causes traction on the brain from the meninges

Question 29

what are the stages of general anesthesia - (4)

Answer 29

1. analgesia 2. disinhibition 3. surgical anesthesia 4. medullary depressed - can lead to death

Question 30

what stage of general anesthesia do we want

Answer 30

we want stage 3 - surgical anesthesia

Question 31

what stage of general anesthesia can lead to death

Answer 31

stage 4 - medullary depression

Question 32

what is stage one of general anesthesia

Answer 32

analgesia

Question 33

stage 2 of general anesthesia

Answer 33

disinhibition

Question 34

stage 3 of general anesthesia

Answer 34

surgical

Question 35

stage four of general anesthesia

Answer 35

medullary depression

Question 36

what is the purpose of general anesthesia - what factors do we want to induce (6)

Answer 36

the purpose is to induce; 1. analgesia 2. sedation 3. relaxation 4. hypnosis 5. amesnia 6. loss of reflex

Question 37

1. analgesia 2. sedation 3. relaxation 4. hypnosis 5. amesnia 6. loss of reflex these are all goals of what

Answer 37

general anesthesia

Question 38

since no single drug can safely accomplish all of the goals of general anesthesia what must be used

Answer 38

balanced anesthesia

Question 39

what is balanced anesthesia - what do we use, what do we want to accomplish

Answer 39

this is the use of several drugs to accomplish general anesthesia

Question 40

what can be used to achieve balanced anesthesia - pharmacological

Answer 40

neuromuscular blockers, short acting benzodiazepines, opioids, general anesthetics

Question 41

neuromuscular blockers, short acting benzodiazepines, opioids, general anesthetics - can all be used to achieve what

Answer 41

balanced anesthesia

Question 42

intravenous anesthetics are typically co-administered with what

Answer 42

typically co-administered with inhaled general anesthetics once the client loses consiousness

Question 43

typically co-administered with inhaled general anesthetics once the client loses consiousness - what

Answer 43

intravenous anesthetics

Question 44

how do we top of IV anesthetics

Answer 44

with inhaled anesthetics

Question 45

what anesthetics allows for the patient to move slowly through stages 1 and 2 of general anesthesia

Answer 45

intravenous

Question 46

inhaled general anesthetics

Answer 46

used to maintain anesthesia, highly lipid soluble

Question 47

how do inhaled general anesthetics work

Answer 47

they prevent the flow of sodium ions into the neurons in the CNS reducing neural activity

Question 48

what prevent the flow of sodium ions into the neurons in the CNS reducing neural activity

Answer 48

inhaled general anesthetics

Question 49

what should patients be monitored for post operatively after inhaled general anesthetics

Answer 49

nausea and vomiting, CNS depression, respiratory depression, changes in vital signs

Question 50

drugs as adjuncts to general anesthesia; pre op - think about ways you can relieve anxiousness in the patient pre operatively

Answer 50

benzos, anticolinergics, histamine

Question 51

how to benzos work pre operatively

Answer 51

as anti-anxiety

Question 52

how to anticholinergics work pre operatively

Answer 52

they dry the repsiratory an oral secretions

Question 53

how does histamine work preoperatively

Answer 53

decrease the gastric fluid volume

Question 54

during surgery, what drugs could be added to increase efficacy of the general anesthetic

Answer 54

neuromuscular blockers

Question 55

how to neuromusclar blockers work during surgery

Answer 55

they induce relaxation of the skeletal muscle for surgery and intbation

Question 56

what drugs can be given as adjuncts to the general anesthesia

Answer 56

opiates and nsaids antiemetics cholinergics

Question 57

why is it good to give cholinergic drugs postoperatively

Answer 57

stimulate smooth muscle contraction in the GI tract and bladder to induce peristalisis and urination