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Pharmacology > General And Local Anthesthetics > Flashcards

General And Local Anthesthetics Flashcards

1
Q

What is neuraxial anesthesia?

A

Spinal, epidural and spinal-epidural anesthesia

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2
Q

What is a Bier block?

A

Local anesthesia via IV

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3
Q

What is MAC? What does it stand for?

A

Injected anesthesia without volatile liquids

Monitored Anesthetic Care

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4
Q

What is induction?

A

Going from consciousness to stage 3

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5
Q

What is PSA?

A

Procedural sedation w/ analgesia

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6
Q

What are the effects of a pt enters stage 4?

A

Loses vasomotor, cardioregulatory and respiratory center

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7
Q

What occurs after a pt after induction?

A

Maintenance

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8
Q

What is monitored by CRNA when pt is in stage 3?

A

ABC

Airways breathing and circulation

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9
Q

What is PONv stand forever

A

Post operative Nausea and Vomitting

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10
Q

What is balance anesthesia?

A

Low doses of many different anesthesia’s meds

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11
Q

What is desflurane(Suprane)? What effect does it have on the body? How pungent is it?

A

Volatile liquid

Causes bronchodilation
Increases SM tone

Very pungent

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12
Q

What is sevoflurane(Ultane)? What does it cause and how pungent is it?

A

Volatile liquid

Causes bronchodilation and SM tone

Not very pungent

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13
Q

What effects do inhaled anesthetics have on memory and pain?

A

Analgesic and amnesia effect

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14
Q

What do General anesthetics and inhaled anesthetics cause in the body?
Vessels, BP, and respiration

A

Vasodilator

Decrease BP

Respiratory depression

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15
Q

What does PONV stand for?

A

Post operative nausea and vomitting

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16
Q

What is the number 1 inhaled anesthetic?

A

Sevoflurane

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17
Q

What do volatile liquids end in?

A

-flurane

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18
Q

What is the MOA if inhaled anesthetics?

A

Activates GABA-A receptors to increase Cl- permeability

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19
Q

How are inhaled anesthetics administered?

A

Via mask

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20
Q

How are inhaled drugs supplied as and then what happens to them during surgery?

A

Start as liquid then are vaporized to be breathed in

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21
Q

What is the route of elimination for inhaled anesthetics?

A

Respirating

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22
Q

True or false: many volatile anesthetics are ethers?

A

True

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23
Q

A drug that has a high blood:gas partition coefficient is considered? How fast can it get to the brain?

A

More soluble in the blood (more hydrophilic)

Takes longer to get to the brain

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24
Q

A low blood:gas partition coefficient is?

A

Hydrophobic. Quicker to get to the brain

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25
Q

Out of desflurane, sevoflurane and halothane, which has the quickest onset or lowest blood:gas partition coefficient?

A

Desflurane

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26
Q

What does MAC stand for? What does it measure?

A

Minimum alveolar concentration

Potency of a drug

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27
Q

A low MAC means?

A

A high potency

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28
Q

What is a common ADR of volatile liquids and NMBD?

A

Malignant hyperthermia

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29
Q

How can malignant hyperthermia occur?

A

Taking volatile liquids or succlynate NMBD

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30
Q

What are the 5 common symptoms of malignant hyperthermia?

A 
Tachypnea
Tachycardia
Muscle rigidity
Acidosis
Increased body temp
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31
Q

True of false: is malignant hyperthermia life threatening?

A

True

32
Q

What is the antidote or used to Tx malignant hyperthermia?

A

Dantrolene(dantrium)

33
Q

What does PSA stand for?

A

Procedural sedation w/ analgesia

34
Q

What is 4 stages are considered PSA? Which has the greatest CNS depression?

A

Analgesia
Minimal sedation
Moderate sedation
Deep sedation

Deep sedation

35
Q

Which form of anesthesia uses volatile liquids?

A

General anesthesia

36
Q

What are the indications for PSA?(5)

A 
Dislocated joint (reduction)
Electrical cardio version
Severe laceration
Abscess incision
Lumbar puncture
37
Q

What is propofol(Diprivan)? How is it given? How quick does it onset and last? PONV? Analgesia or amnesia effect? Pain w/ injection?

A

General anesthetic

IV

Quick onset and recovery

No PONV

No analgesic effect, only amnesia

Pain with injection

38
Q

What drug is considered the milk of amnesia?

A

Propofol(diprivan)

39
Q

True or false: propofol has a large therapeutic range?

A

False, it has a very narrow therapeutic range

40
Q

Why must propofol(diprivan) be given with aseptic technique?

A

Because it can cause necrosis if bacteria in body are able to use it as good

41
Q

What pieces of equipment is needed if a provider is giving a pt propofol?

A

Intubation and respiratory assistance equipment

42
Q

What is etomidate(Amidate)? How is it given? What is is MOA? What is it used for? How does it effect BP or cardiac output? PONV? Pain w/ injection? Analgesic and amnesia activity?

