General and Local Anesthetics - Kinder

Question 1

5 effects of general anesthesia

Answer 1

1 - unconscious
2 - amnesia
3 - analgesia
4 - inhibit autonomic reflexes
5 - skeletal m relax

Question 2

balanced anesthesia

Answer 2

balance IV and inhaled drugs

Question 3

volatile

Answer 3

liquid room temp
- admin with vaporizer

halothane, enflrane, isoflurane, desflurane, sevoflurane

-ane

Question 4

gaseous

Answer 4

gas at room temp

NO

Question 5

inhaled uptake and distribution

Answer 5

two factors - controlled by anesthesiologist

1 inspirited concentration
2 alveolar ventilation

Question 6

Fa/Fi

Answer 6

PP in alveoli

Fa - alveolar concentration
Fi - inspired concentration

approaches 1 - faster anesthesia occuring
-equilibrium of inspired : alveolar

Question 7

blood:gas partition coefficient

Answer 7

affinity of anesthetic for blood

low - rapid

high - slow

Question 8

speed recovery

Answer 8

hyperventilation

-only way to alter elminiation by anesthesiologist

Question 9

MAC

Answer 9

minimum alveolar concentration
-volume % that is anesthetic

1 MAC - 50% population immobile

1.3 MAC - 90%

Question 10

four stages of CNS depression

Answer 10

1 - analgesia
2 - excitement - delirious
3 - surgical anesthesia - slow RR HR
4 - medullary depression - need to be ventilated

Question 11

four planes of surgical anesthesia

Answer 11

ocular movement
eye reflexes
pupil size

increasing depth of anesthesia

Question 12

hepatitis

Answer 12

halothane

Question 13

malignant hypethermia

Answer 13

RyR receptor
-with inhaled anesthetics

tx - dantrolene

Question 14

propofol MOA

Answer 14

potentiate Cl current through GABA complex

lipid

Question 15

propofol ADR

Answer 15

egg allergy

Question 16

propofol PK

Answer 16

fast onset and fast elimination

Question 17

context sensitive half time

Answer 17

elimination half time after discontinue infusion

Question 18

barbituates

Answer 18

thiopental and methohexital

Question 19

barbituate MOA

Answer 19

GABA-A - increased channel opening

lipophilic

no analgesia

is a respiratory depressant

Question 20

benzodiazepenes MOA

Answer 20

increase sensitivity of GABA-A receptor

Question 21

flumazenil

Answer 21

terminate activity of benzodiazepene

antagonist

Question 22

etomidate MOA

Answer 22

GABA-A Cl current potentiation

minimal cardiac effect

Question 23

ketamine MOA

Answer 23

inhibit NMDA receptor

has analgesic effect

Question 24

ADR ketamine

Answer 24

vivid dreams, hallucinations, out of body experience

dissociative anesthesia

Question 25

dexmedetomidine MOA

Answer 25

alpha2 adrenergic agonist water soluble causes hypnosis and psych sleep state

Question 26

local anesthesia

Answer 26

loss of sensation - limited region of body disrupt afferent neural activity

Question 27

ester

Answer 27

shorter duration of action

Question 28

amide

Answer 28

longer duration of action

Question 29

MOA local anesthetic

Answer 29

block voltage gated Na channels

Question 30

differential block

Answer 30

local anesthetic - block all nerve actions myelinated nerve - blocked before unmyelinated more block at higher fire frequency (sensory is faster)

Question 31

orderly evolution

Answer 31

of block sympathetics > temp > pain > light touch > motor

Question 32

benzocaine

Answer 32

topical anesthetic

Question 33

bupivicaine

Answer 33

longer duration of action

Question 34

cocaine

Answer 34

block nerve impulse and cause local vasoconstriction also get euphoria

Question 35

lidocaine

Answer 35

faster, more intense, longer lasting

Question 36

anxiety prior to surgery

Answer 36

give midazolam

Question 37

IV induction agent with rapid onset/recovery and antiemetic

Answer 37

propofol

Question 38

pancuronium

Answer 38

lacks CNS depression lack change in LOC lack analgesia

Question 39

nitric oxide

Answer 39

MAC >100% so need to combine with other agents to knock someone out