Brainscape's Knowledge GenomeTM

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


See full index

Pharmacologie > Final 6e ANESTH > Flashcards

Final 6e ANESTH Flashcards

1
Q

Effet secondaire des Anesthesies locales ?

  1. sys tox 1.5 - 2.3 - 3.1
  2. autre 1
A
  1. Systemic toxicity
    1. Central nervous system
      1. Tinnitus
      2. Metallic taste,
      3. Perioral paresthesia
      4. Seizures
      5. CNS depression
    2. Cardiovascular system
      1. Bradycardia; decreased cardiac contractility; atrioventricular block
      2. Ventricular arrhythmias (especially cocaine)
      3. Cardiogenic shock
    3. Hematologic
      1. methemoglobinemia(especially benzocaine)
  2. Other
    1. Allergy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Anesthésie épidural

  1. Définition
  2. Site injection
  3. Complications 6
A
  1. local anesthetics with or without opioids and alpha-adrenergic agonists are injected into the epidural space and act on the spinal nerve roots
  2. Espace epidural entre dure mère et ligament flavum
  3. Complications
    • Spinal-epidural hematoma
    • Epidural abscess
    • Hypotension
      • sympathetic blockade causes vasodilation and decreases venous return → reduced cardiac output
      • hypotension, dizziness, lightheadedness, and nausea
      • IV fluid resuscitation + small doses of epinephrine
    • Céphalée
    • Bloc sympathique =
      1. peripheral vasodilation, bradycardia, and hypotension
    • Urinary retention and overflow incontinence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Rachianesthésie (= anesthésie rachidienne, anesthésie spinale, spinal block, …)

  1. Définition
  2. Site injection
  3. Complications 3
A
  1. local anesthetics with or without opioids and alpha-adrenergic agonists are injected into the cerebrospinal fluid (LCR) in the lumbar spine and act directly on the spinal cord
  2. Dans le liquide céphalo-rachidien entre la pie-mère et arachnoïde, donne une anesthésie de la moitié inférieure du corps
  3. Complications
    • Increased intracranial pressure / céphalée
    • Infection / hématome at the puncture site
    • Bloc sympathique =
      • peripheral vasodilation, bradycardia, and hypotension
      • Urinary retention and overflow incontinence
    • Coagulopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
  1. Potentiel d’une molécule anesthésiante par inhalation = ?
  2. donc ?
  3. Ratio gaz(anesth)/sang dit quoi ?
A
  1. = 1 / MACconc alvéolaire min
  2. Donc plus le MAC est élevé, moins le potentiel est élevé et moins il est soluble dans les lipides
    → MAC petit = haut solubilité lipidique
  3. Plus le ratio gaz/sang est bas plus l’anesthésiant va agir rapidement et être éliminé rapidement → solubilité dans sang qui est faible
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Effet secondaire des anesthésiques par inhalation 6

A
  1. Postoperative N/V
  2. Risk of malignant hyperthermia
  3. Potential damage to organs/tissues
  4. Nephrotoxic breakdown products
  5. Proconvulsive
  6. Hepatotoxic → halothane hepatite
  7. ⇡ PIC → ↓ Cerebral metabolic demand ↑ Cerebral blood flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Anesthésie IV - Propofol

  1. Mécanisme d’action 2
  2. Effets secondaires 2
  3. indication 2
A
  1. Thought to act as an agonist on GABAA receptors and
    - Na channels of the reticular formation
    → ↓ intracranial pressure
    → hypnotic,
    → antiemetic, and
    → anticonvulsant effects
    → No analgesic or muscle relaxant effects
  2. ES :
    1. Hypotension
    2. Respiratory depression
  3. Indications
    1. anesthesia induction
    2. Total intravenous anesthesia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Anesthésie IV - Etomidate

  1. Mécanisme d’action 2
  2. Effets secondaires 2
  3. indication 1
A
  1. Mécanisme d’action
    • on the GABA receptors in the reticular formation → hypnotic and anticonvulsant effects and ↓ intracranial pressure
    • Peu effect sur CV
  2. Effets secondaires 2
    1. Insuffisance adrénergique aigue
    2. Post op N/V
  3. indication
    1. Patient hémodynamiquement instable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Anesthésie IV - Ketamine

  1. Mécanisme d’action 1
  2. Effets secondaires 2
  3. Indications 2
A
  1. Mécanisme d’action
    • NMDA receptor antagonism → dissociative anesthesia, sympathomimetic effects
  2. Effets secondaires 2
    • ↑ Intracranial pressure
    • Acute psychotomimetic effects: disorientation, hallucinations…
  3. indication
    1. Courte intervention
    2. Polytraumatisé, intubation rapide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Anesthésie IV - Barbiturique

