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Adv Anes. Pharm Spring 2024 > Exam 1/ Lecture 1: Anesthesia Pharmacology > Flashcards

Exam 1/ Lecture 1: Anesthesia Pharmacology Flashcards

1
Q

Lecture 1/17/23

What is anesthesia

A

Lack of feeling or sensation

Artificially induced loss of the ability to feel pain
To permit the performance of surgery or painful procedures

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2
Q

Lecture 1//17/23

What is the:

Lack of feeling or sensation

Artificially induced loss of the ability to feel pain
To permit the performance of surgery or painful procedures

A

Anesthesia

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3
Q

Lecture 1/17/23

A drug-induced loss of consciousness

Patients are not arousable; even by painful stimulation
Intubated? On ventilator? Volatile anesthesia?

A

General Anesthesia

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4
Q

Lecture 1/17/23

General Anesthesia

A

A drug-induced loss of consciousness

Patients are not arousable; even by painful stimulation
Intubated? On ventilator? Volatile anesthesia?

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5
Q

Lecture 1/17/23

Independent ventilatory function often impaires what 3 things

A

Maintain patent airway
Positive pressure ventilation
Cardiovascular support

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6
Q

What type of anesthesia:
* Insensibility caused by interrupting the sensory nerve conduction of a particular region of the body
* Level of consciousness is unchanged (unless sedatives are used)
* Ventilatory/airway protection is maintained

A

Regional Anesthesia

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7
Q

Describe Regional Anesthesia

A
  • Insensibility caused by interrupting the sensory nerve conduction of a particular region of the body
  • Level of consciousness is unchanged (unless sedatives are used)
  • Ventilatory/airway protection is maintained

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8
Q

Lecture 1/17/23

What particular regions in the human body are use to cause an interruption in the sensory nerve conduction for regional Anesthesia

3 particular regions

A
  • Peripheral
  • Spinal
  • Epidural

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9
Q

Lecture 1/17/23

What type of sedation :
Reponsiveness - To verbal commands
Airway - Unaffacted
Spontaneous Ventilation - Unaffacted
Cardiovascular Function - Unaffacted

A

Minimal (Anxiolysis) Sedation

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10
Q

Lecture 1/17/23

What type of sedation :
Reponsiveness - To verbal/ touch
Airway - To assistiance needed
Spontaneous Ventilation - Adequate
Cardiovascular Function - Usually Maintained

A

Moderate Sedation

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11
Q

Lecture 1/17/23

What type of sedation :
Reponsiveness - After repeated or painful stimulation
Airway - Assistance might be required
Spontaneous Ventilation - Possibly inadequate
Cardiovascular Function - Usually maintained

A

Deep Sedation

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12
Q

Lecture 1/16/23

During the 4000BC - 400BC what were 5 agents use for anesthesia?

A
  • Plants…poppy, coca leaves
  • Acupuncture
  • Ethylene fumes from geologic fault lines beneath Apollo’s temple
  • Cannabis vapor
  • Carotid compression

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13
Q

Lecture 1/17/23

In the earliest days of Anesthesia Pharmacology who was the person that accommodate the operator to avoid sinking down and turning away.

A

Hippocrates 460-377 BC

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14
Q

Lecture 1/17/23

In the earliest days of Anesthesia Pharmacology who was the person that created the Materia Medica (pharmacology) that was authoritative for 15 centuries which Included 5 volumes; plants, animal and mineral products and 360 medical properties (antiseptic, anti-inflammatory).

A

Dioscorides 40-90 AD
(a surgeon in Nero’s army)

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15
Q

Lecture 1/17/23

In the earliest days of Anesthesia Pharmacology mandragora and wine caused?

A

Hallucinogenes

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16
Q

Lecture 1/17/23

The mandragora planet was described to have what type of shape and what other properties

A

Human Shape
Magical Properties

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17
Q

Lecture 1/17/23

During the middle ages what were the 5 materials use on a sponge as anesthesia ?

A
  • ½ ounce opium
  • Juice of mandrake leaves
  • Juice of hemlock
  • 3 ounces of hyposcyamus (L-isomer of atropine)
  • Sufficient water

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18
Q

Lecture 1/17/23

What was the reversal agent for an anesthesia sponge used during the middle ages?

A

Vinegar

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19
Q

Lecture 1/17/23

Who created Diethyl ether ?
What 2 agents were use to create Diethyl ether?

A
  • Valerius Cordus 1515-1544 (German botanist, physician)
  • Made from sulfuric acid and ethyl alcohol

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20
Q

Lecture 1/17/23

The word “ether” derive from what language?

What is the root meaning of ether?

A

greek for ignite

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21
Q

Lecture 1/17/23

Diethyl Ether was tested on what anminal?

A

Chickens

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22
Q

Why did diethyl ether become a recreational drug?

A

due to an increase in whiskey tax

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23
Q

Lecture 1/17/23

Why was diethyl ether an inhalation agent?

A

due to access, IV material did not exist at thist time

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24
Q

Lecture 1/17/23

Who are the 2 individual that created IV access?

