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Neuro Round 2 wk 2+ > General Anesthesia > Flashcards

General Anesthesia Flashcards

1
Q

What are the two routes of admin for general anesthetics?

A

IV and inhalation

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2
Q

LOC is achieved by anesthesia drugs that induce…

A

hypnosis

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3
Q

The maintenance of anesthesia is often done using…

A

both IV and inhalation drugs

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4
Q

What is the target for the hypnotic anesthesia drugs?

A

GABAa receptor

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5
Q

Most inhaled anesthetics have an additional method by which they induce membrane…

by working on …

A

hyperpolarization

by activating K channels that control neuronal membrane potential - 2 pore K channels

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6
Q

What drugs work on inhibiting NMDA channels to produce anesthesia?

A

nitrous oxide and ketamine

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7
Q

Hypnotic anesthesia drugs work by…

A

activating GABAa channels

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8
Q

Ketamine induces anesthesia by …

A

blocking glutamate induced excitation

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9
Q

The termination of anesthetic action depends primarily on…

A

redistribution

from the brain to other body tissues

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10
Q

What IV drug can be used to maintain anesthesia, since its duration of action is less sensitive to the duration of application than other drugs?

A

propofol

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11
Q

What benzo is often used for preop or intraop sedation and amnesia?

A

midazolam

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12
Q

What barbituates are used for rapid induction of anesthesia or total IV anesthesia for short procedures?

A

thiopental and methohexital

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13
Q

What drug has the lowest incidence of post op nausea and vomiting compared to other anesthesia drugs?

A

propofol

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14
Q

What is a benefit of the hypnotic agent etomidate over propofol?

A

minimal CV or resp depression

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15
Q

What are AEs of etomidate?

A

N/V

transient muscle movement (including myoclonus)

reduction in cortisol production d/t adrenocortical suppression

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16
Q

What drug produces a “dissociative” state wo complete LOC?

A

ketamine

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17
Q

What opioid is used in balanced anesthesia and conscious sedation, producing marked analgesia?

A

fentanyl

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18
Q

The action of IV anesthesia drugs is rapidly terminated by..

A

redistribution

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19
Q

How do you determine the brain concentration of an anesthetic agent?

A

brain concentration of volatile anesthesia drugs are closely related to the alveolar concentration

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20
Q

The rate of induction of anesthesia is facilitated by factors that maintain..

A

high partial pressure of anesthetic in the inspired gas mixture, alveolar space, and arterial blood

21
Q

What is inversely related to rate of induction of an anesthetic drug?

A

the fat solubility

22
Q

Highly lipid soluble drugs, like halothane, will take (longer/shorter) for induction of anesthesia.

A

longer time

23
Q

How does one eliminate inhaled anesthetics?

A

mostly through exhalation unchanged

24
Q

What is the most toxic of the volatile anesthesia drugs?

A

halothane

25
Q

the anesthesia concentration necessary to prevent movement in 50% of pts exposed to a surgical incision is…

A

minimum alveolar concentration (MAC)

26
Q

How is the potency of an anesthetic related to its MAC%?

A

inversely

27
Q

The MAC values for inhaled anesthetics are…

A

additive

28
Q

The MAC requirement is reduced when…

A

drugs like opioid analgesics and or sedative hypnotics are present

29
Q

What MAC value prevents movement in 95% of pts?

What MAC value is associated with awakening from anesthesia?

A
  1. 3
  2. 3-0.4
30
Q

Hematotoxicity may result from the inactivation of B12 dependent enzymes like methionine synthetase following prolonged exposure to…

This may cause…

A

nitrous oxide

megaloblastic anemia or neuropathy

31
Q

The low solubility of N2O allows it to…

A

have a rapid onset and recovery

32
Q

What are the volatile liquids that are halogenated agents?

What are some of their qualities?

A

halothane, isoflurane, desflurane, sevoflurane

high potency, low to moderate solubility in blood

provide slight to moderate analgesia and variable sk. muscle relaxation

provide full surgical anesthesia when used alone

33
Q

AEs of halogenated volatile agents?

A

decreased MAP - hypotension

decrease myocardial contractility and contractile force (negative ionotropic effects)

resp depression?

vasodilation in the brain, increase ICP

34
Q

What two drugs may sensitize the myocardium to catecholamines, potentially causing arrhythmias?

A

halothane and isoflurane

35
Q

previous exposure to halothane will increase the risk of..

A

hepatotoxicity

36
Q

What kind of toxicity may result from releases of free fluoride ions or other degration of products of anesthetic agents?

A

nephrotoxicity

37
Q

What kind of mutation is likely present when a person has malignant hyperthermia?

A

ryanodine receptor mutation

38
Q

What volatile anesthetic agent has a rapid onset and recovery, low pungency and is pretty good for induction?

A

sevoflurane

39
Q

The inhaled anesthesia drug with the highest MAC% is…

A

nitrous oxide

40
Q

Halothane has the slowest onset of anesthesia because it has the…

A

highest solubiltiy

41
Q

Which inhaled anesthesia drug irritates the respiratory system?

A

desflurane

42
Q

MAC is highest at what age?

What does this mean?

A

6 months

requirement of the most amount of anesthetic drugs is higher than any other time

43
Q

lower solubility gas =

A

faster inhlaed induction and faster emergence

go to sleep and wake

44
Q

When would I use isoflurane?

A

really sick, going to ICU after word, won’t be in pain while we set them up after surgery

45
Q

What drugs are contraindicated in a pt w hx of malignant hyperthermia?

A

succinylcholine and halogenated volatile anesthetics

46
Q

IV anesthetics may or may not cause…

A

analgesia

47
Q

muscle relaxants like roc do not provide…

A

anesthesia or analgesia

48
Q

What is the MC used induction agent?

A

propofol

49
Q

constellation of metabolic derangements occurring after long term high dose propofol infusion, mostly in kids

A

propofol infusion syndrome

Neuro Round 2 wk 2+ (16 decks)

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