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Drug Action > General anaesthetics > Flashcards

General anaesthetics Flashcards

1
Q

What does anaesthesia mean?

A

The abolition of sensation

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2
Q

What does analgesia mean?

A

The abolition of pain

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3
Q

What is the triad of general anaesthesia?

A

The need for:
Unconsciousness
Analgesia
Muscle relaxation/loss of reflexes

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4
Q

What is the structure of inhalational anaesthetics like?

A

Simple, unreactive compounds
Short chain molecules
No one chemical class

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5
Q

What does the lipid theory state?

A

The concentration of agents require to immobilise tadpoles is inversely proportional to its lipid:water partition coefficient

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6
Q

What does the protein theory state?

A

Lipid solubility is the gateway to accessing proteins in the cell
Binding to hydrophobic pockets on proteins

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7
Q

What are the targets of inhaled anaesthetics?

A

GABAa receptor
K+ channel activation
NMDA receptor, 5-HT3, Ach nicotinic
Glycine

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8
Q

What are the four responses to anaesthetic?

A

Memory
Consciousness
Movement
CVRS response

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9
Q

What is the first stage of anaesthesia?

A

Analgesia

Drowsiness
Reflexes intact
Still conscious

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10
Q

What is the second stage of anaesthesia?

A

Delirium (induction phase)

Excitement, delirium, incoherent speech
Loss of consciousness
Unresponsive to non-painful stimuli

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11
Q

What is dangerous about the second stage of anaesthesia?

A

Muscle rigidity, spasmodic movements
Cardiac arrhythmias
Vomiting and choking

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12
Q

What is the third stage of anaesthesia?

A

Surgical anaesthesia

Unresponsive to painful stimuli
Regular breathing
Abolition of reflexes
Muscle relaxation
Synchronised EEG
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13
Q

What is the fourth stage of anaesthesia?

A

Medullary paralysis (overdose)

Pupillary dilation
Respiration/circulation ceases
EEG wanes
Death

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14
Q

What two factors make a good anaesthetic agent?

A

Fast acting

Potent

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15
Q

What is MAC?

A

Minimum alveolar concentration

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16
Q

What does MAC mean?

A

The concentration of anaesthetic in the alveoli required to produce immobility in 50% of patients when exposed to a noxious stimulus
expressed as v/v%

17
Q

What is the main determinant of anaesthetic potency?

A

Lipid solubility

18
Q

How are MAC and lipid solubility related?

A

Inversely proportional

19
Q

What factors influence the rate of induction?

A

Properties of anaesthetic

Physiological factors

20
Q

Why is the blood:gas partition coefficient important?

A

A low coefficient = faster induction

21
Q

Why is tissue:blood partition coefficient important?

A

If it is high in lean tissue there will be fast induction

If it is high in adipose tissue it will accumulate, low induction

22
Q

An increase in anaesthetic concentration and rate of breathing will result in what effect on induction?

A

Increased speed of induction

23
Q

An increase in solubility in the blood will result in what effect on induction?

A

Decreased speed of induction

24
Q

What has to happen before blood transfers anaesthetic to the brain?

A

Blood has to be saturated

25
Q

What is the relationship between blood:gas partition coefficient and speed of induction?

A

Inversely proportional

26
Q

What effect will an increase in pulmonary blood flow have on the speed of induction?

A

Increased speed of induction

27
Q

What is the main method for eliminating anaesthetics?

A

Via the lungs

28
Q

Is metabolism involved in removing the effect of anaesthetics?

A

No, except for methyloxyflurane and halothane

29
Q

What are the characteristics of intravenous anaesthetics?

A

Rapid onset

Short acting

30
Q

What is balanced anaesthesia?

A

Using combinations of different drugs for optimal clinical effect with lowest risk

31
Q

What are the two mechanisms of action of intravenous anaesthetics?

A

Potentiation of GABAa receptor

Antagonism of NMDA receptor

32
Q

What are three types of drugs used alongside anaesthetic?

A

Premedication
Muscle relaxants
Anti-emetic

33
Q

What is the purpose of premedication?

A

Pain relief
Sedation
Amnesia
Muscle relaxation (to aid ventilation)

34
Q

What is the purpose of muscle relaxants?

A

To relax deep muscles such as the diaphragm without needing deeper anaesthesia

35
Q

What is the purpose of anti emetics?

A

To reduce vomiting in induction phase, post operative

Drug Action (19 decks)

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