Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Exam 2 - ANESTHESIA > Flashcards

Exam 2 - ANESTHESIA Flashcards

1
Q

General Anesthetics - effects (2) and forms (2)

A
  • depress CNS to produce loss of conciousness, loss of responsiveness to sensory stimuli, including pain and relaxation of muscles
  • either volatile liquids (injected) or gas vaporized in O2 (inhaled)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

General Anesthesia involves (5 - RAISA)

A

1) analgesia (opiods)
2) amnesia (barbituates)
3) inhibition of reflexes (variety of drugs)
4) skeletal muscle relaxation (NMJ blocking agents)
5) rapid hypnosis (barbituates, others)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do we produce balanced anesthesia?

A

-use combination of drugs to reduce requirement for inhaled anesthetics, reduce dose of barbituates, NMJ blockers, etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Stages of General Anesthesia

A
  • Stage I = analgesia
  • Stage II = excitement
  • Stage III = surgical anesthesia (Plane 1-4)
  • Stage IV = imminent death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Inhaled General Anesthetics – gas

A
  • Nitrous oxide
  • common side effects: dizziness, drowsiness, apnea, euphoria, vomiting
  • serious: malignant hyperthermia, apea, cyanosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Inhaled General Anesthetics – volatile liquid

A
  • the -fluranes
  • common: dizziness, nausea, vomiting
  • serious: myocardial depression, marked hypotension, pulmonary vasoconstriction, hepatotoxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

MAC

A

=Minimum Alveolar Concentration

  • how dosage expressed
  • concentration of which 50% pts don’t move during surgery (% of gas mixture or % of 760 mmHg pressure)
  • an index of potency of inhaled GA
  • steep dose-response curve, inversely proportional to anesthetic potency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

MAC affected by ____

A
  • Age (lower in elderly) *major determining factor of dose, esp after 80
  • NOT by sex, height, weight
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If 90% air, 10% anesthetic, MAC = ?

A

1MAC = 10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If 80% air, 20% anesthetic, MAC = ?

A

1MAC = 20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The higher the % required, the ____ the drug.

A

LESS potent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Stage I

A
  • Analgesia stage

- loss of pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Stage II

A
  • Excitement stage

- excitement and hyperactivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Stage III

A

-surgical anesthesia stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Stage IV

A
  • imminent death stage

- paralysis of medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Percent of MAC = 0.64

A

-loss of awareness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Percent of MAC = 1.00

A

Anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Perfect of MAC = 1.2

A

Surgical anethesia (want to maintain slightly above)

19
Q

MOA - Lipophilicity

A

-extremely lipophilic, so solubility disrupts lipid bilayer of cell membrane, thus increasing threshold to fire

20
Q

Myer-Overton Principle

A

-the more lipid soluble the agent, the more potent anesthetic

21
Q

MAC is influenced by ___ (3)`

A
  1. Pulmonary ventilation – the more rapidly the air is exchanged, the more rapidly anesthesia will be achieved
  2. Pulmonary blood flow – faster blood flow = takes longer to increase blood concentration. slower blood flow (decreased blood volume or BP) = more rapid induction of anesthesia
  3. Water solubility – less water soluble = build up rapidly in alveoli and approach concentration necessary for unconsciousness. more water soluble = first mixes in watery blood reservoir before sufficient concentration reached in alveolus
22
Q

Phamacological Effects (5)

A
  1. block flow of sodium into neurons
  2. enhance inhibitory action of GABA (*general CNS depressant response)
  3. Delay impulses, reduced neural activity
  4. produces unconsciousness
  5. produces lack of responsiveness to painful stimuli
23
Q

Intravenous anesthetics – uses (5)

A
  1. used in situations that require short duration anesthesia (outpatient surgery)
  2. to supplement inhalation anesthetics
  3. primarily used as adjuncts to inhalational agents
  4. administered first
  5. rapidly induce unconsciousness
24
Q

IV Anesthetics – types (5)

A
  1. Barbituate
  2. Benzodiazepines
  3. Opiods
  4. Propofol
  5. Ketamine
25
Q

Barbiturate

A
  • thripental

- rapid onset, potent, NO analgesia

26
Q

Benzodiazepines

A
  • lam/pam

- produce sedation and amnesia but NO analgesia

27
Q

Opiods

A
  • Fentanyl

- good analgesia, for intra-operative pain

28
Q

Propofol

A

-commonly used for sedation during procedures or in ICU

29
Q

Ketamine

A

-rarely used in adults, good analgesia, produces delusions

30
Q

Techniques for applying local anesthetics (5)

A
  • topical
  • nerve block
  • infiltration
  • spinal
  • epidural
31
Q

Local Anesthetics - MOA

A
  • amides and esters
  • stop axonal conduction
  • block Na channels
  • cause rapid sensation loss in limited part of body
32
Q

Local Anesthetics - contraindications

A

-cardiovascular conditions – they have antiarrythmic properties

33
Q

What is co-administered with locals?

A

-vasoconstrictors (NE) to limit absorption and concentrate at injection site

34
Q

Topical Anesthetics

A
  • applied to skin or mucous membrane
  • Benzocaine is major drug
  • relieve pain from minor burns, irritation, itching
  • also given to numb area before injection
  • SE = skin irritation, hypersensitivity reactions
35
Q

Muscle Relaxants – Groups (2)

A
  1. Neuromuscular blockers (NMJ) - used in ICU to cause paralysis and as adjunct to anesthesia
  2. Spasmolytics - to reduce spasticity in variety of neuro disorders
36
Q

NMJ Blockers – uses (3)

A
  • relax skeletal mus during surgery
  • reduce intensity of spasms in electrically induced convulsions
  • manage pts who are fighting mechanical ventilation
37
Q

NMJ Blockers – Non-Depolarizing

A
  • (-curonim’s) block action of AcH.at NMJ
  • don’t cross BBB, no CNS action
  • can be reversed with anticholinesterases (-stigmines)
38
Q

NMJ Blockers – Depolarizing

A
  • succinyl choline
  • causes excessive depolarization which desensitizes muscles, renders them unresponsive
  • acts as agonist but stays locally, broken down by cholinesterase
  • RAPID effect
39
Q

Spasticity

A
  • increase in tonic stretch reflexes
  • increased flexor ms spasm
  • reflex arc involvement
  • higher center involvement (UMN)
40
Q

Universally used adjunct to GA

A
  • Atropine

- dry shit up, prevent bradycardia

41
Q

Bacloven

A

central spasmolytic

  • GABA analog
  • good for addictions, DT in alchys
  • used for para/quadriplegic with SCI due to MS or trauma
42
Q

Diazepam (Valium)

A
  • central spasmolytic
  • effective for acute spasm and chronic spasticity
  • good for spinal cord lesion (transection) and CP
43
Q

Peripheral Spasmolytic

A
  • Dantrolene
  • similar effects to central drugs, but works directly on ms by inhibiting calcium release
  • most effective for spasticity with cerebral origin (MS, CP) and acute things like malignant hyperthermia

Pharmacology (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions