GA

Question 1

Mechanism of action of GA

Answer 1

1. Enhance neurotransmission at inhibitory synapses via allosterically increasing GABA receptor sensitivity to action by GABA itself (positive allosteric modulator)
2. Also depressing neurotransmission at excitatory synapses via blocking glutamate neurotransmitter acting on NMDA receptor thus preventing NMDA receptor activation (negative allosteric modulator)

Question 2

3 main properties (balanced anaesthesia)

Answer 2

Hypnosis (Unconsciousness)
Analgesia (loss of perception of pain)
Amnesia (Not remembering)

Question 3

Name 3 examples of inhalation GA from most potent to least potent

Answer 3

Volatile Liquid:
Halothane
Isoflurane
Sevoflurane

Gas:
Nitrous Oxide

Question 4

Name 3 examples of inhalation GA from most soluble to least soluble

Answer 4

Gas: Nitrous Oxide

Volatile Liquid:
Sevoflurane
Isoflurane
Halothane (most soluble)

Question 5

What is one major concern of Nitrous Oxide?

Answer 5

Postoperative Nausea and Vomiting

Question 6

Inhalation GA (eg. ___ and ____) may cause ____ due to ___ of cardiac output.

Answer 6

Inhalation GA (eg. Halothane and Isoflurane) may cause hypotension due to depression of cardiac output.

(Isoflurane is similar to Halothane with less hypotension and arrhythmia)

Question 7

____ has potential hepatotoxicity

Answer 7

Halothane

Question 8

____ may cause respiratory depression

Answer 8

Halothane

Question 9

____ has potential nephrotoxic

Answer 9

Sevoflurane

Question 10

One unique point to differentiate Isoflurane with Halothane

Answer 10

Isoflurane has a pungent smell

Question 11

What are 2 advantage of Inhaled + IV anaesthetics

Answer 11

1. Dosage of inhalation agent can be reduced
2. Produce effects that cannot be achieved with an inhaled GA alone

Question 12

3 examples of IV GA

Answer 12

Thiopentone
Propofol
Ketamine

Question 13

Onset of action for Thiopentone

Answer 13

10 to 20 seconds after IV

Question 14

Mechanism of action of Thiopentone

Answer 14

Causes CNS depression by potentiating the action of GABA on the GABA receptor -gated chloride ion channels.

Question 15

___ is commonly used for “day surgery”

Answer 15

IV Propofol

Question 16

Propofol needs to be used with caution in ____ and patients with compromised ____ .

Answer 16

Propofol needs to be used with caution in elderly patients and patients with compromised cardiac function.

Question 17

Name a IV anaesthetic that possess analgesic property

Answer 17

Ketamine

Question 18

Name 3 psychologic reactions that may occur during recovery from Ketamine

Answer 18

Hallucinations
Disturbing dreams
Delirium

Question 19

IV Ketamine is a ____ anaesthesia

Answer 19

Dissociative anaesthesia
(feels dissociated from environment)