General Anesthesia

Question 1

What are the two routes of admin for general anesthetics?

Answer 1

IV and inhalation

Question 2

LOC is achieved by anesthesia drugs that induce…

Answer 2

hypnosis

Question 3

The maintenance of anesthesia is often done using…

Answer 3

both IV and inhalation drugs

Question 4

What is the target for the hypnotic anesthesia drugs?

Answer 4

GABAa receptor

Question 5

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

by working on …

Answer 5

hyperpolarization

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

Question 6

What drugs work on inhibiting NMDA channels to produce anesthesia?

Answer 6

nitrous oxide and ketamine

Question 7

Hypnotic anesthesia drugs work by…

Answer 7

activating GABAa channels

Question 8

Ketamine induces anesthesia by …

Answer 8

blocking glutamate induced excitation

Question 9

The termination of anesthetic action depends primarily on…

Answer 9

redistribution

from the brain to other body tissues

Question 10

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?

Answer 10

propofol

Question 11

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

Answer 11

midazolam

Question 12

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

Answer 12

thiopental and methohexital

Question 13

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

Answer 13

propofol

Question 14

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

Answer 14

minimal CV or resp depression

Question 15

What are AEs of etomidate?

Answer 15

N/V

transient muscle movement (including myoclonus)

reduction in cortisol production d/t adrenocortical suppression

Question 16

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

Answer 16

ketamine

Question 17

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

Answer 17

fentanyl

Question 18

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

Answer 18

redistribution

Question 19

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

Answer 19

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

Question 20

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

Answer 20

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

Question 21

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

Answer 21

the fat solubility

Question 22

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

Answer 22

longer time

Question 23

How does one eliminate inhaled anesthetics?

Answer 23

mostly through exhalation unchanged

Question 24

What is the most toxic of the volatile anesthesia drugs?

Answer 24

halothane

Question 25

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

Answer 25

minimum alveolar concentration (MAC)

Question 26

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

Answer 26

inversely

Question 27

The MAC values for inhaled anesthetics are...

Answer 27

additive

Question 28

The MAC requirement is reduced when...

Answer 28

drugs like opioid analgesics and or sedative hypnotics are present

Question 29

What MAC value prevents movement in 95% of pts? What MAC value is associated with awakening from anesthesia?

Answer 29

1. 3 0. 3-0.4

Question 30

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

Answer 30

nitrous oxide megaloblastic anemia or neuropathy

Question 31

The low solubility of N2O allows it to...

Answer 31

have a rapid onset and recovery

Question 32

What are the volatile liquids that are halogenated agents? What are some of their qualities?

Answer 32

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

Question 33

AEs of halogenated volatile agents?

Answer 33

decreased MAP - hypotension decrease myocardial contractility and contractile force (negative ionotropic effects) resp depression? vasodilation in the brain, increase ICP

Question 34

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

Answer 34

halothane and isoflurane

Question 35

previous exposure to halothane will increase the risk of..

Answer 35

hepatotoxicity

Question 36

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

Answer 36

nephrotoxicity

Question 37

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

Answer 37

ryanodine receptor mutation

Question 38

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

Answer 38

sevoflurane

Question 39

The inhaled anesthesia drug with the highest MAC% is...

Answer 39

nitrous oxide

Question 40

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

Answer 40

highest solubiltiy

Question 41

Which inhaled anesthesia drug irritates the respiratory system?

Answer 41

desflurane

Question 42

MAC is highest at what age? What does this mean?

Answer 42

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

Question 43

lower solubility gas =

Answer 43

faster inhlaed induction and faster emergence go to sleep and wake

Question 44

When would I use isoflurane?

Answer 44

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

Question 45

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

Answer 45

succinylcholine and halogenated volatile anesthetics

Question 46

IV anesthetics may or may not cause...

Answer 46

analgesia

Question 47

muscle relaxants like roc do not provide...

Answer 47

anesthesia or analgesia

Question 48

What is the MC used induction agent?

Answer 48

propofol

Question 49

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

Answer 49

propofol infusion syndrome