A

Sir Christopher Wren
Robert Boyle
in the 1650’s

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25
Q

Lecture 1/17/23

Sir Christopher Wren and Robert Boyle created IV therapy using what material?

A

goose quill

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26
Q

Lecture 1/17/23

What was the material that Sir Christopher Wren and Robert Boyle adminstered to what type of animal?

A

Alcohol
dog’s vien

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27
Q

Lecture 1/17/23

What is the name of the english chemist that discovered oxygen, nitrous oxide and photosynthesis?

A

Jospeh Priestly

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28
Q

Lecture 1/17/23

What is the name of the british chemist that discovered potassium, sodium, calcium, and magnesium and suggested nitrous oxide be use for surgical pain control?

A

Humphry Davy

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29
Q

Lecture 1/17/23

What is the name of the person that noticed that a man under the influence of N2O had no recall of pain/injury
Self administered for tooth extraction and uses on several dental patients?
They also arrange the administration of nitrous oxide at Mass General in 1845
“humbug”

A

Horace Wells

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30
Q

Lecture 1/17/23

What is the occpation of Horace Wells?

A

Dentist

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31
Q

Lecture 1/17/23

What year was nitrous oxide administered with air introduce?

A

1868

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32
Q

Lecture 1/17/23

What is the name of the Chicago surgeon that discovered that by combining nitrous oxide and oxygen the surgeon can prevent cyanosis

A

Andrews

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33
Q

Lecture 1/17/23

Who was the individual that created the 1st anesthesia machine with nitrous/oxygen?

A

Hewitt

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34
Q

Lecture 1/17/23

What is the name of the indivdual that delivered ether to a patient that had 2 vascular neck tumors with whiskey?

A

Crawd Long 1842

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35
Q

Lecture 1/17/23

What is the name of the dentist that use ether for denture fitting?

A

William Morton

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36
Q

Lecture 1/17/23

What year did the 1st successful public demonstration of ether, (called it Letheon)?

A

1846

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37
Q

Lecture 1/17/23

What is the name of the doctor that develop the process for purifying ether (1856) and founded Squibb pharmaceuticals….leading manufacturer?

A

Dr. Robinson Squibb

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38
Q

Lecture 1/17/23

What are the disadvantages of using ether?

A
  • Flammable
  • Prolonged induction
  • Unpleasant, persistent odor
  • High incidence of nausea/vomiting

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39
Q

Lecture 1/17/23

What is the year that chloroform was independently discovered in the USA, France, Germany, and Great Britan?

A

1831

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40
Q

Lecture 1/17/23

What is the name of the Scotland Obstertrician that define pain and experimented following a dinner party?

A

Sir James Simpson

Slide 17

41
Q

What year did the Scotland Obstertrician define pain and experimented following dinner party?

A

1847

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42
Q

Lecture 1/17/23

What is the name of the doctor that use full anestheisa on the Queen Victoria during her deliver of prince Leopold and princess Beatrice and “discovered” epidemiology when he traced London cholera outbreak to water source?

A

Dr. John Snow

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43
Q

Lecture 1/17/23

What year did the Hyderaboad commission meet and why?

A

1888 and 1891
to evaluate the method in adminstering chloroform

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44
Q

Who discovered that delaying chloroform would cause hepatotoxicity in children?

What year was this discovered?

A

Guthrie, 1894

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45
Q

Lecture 1/17/23

Which doctor discovered that giving light chloroform anesthesia and adrenaline can be fatel in animals causing V. fib.?
What year was this discovered?

A

Levy,
1900

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46
Q

Lecture 1/17/23

What is the name of the Viennese ophthalmologist that use cocaine as an anesthetic for eye surgery?

A

Dr. Koller 1857-1944 Viennese ophthalmologist (colleague of Sigmund Freud)
Anesthetic for eye surgery

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47
Q

Lecture 1/17/23

What is the name of the doctor that did the first regional (mandibular) nerve block with cocaine?

A

Dr. Halsted 1852-1922

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48
Q

Lecture 1/17/23

What is the name of the doctor that did the first spinal anesthetic with cocaine?

They also develop a particular block?

A

Dr. August Bier 1861-1949
1st spinal anesthetic with cocaine
Developed Bier block

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49
Q

Lecture 1/17/23

What is the name of the first nurse anesthetist that was intelligent, focus and got paid pennys?

A

Sister Mary Bernard, 1877

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50
Q

Lectuure 1/17/23

What is the name of the nurese anesthetist that is known as the “mother of anesthesia” and did 14,000 open drop ether cases without a death?

A

Alice Magaw 1860-1928

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51
Q

Lecture 1/17/23

What is the name of the nurse anesthesia that open up one of 1st nurse anesthesia schools, taught in France, developed nitrous/oxygen techniques and founded AANA?

A

Agatha Hodgins 1877-1945

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52
Q

Lecture / 17/23

What anesthetic causes violently explosive?

A

Cyclopropane 1934

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53
Q

Lecture 1/17/23

What anesthetic causes hepatitis and as a slow onset?

A

Halothane 1956

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54
Q

Lecture 1/17/23

What relatively safe anesthetic that causes, less nausea and vomiting with a quicker onset than halothane?

