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Pharm Block 4 > General Anesthesia > Flashcards

General Anesthesia Flashcards

1
Q

analgesia - decrease awareness of pain with some amnesia - can make conversation

A

stage 1

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2
Q

disinhibition - delirious and excited. reflexes are enhanced, irregular respiration

A

stage 2

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3
Q

plane 2 - best stage

surgical anesthesia - px unconscious, no pain reflexes

A

stage 3

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4
Q

medullary paralysis - severe respiratory and cardiovascular depression

A

stage 4

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5
Q

driving force that moves gas from anesthetic machine to lungs
directly proportionate to it [ ] in the inhaled mix and inversely proportionate to solubility in tissue
easily controlled by anesthetist

A

partial pressure

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6
Q

the [ ] of inhaled anesthetic at which 50% of px do not respond to a surgical stimulus
measure potency

A

MAC - minimal alveolar anesthetic [ ]

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7
Q

more lipid soluble

A

lower MAC and greater potency

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8
Q

more soluble anesthetic in blood the slower reaction

A

blood gas ratio

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9
Q

slow onset and slow recovery

A

anesthetics with high blood gas ratios

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10
Q

fast onset and recovery

A

anesthetics with low blood gas ratio

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11
Q

used: preoperative sedation, anterograde amnesia, induction, outpatient surgery
SE: depresses respiratory function
antidote: flumazenil

A

midazolam

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12
Q

DOC for providing anesthesia in px undergoing ECT

A

methohexital

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13
Q

used to induce and maintain anesthesia
antiemetic and do not use with egg allergy
gaba A receptor complex
causes profound vasodilation = hypotension and increase IP

A

propofol

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14
Q

used to induce anesthesia
preserves cardiovascular stability
ADR: pain and myoclonus on injection; prolong admin can cause adrenal suppression (inhibit 11b-hydrocylase)

A

etomidate

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15
Q

used to induce anesthesia
inhibits NMDA receptor
ADR: dissociative amnesia (eyes remain open with slow nystagmic gaze); unpleasant emergence reactions (vivid colorful dreams, hallucinations, out of body experiences); cardiovascular stimulation (increased IP, HR, CO)

A

ketamine

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16
Q

used to induce surgical anesthesia in 1 min.
termination of anesthesia effects by redistribution from brain to other tissues after one dose - 4 min
dilate peripheral vessels
rapid onset and short duration of action
decreases IP due to decrease CNS metabolism
CI: in px with porphyria

A

thiopental

17
Q

valuable in high risk px where px may not survive a full dose of anesthetic

A

opioids

18
Q

IV opioids cause chest wall rigidity can impair ventilation
increase IP
Respiratory depression - reversed by naloxone
neuroleptic anesthesia (fentanyl + droperidol + N2O)

A

morphine and fentanyl

19
Q 
alpha 2 agonist 
analgesic and hypnotic 
rapid clearance 
no respiratory depression
useful in ICU
A

dexmedetomidine

20
Q 
least potent 
balanced anesthesia 
analgesic @ 20% [ ]
\+ SANS
increase arterial BP, CBF, IP
SE: mesoblastic anemia (phys. affected) - inhibits B12 enzyme methionine synthase b/c oxidizes cobalt
A

nitrous oxide

21
Q

well tolerated by children
degrades upon exposure to light
effective bronchodilator
causes sk mus and uterine mus relaxant (not used in labor)
liver toxicity and malignant hyperthermia

A

halothane

22
Q

widely used in OP - rapid recovery
used in children - non irritant
does not produce tachycardia
safe in px prone to MI (inhibits baro R)

A

sevoflurane

23
Q

heart - inotropic

A

enflurane

halothane

24
Q

airway irritation

A

desflurane

isoflurane

25
Q

kidney toxicity

A

enflurane

methoxyflurane

26
Q

hepatotoxicity

A

halothane

27
Q

seizure

A

enflurane

28
Q

malignant hyperthermia tx

A

dantrolene

29
Q

decrease brain metabolite rate
increase CBF through vasodilation
increase IP

A

CNS effects of inhaled halogenated

30
Q

decrease TV but increase rate of respiration (rapid and shallow), most are bronchodilators

A

respiratory effects of inhaled halogenated

31
Q

DOC for px with underlying airway problem

A

halothane

sevoflurane

Pharm Block 4 (18 decks)

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