  1. Mécanisme d’action 2
  2. Effets secondaires 3
  3. Indication 1
A
  1. Mécanisme d’action
    • Bind to GABAA receptors → ↓ neuronal excitability in the brain → ↓ ICP, as well as sedative, hypnotic, and antiepileptic effects
    • High lipid solubility (rapid distribution into fat)
  2. Effets secondaires
    1. Hypotension, respiratory depression
    2. ↓ Intracerebral blood flow
    3. Cytochrome P450 induction
  3. Contre-indications
    1. Porphyria
    2. Severe anemia
    3. Myasthenia gravis
  4. Indication
    1. IV anesthesia induction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Anesthésie IV - Opioïde

  1. Mécanisme d’action 1
  2. Effets secondaires 2
  3. Indication 1
A
  1. Mécanisme d’action
    1. Agonism at rcp protéine G μ, δ, and/or κ → ↓ synaptic transmission → analgesia, euphoria, sedation, slowed gastrointestinal transit
  2. Effets secondaires
    • Muscle rigidity
    • Cardiovascular and respiratory depression
  3. indication
    1. IV anesthesia induction / maintenance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Anesthésie IV - Benzodiazépines

  1. Mécanisme d’action 2
  2. Effets secondaires
A
  1. Mécanisme d’action
    • Indirect GABAA receptor agonism → ↓ neuronal excitability
  2. Effets secondaires
    • Anterograde amnesia
    • ↓ Blood pressure
    • Can cause severe respiratory depression
  3. indication
    1. IV anesthesia induction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Curares

Dépolarisant

  1. Mécanisme 1
  2. induction/maintient
  3. Effets secondaires 3
A

Succinylcholine

  1. Ach rcp → dépolarisation → paralysie flasque
  2. Induction
  3. ES :
    1. HyperT°
    2. Dépolarisation importante → ⇣-erase prolongé paralysie
    3. Hyperkaliémie → arythmie !! brulure, rabdo !!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Curares

Non Dépolarisant

  1. Mécanisme 1
  2. induction/maintient
  3. Effets secondaires 3
A

Succinylcholine

  1. Compete with ACh to bind with the (nicotinic) ACh receptors at the motor end plate (competitive antagonists) → prevention of motor end plate depolarization (nondepolarization block)
  2. Induction / maintien
  3. ES :
    • Histamine release → rash, bronchospasm, hypotension
    • HTA
    • Paralysie
    • Depression resp
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Benzodiazépine

  1. Mécanisme 1
  2. Propriétés 6
  3. Effets secondaires 5
  4. Contre-indication 5
  5. Antidote
A
  1. Agoniste Indirect des rcp GABAA → ↓ neuronal excitability
  2. Indication :
    1. Sédatives : créé une somnolence
    2. Hypnotiques : capacité à passer dans le sommeil
    3. Anxiolytiques
    4. Amnésiantes : peu utilisé en clinique, plutôt EI, sauf lorsqu’on fait des gestes désagréables (endoscopie par ex.) —> amnésie antérograde du geste
    5. Anti-convulsivantes : IC épilepsie
    6. Myorelaxantes
  3. ES :
    1. Sédation résiduelle
    2. Difficulté de concentration
    3. Amnésie antérograde
    4. Confusion
    5. Dépression respiratoire : effet central → redouté selon les comorbidités (respiratoires) ou en surdosage
  4. CI :
    1. Hypersensitivity
    2. Myasthenia gravis
    3. Narrow-angle glaucoma
    4. Respiratory depression
    5. Drug dependence
  5. Flumazenil
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Sevrage Benzodiazépine

  1. Sevrage clinique 8 1.3 2.3 .3.2
  2. TTT 1
A
  1. Withdrawal symptoms
    • SNA
      • Sweating
      • Nausea, vomiting
      • Hypertension
    • Neurological
      • Seizures
      • Tremors
      • Memory impairment
    • Psychiatric
      1. Depressive moods
      2. Insomnia
  2. Treatment
    • Seizure prophylaxis (e.g., carbamazepine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
  1. Réaction paradoxal des benzo = ?
  2. Facteurs de risques ? 2
  3. TTT ?
A
  1. It may be due to the alteration of serotonin transmission and cortical inhibition +++ chez enfants et vieux →
  2. Facteurs de risques :
    1. include substance use and
    2. preexisting psychiatric conditions (e.g., anxiety disorder, personality disorders).
  3. Benzodiazepines should never be discontinued abruptly → R withdrawal symptoms and rebound phenomenon.
    Diminution progressive

Pharmacologie (8 decks)

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