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NMSP - Exam 2 > General and Local Anesthetics > Flashcards

General and Local Anesthetics Flashcards

1
Q

What are the Inhaled Anesthetics?

A

Nitrous Oxide
Halothane
–Fluranes

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2
Q

What are the Inhaled Anesthetics?

A

Nitrous Oxide
Halothane
–Fluranes

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3
Q

What are the Local Anesthetics?

A

–Caines

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4
Q

What are the Local Anesthetics?

A

–Caines

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5
Q

What are 2 IV Anesthetics that are Benzodiazepines?

A

Diazepam

Midazolam

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6
Q

What are the 2 IV Anesthetics that work at different MOA than most of the IV Anesthetics?

A

Ketamine - NMDA antagonist

Fentanyl - opiate receptor

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7
Q

Besides Ketamine, Fentanyl and the 2 benzodiazepines, what are 2 other IV Anesthetics?

A

Etomidate

Propofol

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8
Q

Which Inhaled Anesthetics are gas at room temperature and which are liquid (volatile) at room temperature?

A

Gas = Nitrous Oxide

Liquid (volatile) = All the rest

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9
Q

What is the Blood:Gas Partition Coefficient with Inhaled Anesthetics?

A

Affinity of an anesthetic for the blood compared to that of inspired air

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10
Q

What type of relationship is there btwn the Blood:Gas Partition Coefficient and Rate of anesthesia onset for Inhaled Anesthetics?

A

Inverse relationship

==> LOW coefficient = FAST onset of action

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11
Q

If an Inhaled Anesthetic has a LOW Blood:Gas Partition Coefficient, what does that mean?

A

LOW blood solubility => FAST onset of action

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12
Q

What are 2 Inhaled Anesthetics that have LOW Blood:Gas Partition Coefficients?

A

Nitrous Oxide

Desflurane

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13
Q

If an Inhaled Anesthetic has a HIGH Blood:Gas Partition Coefficient, what does that mean?

A

HIGH blood solubility => SLOW onset of action

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14
Q

What is 1 Inhaled Anesthetic that has a HIGH Blood:Gas Partition Coefficient?

A

Halothane

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15
Q

What is the Minimal Alveolar Concentration (MAC) for Inhaled Anesthetics?

A

Measurement of anesthetic potency

= concentration of inhaled anesthetic that can prevent movement in response to surgical stimulation in 50% of subjects

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16
Q

Concentration of an Inhaled Anesthetic that can prevent movement in response to surgical stimulation in 50% of subjects

A

Minimal Alveolar Concentration (MAC)

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17
Q

Minimal Alveolar Concentrations are reported as %. What does that % correlate to?

A

Percentage of atmosphere that is anesthetic at the Minimal Alveolar Concentration

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18
Q

What adverse effect can Halothane cause?

A

Hepatitis

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19
Q

What are the symptoms of Halothane induced Hepatitis?

A

2 days - 3 weeks later

= N/V, rash, myalgia, jaundice with elevated liver enzymes and eosinophils

20
Q

What Inhaled Anesthetic can cause N/V, rash, myalgia, jaundice with elevated liver enzymes and eosinophils?

A

Halothane induced Hepatitis

21
Q

If you combine Inhaled Volatile Anesthetics with _____ you will get what adverse effect?

A

Inhaled Volatile Anesthetics + Succinylcholine

=> Malignant Hyperthermia

22
Q

What are the symptoms of Malignant Hyperthermia seen when Inhaled Volatile Anesthetics are combined with Succinylcholine?

A

Rapid onset

= Increased HR, temp, K+ and HTN, with muscle rigidity, rhabdomyolysis and acidosis

23
Q

What can cause a rapid onset of increased HR, temp, K+, HTN, muscle rigidity, rhabdomyolysis and acidosis?

A

Inhaled Volatile Anesthetics + Succinylcholine

=> Malignant Hyperthermia

24
Q

What is the antidote for Malignant Hyperthermia?

A

Dantrolene

25
Q

What is the majority of MOA for IV Anesthetics?

A

GABA Agonists

26
Q

What IV Anesthetic produces a dissociative anesthetic state?

A

Ketamine

27
Q

Describe the Ketamine induced dissociative anesthetic state?

A

+/- LOC

  • Analgesia
  • Amnesia
  • Catatonia
28
Q

What adverse effects can be seen after administration of Ketamine?

A

Dreams, hallucinations and unpleasant reactions

29
Q

Which IV Anesthetic activates the sympathetics and is the only one to produce profound analgesia?

A

Ketamine

30
Q

Propofol is a GABA(a) Agonist. What is the time it takes for onset and its duration?

A

30 seconds for onset

– lasts for 3-10 minutes

31
Q

What are 2 possible side effects of Propofol?

A

Hypotension and respiratory depression

32
Q

What is the water-soluble prodrug form of Propofol and what change in onset/recovery time does it have?

A

Fospropofol

– increased onset and recovery time

33
Q

Etomidate enhances GABA current through GABA(a) receptors. What type of patients is it useful in?

A

Patients with impaired cardiovascular or respiratory symptoms

34
Q

What is a possible adverse effect of Etomidate?

A

Adrenocortical suppression by (-) 11beta hydroxylase

35
Q

Benzodiazepines can be used as Anesthesia Adjuncts. What is the MOA?

A

Increase GABA(a) receptor sensitivity to GABA

36
Q

What are 2 Benzodiazepines and their MOA?

A

Diazepam
Midazolam
= Increase GABA(a) receptor sensitivity to GABA

37
Q

With is the MOA for Local Anesthetics?

A

(-) voltage gated Na+ channels to stop AP spread

38
Q

If Local Anesthetics have 2 “i”s in their name, what chemical class are they from?

A

Amide chemical class

39
Q

If Local Anesthetics have 1 “i” in their name, what chemical class are they from?

A

Ester chemical class

40
Q

What is the adverse effects of the Ester chemical class of Local Anesthetics?

A

Skin reactions

41
Q

If Local Anesthetics are given with a vasoconstrictor (epi) what does that result in?

A

Decreased rate of absorption into circulation

42
Q

Where should you not give vasoconstrictors with Local Anesthetics at?

A

Places supplied by end arteries

43
Q

What are 3 Local Anesthetics that can be applied to the surface as a cream?

A

Benzocaine
Dibucaine
Cocaine

44
Q

What are 3 Local Anesthetics that can be applied to the surface as a cream?

A

Benzocaine
Dibucaine
Cocaine

45
Q

What are 3 Local Anesthetics that can be applied to the surface as a cream?

A

Benzocaine
Dibucaine
Cocaine

NMSP - Exam 2 (29 decks)

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