A

General anesthetic

Given thru injection

Enhances GABA-A

Used for PSA and RSI

No effect on BP and cardiac output

Cause PONV

Pain w/ injection

Amnesia effect w/ No analgesic activity

43
Q

What is dexmedetomidine(Precedex)? What does it cause? Respiratory depression? Analgesic or amnesia effect? Indications? Why used in ventilator pt?

A

Alpha 2 agonist

Reduces NE release from Pons

Causes no respiratory depression

Small analgesic activity with amnesia

Used for PSA and RSI

Used on ventilator pt to not fight ventilator

44
Q

What is ketamine(Ketalar)? Indications? MOA? Analgesic and amnesia effect? Respiratory depression? Route?

A

General anesthetic

General anesthesia and setting broken bones

NMDA receptor antagonist (blocks excitation)

Good analgesic w/ amnesia

Oral or injected

45
Q

What does ketamine have effect on a pt eyes?

A

Eyes remain open

46
Q

What effect on skeletal muscle does ketamine have?

A

No effect

47
Q

What is midazolam(Versed)? What is it used for? Analgesic or amnesia effect? What is it used with? route? What age of pt often receive this medication?

A

Benzodiazepine

Minimal sedation (PSA)

Amnesia effect with no analgesic effect

Oral and rectal

Used with kids to calm them down

48
Q

What is another name for nitrous oxide? What must it be given with? PONV? Analgesic effect?

A

Laughing gas

Oxygen

Causes PONV

Analgesic effect

49
Q

Drugs that are GABA-A receptor enhancers?

A 
Barbiturates
Benzodiazepines
Etomidate
Propofol
Volatile anesthetics
50
Q

Drugs that are NMDA glutamate antagonists?

A

Ketamine
Nitrous oxide
Glutamate

51
Q

What is a local anesthetic pH before injection into body? Solution? ECF? Inside cell?

A

Weak base

Acidic

Basic

Acidic

52
Q

What is the MOA of local anesthetics?

A

Blocks Na inactivation gate

53
Q

What fibers are effected from local anesthetics?

A

A-delta fibers
C fibers
Small nerve fibers
Non-myelinated fibers

54
Q

What are the two different types of local anesthetics? How are they broken down? How long are they active?

A

Esters(broken down by AChase)
-short acting

Amides(broken down by liver)
-long acting

55
Q

What category of local anesthetic is cocaine? Route?

A

Ester

Given as injection

56
Q

What is Benzocaine? What category is it? What can long use cause? What is it used for?

A

Local anesthetic

Ester group

Causes allergies

Skin abrasions
Sunburn
Insect bite

57
Q

What is bupivicaine(Marcaine)? How long does it last? What is it used for?

A

Amide local anesthetic

Long acting

Used as epidural and nerve block

58
Q

What is lidocaine(Xylocaine)? What is the onset time? How long does it last?

A

Amide local anesthetic

Rapid onset

Intermediate lasting

59
Q

What is lidocaine(lidoderm patch)? What is it used for?

A

Amide local anesthetic

Used for postherapetic neuralgia (shingles)

60
Q

What are the difference route of local anesthetics?

A

OTC
EMLA
Injection
Infiltration analgesia

61
Q

What is intradermal injection with local anesthetic?

A

Infiltration analgesic

62
Q

What effects does epi w/ lidocaine cause? This helps with what?(2)

A

Vasoconstriction
Increase half life
Prevents it going systemic

63
Q

What local anesthetics penetrate the dura mater? Where must they be inserted below?

A

Spinal injections and taps

Below L2

64
Q

What are the ADR if local anesthetic goes systemic?

A

Cardiovascular collapse

Convulsions…leading to coma

Spinal headache

65
Q

How can you take away a spinal headache?

A

Inject blood into leaking area of spinal entry

Have pt Lay down

66
Q

What are the two type of skeletal muscle blockers/paralytic/NMBD?

A

Non-depolarize gets

Depolarizing

67
Q

What is succcinylcholine? MOA? Indication? ADR?

A

Depolarizing NMBD antagonist

Binds to N1 receptor causing twitching (agonist)
Then alters N1 receptor to not respond to ACh(antagonist)

RSI

Can cause malignant hyperthermia

68
Q

What are the two drugs that cause malignant hyperthermia?

A

Volatile liquids

Succcinylcholine

69
Q

What do non-depolarizing blockers end in?

A

-curium or -curonium

70
Q

How long does a blockade for non-depolarizing blockers last? How long is the onset to occur?

A

20-30min

3-5min wait for onset

71
Q

What is vecuronium bromide(Norcuron)?

A

Non-depolarizing blocker (paralytic)

72
Q

What is cisatracurium(Nimbex)?

A

Non-depolarizing blocker (paralytic)

73
Q

What is rocuronium bromide(Zemuron)?

A

Non-depolarizing blocker (paralytic)

74
Q

What is pancuronium bromide(Pavulon)?

A

Non-depolarizing blocker (paralytic)

75
Q

Before using NMBD what should a Hx been known on pt?

A

Hx of response time analgesia
Hx of allergies and medications
Hx of alcohol and opioids

Pharmacology (27 decks)

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