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FPT > General Anaesthetics > Flashcards

General Anaesthetics Flashcards

1
Q

agents that bring about reversible loss of all sensations and consciousness

A

general anesthetics.

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2
Q

list the 5 primary effects that characterizes the neurophysiological state produced by GA?

A

1- unconsciousness.
2- amnesia.
3- analgesia.
4- inhibition of autonomic reflexes.
5- skeletal muscle relaxant.

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3
Q

which type of anesthesia is generally used to minimize side effects?

A

balanced anesthesia.

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4
Q

list the types of drugs that are involved in balanced anesthesia?

A

inhaled anesthetics, intravenous anesthetics, sedative-hypnotics, opioids, neuromuscular blocking drugs.

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5
Q

the practice of clinical anesthesia requires integrating _________ and ____________ of each individual patient.

A

pharmacology of GA, and the pathophysiological state.

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6
Q

the choice of anesthetic agent depends on what?

A

1- status of organ systems.
2- concomitant use of drugs.

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7
Q

list the 3 classification of general anesthetics?

A

1- inhalational agents.
2- intravenous anesthetics.
3- dissociative anesthetics.

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8
Q

list the 2 types of inhalation agents?

A

1- gas.
2- liquids.

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9
Q

give an example of a gas inhalation agent?

A

nitrous oxide.

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10
Q

give examples of liquid inhalation agents?

A

1- halothane.
2- methoxyflurane.
3- desflurane.
4- isoflurane.
5- enflurane.
6- xenon.

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11
Q

list the 3 types of intravenous anesthetics?

A

1- barbiturates.
2- non-barbiturate.
3- benzodiazepines.

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12
Q

give examples of intravenous anesthetics barbiturates?

A

1- thiopentone.
2- methohexitone.

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13
Q

give examples of intravenous anesthetic non-barbiturates?

A

propofol.

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14
Q

give example of intravenous anesthetic benzodiazepines?

A

1- diazepam.
2- lorazepam.
3- midazolam.

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15
Q

give an example of dissociative anesthetics?

A

ketamine.

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16
Q

list the 4 states of general anesthesia?

A

1- pre-anaesthetic medication.
2- induction.
3- maintenance.
4- recovery.

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17
Q

general anesthesia is a reversible state of _______.

A

CNS depression.

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18
Q

give examples of pre anesthetic medication?

A

benzodiazepines.

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19
Q

give example of induction drugs?

A

thiopental, and propofol.

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20
Q

give an example of agents used in maintance?

A

inhaled or IV agents or both.

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21
Q

give an example of agents used in maintenance?

A

inhaled or IV agents or both.

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22
Q

the depth of anesthesia has four sequential stages, list them?

A

1- stage 1: analgesia.
2- stage 2: excitement.
3- stage 3: surgical anesthesia.
4- stage 4: medullary paralysis.

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23
Q

what happens in stage 1 (analgesia) of anesthesia?

A

loss of pain sensation.

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24
Q

what happens in stage 2 (excitement) of anesthesia?

A
  • patient displays delirium.
  • rise and irregularity in BP and respiration.
  • rapid acting IV agents shorten this stage.
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25
Q

what happens in stage 3 (surgical anesthesia) of anesthesia?

A
  • regular respiration and skeletal muscle relaxation with loss of spontaneous movement.
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26
Q

what happens in stage 4 (medullary paralysis) of anesthesia?

A

severe depression of respiratory and vasomotor centers occurs.

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27
Q

what stage of anesthesia is the ideal stage for surgery?

A

stage 3 (surgical anesthesia).

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28
Q

the minimum concentration of an inhalation agent required in the alveoli to produce unresponsiveness to the skin incision in 50% patients?

A

minimum alveolar concentration (MAC).

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29
Q

MAC is a measure of ______ of an agent?

A

potency.

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30
Q

greater is the MAC, _______ is the potency.

A

lesser

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31
Q

which drug has maximum MAC, thus least potency?

A

nitrous oxide.

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32
Q

which drug is the most potent, having the least MAC?

A

methoxyflurane.

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33
Q

Blood gas partition coefficient is determined by?

A

the solubility of an agent in blood

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34
Q

Blood gas partition coefficient determines what?

A

the speed of onset and recovery

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35
Q

Greater is the blood gas partition coefficient, _______ is the speed of onset

A

lesser

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36
Q

which drug is the fastest acting agent as it has minimum blood gas partition coefficient?

A

xenon.

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37
Q

which drug is the slowest acting agent (maximum blood gas partition coefficient)

A

Methoxyflurane

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38
Q

All inhalational agents result in what in the respiratory system?

A

respiratory depression

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39
Q

which inhalation agent causes respiratory depression?

A

Enflurane

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40
Q

Inhalation agents effects in the respiratory system: Blunt ventilatory response to?

A

hypercapnia and hypoxia

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41
Q

Blunt ventilatory response to hypercapnia and hypoxia is seen most with which inhalation agent?

A

halothane.

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42
Q

All inhalational agents cause what?

A

bronchodilation

43
Q

All inhalational agents cause bronchodilation, seen the most with which drugs?

A

halothane in asthmatics
and with sevoflurane in non-asthmatics.

44
Q

list the systemic effects of inhalation agents on the CVS?

A

1- Reduce cardiac output.
2- Reduce BP.
3- Baroreceptor reflexes are blunted.

45
Q

which inhalation agents do NOT reduce cardiac output?

A

isoflurane and desflurane.

46
Q

which inhalation agents show max decrease in BP?

A

Isoflurane.

47
Q

which inhalation agent increases BP?

