General and Local Anesthetics Flashcards
What are the Inhaled Anesthetics?
Nitrous Oxide
Halothane
–Fluranes
What are the Inhaled Anesthetics?
Nitrous Oxide
Halothane
–Fluranes
What are the Local Anesthetics?
–Caines
What are the Local Anesthetics?
–Caines
What are 2 IV Anesthetics that are Benzodiazepines?
Diazepam
Midazolam
What are the 2 IV Anesthetics that work at different MOA than most of the IV Anesthetics?
Ketamine - NMDA antagonist
Fentanyl - opiate receptor
Besides Ketamine, Fentanyl and the 2 benzodiazepines, what are 2 other IV Anesthetics?
Etomidate
Propofol
Which Inhaled Anesthetics are gas at room temperature and which are liquid (volatile) at room temperature?
Gas = Nitrous Oxide
Liquid (volatile) = All the rest
What is the Blood:Gas Partition Coefficient with Inhaled Anesthetics?
Affinity of an anesthetic for the blood compared to that of inspired air
What type of relationship is there btwn the Blood:Gas Partition Coefficient and Rate of anesthesia onset for Inhaled Anesthetics?
Inverse relationship
==> LOW coefficient = FAST onset of action
If an Inhaled Anesthetic has a LOW Blood:Gas Partition Coefficient, what does that mean?
LOW blood solubility => FAST onset of action
What are 2 Inhaled Anesthetics that have LOW Blood:Gas Partition Coefficients?
Nitrous Oxide
Desflurane
If an Inhaled Anesthetic has a HIGH Blood:Gas Partition Coefficient, what does that mean?
HIGH blood solubility => SLOW onset of action
What is 1 Inhaled Anesthetic that has a HIGH Blood:Gas Partition Coefficient?
Halothane
What is the Minimal Alveolar Concentration (MAC) for Inhaled Anesthetics?
Measurement of anesthetic potency
= concentration of inhaled anesthetic that can prevent movement in response to surgical stimulation in 50% of subjects
Concentration of an Inhaled Anesthetic that can prevent movement in response to surgical stimulation in 50% of subjects
Minimal Alveolar Concentration (MAC)
Minimal Alveolar Concentrations are reported as %. What does that % correlate to?
Percentage of atmosphere that is anesthetic at the Minimal Alveolar Concentration
What adverse effect can Halothane cause?
Hepatitis
What are the symptoms of Halothane induced Hepatitis?
2 days - 3 weeks later
= N/V, rash, myalgia, jaundice with elevated liver enzymes and eosinophils
What Inhaled Anesthetic can cause N/V, rash, myalgia, jaundice with elevated liver enzymes and eosinophils?
Halothane induced Hepatitis
If you combine Inhaled Volatile Anesthetics with _____ you will get what adverse effect?
Inhaled Volatile Anesthetics + Succinylcholine
=> Malignant Hyperthermia
What are the symptoms of Malignant Hyperthermia seen when Inhaled Volatile Anesthetics are combined with Succinylcholine?
Rapid onset
= Increased HR, temp, K+ and HTN, with muscle rigidity, rhabdomyolysis and acidosis
What can cause a rapid onset of increased HR, temp, K+, HTN, muscle rigidity, rhabdomyolysis and acidosis?
Inhaled Volatile Anesthetics + Succinylcholine
=> Malignant Hyperthermia
What is the antidote for Malignant Hyperthermia?
Dantrolene
What is the majority of MOA for IV Anesthetics?
GABA Agonists
What IV Anesthetic produces a dissociative anesthetic state?
Ketamine
Describe the Ketamine induced dissociative anesthetic state?
+/- LOC
- Analgesia
- Amnesia
- Catatonia
What adverse effects can be seen after administration of Ketamine?
Dreams, hallucinations and unpleasant reactions
Which IV Anesthetic activates the sympathetics and is the only one to produce profound analgesia?
Ketamine
Propofol is a GABA(a) Agonist. What is the time it takes for onset and its duration?
30 seconds for onset
– lasts for 3-10 minutes
What are 2 possible side effects of Propofol?
Hypotension and respiratory depression
What is the water-soluble prodrug form of Propofol and what change in onset/recovery time does it have?
Fospropofol
– increased onset and recovery time
Etomidate enhances GABA current through GABA(a) receptors. What type of patients is it useful in?
Patients with impaired cardiovascular or respiratory symptoms
What is a possible adverse effect of Etomidate?
Adrenocortical suppression by (-) 11beta hydroxylase
Benzodiazepines can be used as Anesthesia Adjuncts. What is the MOA?
Increase GABA(a) receptor sensitivity to GABA
What are 2 Benzodiazepines and their MOA?
Diazepam
Midazolam
= Increase GABA(a) receptor sensitivity to GABA
With is the MOA for Local Anesthetics?
(-) voltage gated Na+ channels to stop AP spread
If Local Anesthetics have 2 “i”s in their name, what chemical class are they from?
Amide chemical class
If Local Anesthetics have 1 “i” in their name, what chemical class are they from?
Ester chemical class
What is the adverse effects of the Ester chemical class of Local Anesthetics?
Skin reactions
If Local Anesthetics are given with a vasoconstrictor (epi) what does that result in?
Decreased rate of absorption into circulation
Where should you not give vasoconstrictors with Local Anesthetics at?
Places supplied by end arteries
What are 3 Local Anesthetics that can be applied to the surface as a cream?
Benzocaine
Dibucaine
Cocaine
What are 3 Local Anesthetics that can be applied to the surface as a cream?
Benzocaine
Dibucaine
Cocaine
What are 3 Local Anesthetics that can be applied to the surface as a cream?
Benzocaine
Dibucaine
Cocaine