A

Isoflurane 1981

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55
Q

Lecture 1/17/23

What type of anesthetic as a rapid uptake and distribution, high vapor pressure, and take large quantity to achieve anesthesia?

A

Desflurane 1992

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56
Q

Lecture 1/17/23

What is the name of the person that found that end- tidal concentration correlated to movement….MAC?

A

Edmund Egar
1960’s-1990’s

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57
Q

Lecture 1/17/23

What is the name of the anesthetic that Intermediate action between isoflurane and desflurane?
It is unstable in soda lime with toxic degradation product concerns.
No new inhaled anesthetics since

A

Sevoflurane 1995 in US

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58
Q

Lecture 1/17/23

What is the triad of Anesthesia?

A

Amnesia
Analgesia
Muscle relaxtion

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59
Q

Lecture 1/17/23

What part of the triad stimulate inhibitory and inhibit stimulatory trransmissons by affecting the acetylcholine and GABA neurotransmitters?

A

Amnesia

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60
Q

Lecture 1/17/23

What was the 1st analgesia from opium in 1895?

A

Morphine

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61
Q

Lecture 1/17/23

Why was analgesia initially not favorable?

A

due to the high death rate

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62
Q

Lecture 1/17/23

What are 5 different examples of analgesic agents that are use today?

A

Narcotics (opioids)
Cyclooxygenase inhibitors
Gabapentin (pregabalin)
Acetaminophen
Peripheral nerve blocks

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63
Q

Lecture 1/17/23

What is the first known muscle relaxation?

A

Curare
1942

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64
Q

Lecture 1/17/23

True or False: muscle relaxation increase amount of anesthesia use during surgery which will decrease mortality rate.

A

False, Decreased amount of anesthesia due to relaxation

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65
Q

Lecture 1/17/23

What are the 4 ways to balance anesthesia or become stress free?

A

Muscle relaxation
Amnesia
Homeostasis
Analgesia

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66
Q

Lecture 1/17/23

What is the name of the surgican that did cases less than 20 minutes which lead to his patient (s) death?

A

Dr. Liston

Slide 29

67
Q

Lecture 1/17/23

What is the name of the person that used light nitrous/ oxygen anesthesia at the cleveland clinic?

A

George Crile (1864-1943)

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68
Q

Lecture 1/17/23

What is the name of the person that use regional blocks prior to the patient emergence from ether and reorded anesthetic and BP/ HR messurements?

A

Harvey Cushing (1869-1939)

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69
Q

Lecture 1/17/23

What year was neurolept anesthesia establish?

A

1959…neurolept anesthesia

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70
Q

Lecture 1/17/23

What 3 classes of medication can be use in neurolept anesthesia?

A
  • Opioids
  • antipsychotics (Haldol, droperidol)
  • nitrous

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71
Q

Lecture 1/17/23

What year did surgical stimulation produced despite lack of movement attempting to maintain balance aneshesia?

A

1981

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72
Q

Lecture 1/17/23

What year was opioid sparing techniques use to attempt to balance anesthesia?

A

2000’s

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73
Q

Lecture 1/17/23

What phase of aneshesia use BZD, H1, and H2 blockers, and bronchodilators?

A

Preoperative period

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74
Q

Lecture 1/17/23

What phase of anesthia uses Etomidate, ketamine, propofol, and narcotics?

A

Induction of anesthesia

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75
Q

Lecture 1/17/23

Which phase of anesthia uses inhalation drugs, neuromuscular blockers, prssors, and blockers?

A

Maintenance of anesthesia

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76
Q

Lecture 1/17/23

What phase of anesthesia uses NMB reversal, local anesthetics?

A

Emergence from anesthesia

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77
Q

Lectue 1/17/23

What are the 4 statges of anesthesia?

A
  • Stage I: beginning of induction of general anesthesia to loss of consciousness
  • Stage II: loss of consciousness to onset of automatic breathing
  • Stage III: onset of automatic respiration to respiratory paralysis (surgical plane)
  • Stage IV: stoppage of respiration till death

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78
Q

Lecture 1/17/23

What are the 3 planes Stage 1: beginning of induction of general anesthesia to loss of consciousness?

A

1st plane: no amnesia or analgesia
2nd plane: amnestic but only partially analgesic
3rd plane: complete analgesia and amnesia

Slide 34

79
Q

Lecture 1/17/23

What type of body functions take place during 2nd Stage of anesthesia which involve the loss of consciousness to onset of automatic breathing?

A

eyelash reflex disappears
coughing, vomiting, struggling may occur
irregular respirations with breath-holding

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80
Q

Lecture 1/17/23

What are the 4 planes in Stage III: onset of automatic respiration to respiratory paralysis (surgical plane)?

A
  • 1st plane: automatic respiration to cessation of eyeball movements
  • 2nd plane: cessation of eyeball movements to beginning of intercostal muscle paralysis; secretion of tears increases
  • 3rd plane: beginning to completion of intercostal muscle paralysis; pupils dilate; desired plane prior to muscle relaxants
  • 4th plane: complete intercostal paralysis to diaphragmatic paralysis (apnea)

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