FINAL 03 - Anesthetics Flashcards by Juan Carlos Cornelio

Analgesia (Stages of general anesthesia)

Stage 1

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Delirium (Stages of general anesthesia)

Stage 2

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Surgical anesthesia (Stages of general anesthesia)

Stage 3

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Respiratory paralysis (Stages of general anesthesia)

Stage 4

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Have low vapor pressures and high boiling points (Types of inhaled anesthetics)

Volatile anesthetics

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Liquids at room temperature (Types of inhaled anesthetics)

Volatile anesthetics

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Halothane, enflurane, isoflurane, desflurane, sevoflurane (Types of inhaled anesthetics)

Volatile anesthetics

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Have high vapor pressures and low boiling points (Types of inhaled anesthetics)

Gaseous anesthetics

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In gas form at room temperature (Types of inhaled anesthetics)

Gaseous anesthetics

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Nitrous oxide, Xenon (Types of inhaled anesthetics)

Gaseous anesthetics

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The most common way to measure inhaled anesthetic potency is by recording the ___________ needed to prevent movement to a painful stimulus

Minimum alveolar concentration (MAC)

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The MAC concentrations are recorded at 1 atm and reported as the mean concentration needed to abolish movement in __________% of subjects

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Inhaled agents with low potencies (high MACs) such as __________ require administration at increased pressure or are used only in combination with more potent inhaled agents

Nitrous oxide

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Is defined as the ratio of the concentration of the drug in the blood to the concentration of the drug in the gas phase at equilibrium

Blood:gas partition coefficient

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An ideal general anesthetic has a low solubility (__________ blood:gas partition coefficient), which leads to quick onset and faster recovery

Low

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Most inhaled anesthetics have similar solubilities in lean organs, but their solubilities in fat vary as predicted by their __________

Oil:gas partition coefficient

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Obese patients may have __________ recovery times if an inhaled anesthetic with high-fat solubility is used for a prolonged period

Increased

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Theory that suggests that the potency of a substance as an anesthetic was directly related to its lipid solubility, or oil/gas partition coefficient

Meyer-Overton theory

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Meyer-Overton theory has commonly been referred to as the __________

Unitary theory of anesthesia

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Compounds with __________ lipid solubility require lower concentrations to produce anesthesia

High

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___________ stabilizes the inhaled agent

Halogenation

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Halogenating ___________ and ___________ anesthetics diminish explosiveness and flammability of drugs (EH)

Ether, Hydrocarbon

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The potency of alkanes, cycloalkanes, and aromatic hydrocarbons increase in ___________ proportion to the number of carbon atoms in the structure up to a cutoff point

Direct

The cutoff number is ___________, with n-decane showing minimal anesthetic potency (SAR of volatile general anesthetics) (N-alkane series)

The cutoff number in most studies is ___________, with cyclooctane showing no anesthetic activity in rats (SAR of volatile general anesthetics) (Cycloalkane series)

The ___________ are more potent anesthetics than the straight chain analog with the same number of carbons (SAR of volatile general anesthetics)

Cycloalkanes

A similar increase in potency with increase in carbon length was seen in the __________ series (SAR of volatile general anesthetics) (Alkanol series)

N-alkanol

The __________ with a given number of carbons is more potent than the n-alkane with the same chain length (SAR of volatile general anesthetics)

N-alkanol

First inhaled anesthetics used in the late 1800s; caused laryngospasms; is explosive and flammable (DC)

Diethyl ether, Cyclopropane

__________ decreases flammability, enhances stability, and increases potency (SAR of volatile general anesthetics)

Halogenation

High atomic mass halogens __________ potency compared to lower atomic mass halogens (SAR of volatile general anesthetics)

Increase

Halogenated ether compounds cause __________ laryngospasms than un-halogenated compounds (SAR of volatile general anesthetics)

Less

Halogenated ether compounds __________ the propensity of the drugs to cause cardiac arrhythmias and/or convulsions (SAR of volatile general anesthetics)

Increase

Also known as laughing gas (Gaseous anesthetics)

Nitrous oxide

An inert gas/Noble gas (Gaseous anesthetics)

Xenon

An ultra-short acting barbiturate (Intravenous general anesthetics)

Thiopental

A short-acting benzodiazepine with a 1,2-fused imidazole ring (Intravenous general anesthetics)

Midazolam

A 2,6-diisopropylphenol (Intravenous general anesthetics)

Propofol

A water-soluble prodrug of propofol

Fospropofol

A carboxylated imidazole derivative; marketed as the more potent R(+) isomer (Intravenous general anesthetics)

Etomidate

A congener of phenycyclidine (Angel dust); "dissociative anesthesia"; S(+) form is more potent than R(-) isomer (Intravenous general anesthetics)

Ketamine

3 parts of the structure of most local anesthetics (LLA)

Lipophilic ring, Linker, Amine group

The aromatic ring ___________ lipophilicity to the anesthetic and helps the molecule penetrate through biological membranes (SAR of local anesthetics)

Adds

Lipophilic substituents and electron-donating substituents in the para position ___________ anesthetic activity (SAR of local anesthetics)

Increase

When the aromatic ring is substituted with an electron-withdrawing group, anesthetic activity is __________ (SAR of local anesthetics)

Decreased

The linker is usually an ___________ or ___________ group along with a hydrophobic chain of various lengths (SAR of local anesthetics) (EA)

Ester, Amide

Local anesthetics with one "i" in its name contain __________ (SAR of local anesthetics)

Esters

Cocaine, procaine, chloroprocaine, tetracaine, and benzocaine contain __________ linkers (SAR of local anesthetics)

Ester

Lidocaine, mepivacaine, prilocaine, etidocaine, ropivacaine, dibucaine, and articaine contain __________ linkers (SAR of local anesthetics)

Amide

Amide linkers are __________ stable than esters and thus have longer half-lives than esters (SAR of local anesthetics)

Ester linkers are more susceptible to __________ than amide functional groups (SAR of local anesthetics)

Hydrolysis

Allergies to the ester anesthetics are __________ common than allergies to the amide anesthetics (SAR of local anesthetics)

The ____________ metabolite, common to the ester class of drugs, is believed to be responsible for the allergic reactions (SAR of local anesthetics)

Para-aminobenzoic acid (PABA)

Most local anesthetics contain a __________ with a pKa between 7.5 and 9.5 (SAR of local anesthetics)

Tertiary nitrogen

__________ does not contain a tertiary amine; is uncharged at physiological pH (SAR of local anesthetics)

Benzocaine

Local anesthetics with two "i" in its name contain __________ (SAR of local anesthetics)

Amides