General and Local Anesthetics Flashcards
thiopental: what it is, use, positive/negative aspects, side effects, contraindications
- parenterally administered barbiturate general anesthetic
- induction only
- has a long half-life so it can produce “hang-over” effects after anesthesia has worn off
- side effect: causes decreased ICP, venodilation, respiratory depression
- contraindicated in patients with impaired ability to compensate for venodilation (e.g., hypovolemia, cardiomyopathy)
can cause “hang-over” effects after anesthesia has worn off
thiopental
propofol: what it is, use, positive/negative aspects, side effects, contraindications
-parenterally administered general anesthetic
-induction and maintenance
-antiemetic
-shorter half-life than thiopental so it is used for outpatient surgery
-side effects: decreased ICP,
more severe decrease in BP than thiopental, more respiratory depression than thiopental
-contraindicated in patients with impaired ability to compensate for venodilation (e.g., hypovolemia, cardiomyopathy)
antiemetic
propofol
shorter half-life than thiopental so it is used for outpatient surgery
propofol
contraindicated in patients with impaired ability to compensate for venodilation (e.g., hypovolemia, cardiomyopathy)
thiopental, propofol
etomidate: what it is, use, positive/negative aspects, side effects
- parenterally administered general anesthetic
- induction for patients at risk for hypotension
- little or no decrease in BP, less respiratory depression than thiopental and propofol
- side effects: significantly more nausea and vomiting than thiopental, increased post-surgical morbidity due to suppression of adrenocortical stress response
suppression of adrenocortical stress response
etomidate
used for induction for patients at risk for hypotension
etomidate
dissociative anesthesia
ketamine
parenterally administered general anesthetic that does not act on GABA receptors
ketamine (NMDA receptor antagonist)
emergence delirium
ketamine
ketamine: what it is, use, positive/negative aspects, side effects
- parenterally-administered general anesthetic reserved for patients with asthma/bronchospasm
- NMDA receptor antagonist
- causes “dissociative anesthesia”
- causes no respiratory depression and is a bronchodilator
- side effects: nystagmus, spontaneous limb movements, increased ICP, hypertension, emergence delirium
anesthetic reserved for patients with asthma/bronchospasm
ketamine
short-acting benzodiazepine parenterally-administered general anesthetic
midazolam
conscious sedation
midazolam
anxiolytic
midazolam
midazolam: what it is, duration of action, use, positive/negative aspects, side effects, contraindications
- parenterally-administerd short-acting benzodiazepine general anesthetic
- induction only
- used for conscious sedation
- anxiolytic = good for pre-op
- side effects: respiratory depression/respiratory arrest, decreased BP
- contraindicated in patients with neuromuscular disease, Parkinson’s, bipolar disorder
how does blood:gas coefficient influence the rate of induction and recovery from anesthesia?
the lower the blood:gas partition coefficient, the faster the rate of induction and the shorter the recovery from anesthesia
isoflurane: what it is, blood:gas coefficient, use, side effects
- inhalational anesthetic
- moderate blood:gas coefficient
- induction and maintenance
- side effects: airway irritant, decreases BP, increased ICP
desflurane: what it is, blood:gas coefficient, use, side effects
- inhalational anesthetic
- very low blood:gas coefficient (=rapid induction and recovery)
- maintenance (not used to induce because it can cause bronchospasm)
- side effects: airway irritant, decreases BP, increased ICP
sevoflurane: what it is, blood:gas coefficient, use, side effects
- very low blood:gas coefficient (=rapid induction and recovery)
- induction and maintenance
- side effects: NOT a respiratory irritant, decreases BP, increased ICP, less respiratory depression than isoflurane; can be metabolized to fluoride ion in the liver –> renal damage
inhalational anesthetic that is NOT a respiratory irritant
sevoflurane
moderate blood:gas coefficient
isoflurane
anesthetics used for induction and maintenance
SIP: propofol, sevoflurane, isoflurane
nitrous oxide
- rapid uptake from the alveolae results in “concentration” of gases that are administered at the same time
- can dilute oxygen when its use is discontinued, therefore need to place patients on 100% O2 during emergence
cocaine: what it is, use
- ester local anesthetic
- potent vasoconstrictor–>shrinks mucosal membranes and limits bleeding
- used as topical anesthetic for upper respiratory tract
procaine: duration of action, what it is, use
- short-acting synthetic ester local anesthetic
- infiltration anesthesia
tetracaine: duration of action, what it is, use
- long-acting ester local anesthetic
- used in spinal anesthesia and in topical and ophthalmic preparations
benzocaine: what it is, use
- ester local anesthetic
- applied topically to burns and ulcerated surfaces
lidocaine: what it is, duration of action, comparison with procaine, uses
- amide local anesthetic
- intermediate duration of action
- faster, more intense, longer lasting anesthesia than procaine
- wide range of clinical uses
bupivacaine: duration of action, what it is, positive aspect, side effects
- long acting amide local anesthetic
- motor-sparing
- more cardiotoxic than lidocaine
ropivacaine: duration of action, what it is, positive aspects, uses
- long acting amide local anesthetic
- less cardiotoxic than bupivacaine
- even more motor-sparing than bupivacaine
- epidural and regional anesthesia
drugs that are long acting amide local anesthetics
bupivacaine, ropivacaine
least cardiotoxic amide local anesthetic
ropivacaine
most cardiotoxic amide local anesthetic
bupivacaine
short-acting synthetic ester local anesthetic
procaine
long-acting ester local anesthetic used in spinal anesthesia and in topical and ophthalmic preparations
tetracaine
most motor-sparing amide local anesthetic
ropivacaine