A

cyclopropane.

48
Q

which inhalation agent is used for producing controlled hypotension?

A

isoflurane.

49
Q

which inhalation agent is used for patients with shock?

A

cyclopropane.

50
Q

which inhalation agent does NOT blunt baroreceptor reflexes?

A

isoflurane.

51
Q

which inhalation agent is used in cardiac patients?

A

isoflurane.

52
Q

which inhalation agents may result in hepatotoxicity?

A

halothane, chloroform, and methoxyflurane.

53
Q

which drug can result in vasopressin resistant polyuric renal failure?

A

Methoxyflurane

54
Q

which drug is added to decrease renal inflammability with methoxyflurane?

A

fluoride.

55
Q

which drug can cause megaloblastic anemia?

A

nitrous oxide.

56
Q

all inhalation drugs are good muscle relaxants except?

A

nitrous oxide.

57
Q

max effect of muscle relaxation with which drug?

A

ether.

58
Q

max analgesia is cause by which drug?

A

trilene.

59
Q

ether is also a good _____ agent

A

analgesic.

60
Q

which drug is also called laughing gas?

A

nitrous oxide.

61
Q

nitrous oxide is a _____ analgesic agent but _____ anaesthetic.

A

good analgesic.
poor anaesthetic.

62
Q

which drug has highest MAC?

A

nitrous oxide.

63
Q

nitrous oxide is a _____ muscle relaxant.

A

poor.

64
Q

nitrous oxide shows ________ induction and recovery of anesthesia

A

fast.

65
Q

nitrous oxide is used in a concentration of ______% with ____% ____.

A

50-60% with 33% oxygen.

66
Q

________ is a mixture of 50% N2O + 50% O2.

A

entonox.

67
Q

what can occur when supply of N20 is stopped while recovery from anaesthesia?

A

Diffusion hypoxia

68
Q

how can we prevent Diffusion hypoxia?

A

by 100% oxygen for a few minutes before stopping N20

69
Q

which drug comes in a blue cylinder?

A

nitrous oxide.

70
Q

which drug comes in amber colored bottles?

A

Halothane.

71
Q

which drug contains thymol as preservative?

A

Halothane.

72
Q

halothane is a _____ anaesthetic but very _____ analgesic agent

A

good anesthetic.
poor analgesic.

73
Q

halothane relaxes which organ?

A

uterus.

74
Q

halothane is used for what?

A

internal version and manual
removal of placenta

75
Q

what is halothane contradicted in and why?

A

Contraindicated in labour: risk of postpartum hemorrhage (PPH)

76
Q

halothane is agent of choice in what?

A

bronchial asthma.

77
Q

why is halothane agent of choice in bronchial asthma?

A

has bronchodilator action.

78
Q

halothane is agent of induction in which age group?

A

children.

79
Q

list the properties of halothane?

A
  • H- Hyperthermia (malignant hyperthermia)
  • A- Arrhythmias (sensitizes the heart to adrenaline)
  • L- Liver toxic
  • O- Orthostatic hypotension
  • T- Tocolytic
  • H- Heart (inhibits heart > decreases cardiac output)
  • A- Asthma (bronchodilator)
  • N
  • E- Non-Explosive
  • C- Chills (post-anesthetic shivering)
  • C- Catecholamines (sensitizes the heart to arrhythmogenic action)
  • C- Children (safe in children)
80
Q

isoflurane is _______ analgesic agent.

A

not a good.

81
Q

cardiac output is maintained with which drug?

A

isoflurane.

82
Q

which drug is the agent of choice for cardiac surgery?

A

isoflurane.

83
Q

which drug produces the least increase in intracranial pressure?

A

isoflurane.

84
Q

which drug is the agent of choice in neurosurgery?

A

isoflurane.

85
Q

which drug produces max decrease in BP?

A

isoflurane.

86
Q

which drug is the agent for producing controlled hypotension?

A

isoflurane.

87
Q

which inhalation agent can be used in day care surgery?

A

isoflurane.

88
Q

which drug is safe in pheochromocytoma?

A

isoflurane.

89
Q

which drug is inflammable and explosive agent?

A

ether

90
Q

which drug is the safest agent in unskilled hands?

A

ether

91
Q

which drug is the agent of choice for induction in children?

A

sevoflurane.

92
Q

which drug produces a nephrotoxic metabolite, Compound A: do not use in
closed circuit?

A

sevoflurane.

93
Q

which drug is the most potent analgesic agent: used for analgesia in labour?

A

Trielene

94
Q

which drug is the inhalational agent of choice in hemorrhagic shock (increases BP by increasing sympathetic tone)?

A

Cyclopropane

95
Q

which drug is very close to an ‘ideal inhalational anaesthetic’?

A

xenon.

96
Q

which drug Does not cause respiratory or cardiovascular depression?

A

xenon.

97
Q

which drug is Not metabolised in the body?

A

xenon.

98
Q

which drug is Stable in storage and has no interaction with anesthesia circuit or soda lime?

A

xenon.

99
Q

which type of anesthetics are Used for rapid induction of anaesthesia?

A

Intravenous anesthetics

100
Q

which type of anesthetics Provide sedation during Monitored Anaesthesia Care?

A

Intravenous anesthetics

101
Q

which type of anesthetics are Used as sedative in ICU settings?

A

Intravenous anesthetics

102
Q

which type of anesthetics Can also be used for maintenance of anaesthesia?

A

Intravenous anesthetics

103
Q

which IV agent can be used for maintenance of anesthesia?

A

propofol

FPT (17 decks)

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