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pharmacology > drugs for local anesthesia > Flashcards

drugs for local anesthesia Flashcards

1
Q

what is general anesthesia

A

loss of sensation throughout the entire body, accompanied by LOC

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2
Q

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

A

general

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3
Q

what is local anesthesia

A

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

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4
Q

regional anesthesia

A

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

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5
Q

ROA for regional anesthesia

A

epidural, spinal

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6
Q

roa for local anesthesia

A

topical, nerve block, infiltration

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7
Q

how can we improve the duration of action of local anesthetics

A

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

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8
Q

procaines and lidocaine

A

esters and amines

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9
Q

esters - procaines and lidocaine

A

rapidly metabolized in the blood stream, short half life

pka of 8.6-8.9

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10
Q

amides - procaines and lidocaine

A

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

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11
Q

regional anesthesia in labour - how is it usually administered

A

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

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12
Q

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

A

they attenuate to both the emotional and sensory aspects of pain

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13
Q

eipdural injection of anesthsia, where do we administer

A

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

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14
Q

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

A

this is the epidural injection

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15
Q

what anesthetic causes the client to become bed bound

A

local anesthetic

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16
Q

intrathecal regional anesthesia

A

injection is directly into the CSF

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17
Q

what anesthesia is injected into the CSF space

A

intrathecal

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18
Q

what anesthesia is typically adminstered during labour?

A

intrathecal

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19
Q

what is the easiest administered anesthesia?

A

intrathecal

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20
Q

what is administered in the space just above the coccyx

A

intrathecal

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21
Q

what can be administered in the CSF or epidural space?

A

opiods or regional anesthesia

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22
Q

how do opioids and regional anesthesia work?

A

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

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23
Q

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

A

this is how opiod and regional anesthesia work

24
Q

what anesthesia allows for no blockade on the motor neurons

A

opioid and regional anesthesia

25
Q

adverse effects of opiod regional analgesia

A

pruitis, itchy, nausea, vomiting, respiratory depression

26
Q

adverse effects of epidural and spinal anesthesia

A

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

27
Q

how is a spinal headache treated

A

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

28
Q

what is spinal headache

A

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

29
Q

what are the stages of general anesthesia - (4)

A
  1. analgesia
  2. disinhibition
  3. surgical anesthesia
  4. medullary depressed - can lead to death
30
Q

what stage of general anesthesia do we want

A

we want stage 3 - surgical anesthesia

31
Q

what stage of general anesthesia can lead to death

A

stage 4 - medullary depression

32
Q

what is stage one of general anesthesia

A

analgesia

33
Q

stage 2 of general anesthesia

A

disinhibition

34
Q

stage 3 of general anesthesia

A

surgical

35
Q

stage four of general anesthesia

A

medullary depression

36
Q

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

A

the purpose is to induce;

  1. analgesia
  2. sedation
  3. relaxation
  4. hypnosis
  5. amesnia
  6. loss of reflex
37
Q
  1. analgesia
  2. sedation
  3. relaxation
  4. hypnosis
  5. amesnia
  6. loss of reflex
    these are all goals of what
A

general anesthesia

38
Q

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

A

balanced anesthesia

39
Q

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

A

this is the use of several drugs to accomplish general anesthesia

40
Q

what can be used to achieve balanced anesthesia - pharmacological

A

neuromuscular blockers, short acting benzodiazepines, opioids, general anesthetics

41
Q

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

A

balanced anesthesia

42
Q

intravenous anesthetics are typically co-administered with what

A

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

43
Q

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

A

intravenous anesthetics

44
Q

how do we top of IV anesthetics

A

with inhaled anesthetics

45
Q

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

A

intravenous

46
Q

inhaled general anesthetics

A

used to maintain anesthesia, highly lipid soluble

47
Q

how do inhaled general anesthetics work

A

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

48
Q

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

A

inhaled general anesthetics

49
Q

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

A

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

50
Q

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

A

benzos, anticolinergics, histamine

51
Q

how to benzos work pre operatively

A

as anti-anxiety

52
Q

how to anticholinergics work pre operatively

A

they dry the repsiratory an oral secretions

53
Q

how does histamine work preoperatively

A

decrease the gastric fluid volume

54
Q

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

A

neuromuscular blockers

55
Q

how to neuromusclar blockers work during surgery

A

they induce relaxation of the skeletal muscle for surgery and intbation

56
Q

what drugs can be given as adjuncts to the general anesthesia

A

opiates and nsaids
antiemetics
cholinergics

57
Q

why is it good to give cholinergic drugs postoperatively

A

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

pharmacology (26 decks)

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