General Anesthesia Flashcards by Jamaira Belmes

Inhalational Anesthetics

Nitrous Oxide

Halothane -hepatotoxic

Desflurane - causes reflex tachycardia; bronchoconstriction; ekis sa asthma

Isoflurane - causes reflex tachycardia; coronary steal syndrome; ekis sa pheochromocytoma

Enflurane
Sevoflurane
Methoxyflurane

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LEAST POTENT FASTEST ONSET

Nitrous Oxide

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MOST POTENT SLOWEST ONSET

Methoxyflurane

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Effects of Anesthesia

CNS depression
Respiratory depression
CV depression
smooth muscle relaxation

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Malignant Hyperthermia

mutation in ryanodine receptor –> uncontrolled release of calcium from SR

muscle rigidity
hyperthermia
tachycardia
hypercapnia
hyperkalemia
metabolic acidosis

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Treatment for Malignant Hyperthermia

DANTROLENE

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Intravenous Anesthetics

Barbiturates
Benzodiazepenes
Ketamine
Etomidate
Propofol
Dexmedetomidine

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MOA of Barbiturates

bind to GABAa

increase DURATION of chloride channels

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MOA of Benzodiazepenes

bind to GABAa

increase FREQUENCY of chloride channels

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Antidote of Benzodiazepenes

FLUMAZENIL

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MOA of Ketamine

NMDA antagonist

causes DISSOCIATIVE AMNESIA

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MOA of Etomidate

modulates GABAa receptors containing B3 subunits

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Adverse effects of Etomidate

ADRENOCORTICAL SUPRESSION

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MOA of Propofol

potentiates GABAa receptors

blocks Na channels

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IV anesthetics induction of choice

Propofol

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Called the MILK OF MAGNESIA

Contains EGG LECITHIN

Propofol

Cardinal Feature of Propofol Infusion Syndrome

metabolic acidosis

Fentanyl + Droperidol causes

NEUROLEPTANALGESIA

Fentanyl + Droperidol + Nitrous Oxide causes

NEUROLEPTANESTHESIA

MOA of DEXMEDETOMIDINE

sedative analgesic agent

alpha 2 adrenoceptor agonist

Opioid ANTIDODE

NALOXONE

BEST inhalational anesthetics for patients with HEART FAILURE

ISOFLURANE
DESFLURANE
SEVOFLURANE

depress normal cardiac contractility via VASODILATION BUT CO is PRESERVED

Produces the MOST CO out of all inhaled anesthetics

Desflurane

Inhalational Anesthetics

Contraindicated in patients with asthma
PUNGENT ODOR
bronchoconstrictor!!!

Desflurane

Inhalational Anesthetics SWEET SMELLING BEST for ASTHMATIC SE: nephrotoxic

Sevoflurane

Inhalational Anesthetics SE: CORONARY STEAL SYNDROME

Isoflurane

Inhalational Anesthetics SE: spike and wave activity in EEG, muscle twitching, breath holding PUNGENT ODOR

Enflurane

Inhalational Anesthetics HIGHEST POTENCY LOWEST MAC

Methoxyflurane

Inhalational Anesthetics SE: Hepatitis

Halothane

Intravenous Anesthetics NMDA antagonist Weak GABAa modulation for DISSOCIATE ANESTHESIA ideal for asthmatic patients

PHENYCYCLIDINE DERIVATIVE Ketamine SE: emergence delirium increased ICP lacrimation and salivation

Intravenous Anesthetics Modulates GABAa receptors containing B3 subunits Induction agent of choice for UNSTABLE PATIENT (limited cardiac or respiratory reserve)

IMIDAZOLE DERIVATIVE Etomidate SE: adrenocortical suppression

Intravenous Anesthetics Interact with m (mu), delta and k (kappa) receptors for endogenous opioid peptides for ANALGESIA

OPIOID ANALGESICS Fentanyl Morphine Alfentanil Remifentanil SE: respiratory depression chest wall rigidity

Intravenous Anesthetics Potentiates GABAa receptors Blocks Na channels "MILK OF MAGNESIA" IV anesthetic induction of choice sedation for ICU patients and outpatients procedures

Propofol

Alternative general anesthetic maintenance for patients susceptible to malignant hyperthermia

Propofol

Binds to GABAa receptor sites for INCREASED ICP do NOT produce analgesia rather CAUSE HYPERALGESIA

BARBITURATES Thiopental Methohexital - for identification of epileptic foci Thiamylal

Binds to GABAa receptor sites

BENZODIAZEPINES ``` Midazolam Brotizolam Triazolam Oxazepam Etizolam Lorazepam ``` SE: anterograde amnesia

Usual adjunct with INHALATIONAL ANESTHETICS and IV OPIOIDS

Midazolam

Novel sedative analgesic agent Alpha 2 adrenoceptor agonist

Dexmedetomidine