Exam #01g - General Anesthetics Flashcards

1
Q

Name the (8) desirable properties of general anesthesia?

A
  1. analgesia
  2. loss of consciousness (not always needed)
  3. retrograde amnesia
  4. skeletal muscle relaxation (esp during surgery)
  5. smooth, rapid induction
  6. controllable concentration
  7. rapid termination
  8. wide margin of safety
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2
Q

What are the (2) types of general anesthetics?

A
  1. Inhaled

2. IV

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3
Q

Name the (2) subtypes of inhaled GA and give one example for each?

A
  1. gases - nitrous oxide

2. volatile liquids - halothane

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4
Q

Name the (4) subtypes of IV GA and give one example for each?

A
  1. Barbiturates - thiopental (phenobarbital)
  2. Benzodiazepines - midazolam (Versed), diazepam (valium)
  3. Dissociative - ketamine
  4. Miscellaneous - etomidate propofol
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5
Q

Name the (5) drugs that positively allosterically modulate GABAa receptor? What happens when these agents modulate GABA receptor?

A
  1. barbiturates
  2. benzodiazepines
  3. nitrous oxide
  4. propofol
  5. etomidate

enhances Cl- influx and DECREASES neuronal activity (hyperpolarizes cell)

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6
Q

True or False - there is a positive correlation between lipid solubility and inhaled GA activity?

A

True

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7
Q

Name (4) drugs that negatively allosterically modulate Na+ ionotropic channel? What happens when these agents modulate the Na+ channel?

A
  1. cyclopropane
  2. ketamine
  3. nitrous oxide
  4. xenon

these agents INHIBIT ion influx

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8
Q

What effect does glutamate have on a Na+ channel?

A

glutamate allows influx of Na+ leads to hypopolarization

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9
Q

What is the inhaled GA equivalent of an ED50?

A

MAC (minimum alveolar concentration)

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10
Q

List the (5) most widely used GA inhalation agents?

A
  1. desflurane
  2. enflurane
  3. halothane
  4. isoflurane
  5. nitrous oxide
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11
Q

Which inhalation GA agent has a rapid onset & recovery, but is PUNGENT and cannot give to children?

A

Desflurane

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12
Q

Which inhalation GA agent is a better skeletal muscle relaxant than halothane, but can cause seizures, and can cause hepatic AE after repeated administration?

A

Enflurane

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13
Q

Which inhalation GA agent would be the best choice for children?

A

halothane

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14
Q

Which inhalation GA agent may have a prolonged induction and recovery and shivering is common during recovery?

A

Halothane

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15
Q

Which inhalation GA agent is a better skeletal muscle relaxant than both halothane and enflurane, but produces significant respiratory depression?

A

isoflurane

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16
Q

Which inhalation GA agent is contraindicated in pregnant women, immunosuppressed patients, and patients with pernicious anemia?

A

Nitrous oxide

17
Q

True or False - all potent inhalation agents can trigger malignant hyperthermia?

A

True - in response to anesthesia, a sudden, rapid rise in body temp occurs with signs of increased muscle metabolism

18
Q

This term is defined as a state in which patients feel totally dissociated from their surroundings? Give one drug that can cause this?

A

Dissociative anesthesia

Ketamine - IV; negatively allosterically modulate Na+ channel

19
Q

Which (2) GA IV agents have a slow onset and recovery?

A

Midazolam (Versed) and fentanyl

20
Q

Which IV GA agent is used in balanced anesthesia and conscious sedation but show signs of marked amnesia?

A

Midazolam (Versed)

21
Q

Which inhalation GA agent would you want to avoid in porphyrias (inherited disorder of enzymes)?

A

Thiopental

22
Q

Which inhalation GA agent produces cardiovascular stimulation and increased cerebral blood flow?

A

ketamine

23
Q

Which inhalation GA agent is used in induction and for maintenance?

A

Propofol

24
Q

Which inhalation GA agent is a useful antiemetic?

A

Propofol