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Pharmacology > General anesthetic agents > Flashcards

General anesthetic agents Flashcards

1
Q

Therapeutic use of IV anesthetics

A

induction of anesthesia

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2
Q

What is the therapeutic use of benzodiazepines for anesthetics

A

for sedation and anxiolysis

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3
Q

Main contributor to IV anesthetics duration of action

A

redistribution out of CNS

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4
Q

MOA of Methohexital

A

short acting barbituate, acts on GABA-A receptors

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5
Q

Pharmacokinetics of methohexital

A

onset 30sec, duration 10 min

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6
Q

Therapeutic use of methohexital

A

induction of anesthesia and procedural sedation

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7
Q

MOA of propofol

A

GABA-A agonist, sedative and amnestic, but not analgesic

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8
Q

Therapeutic use of propofol

A

most commonly used in US. general anesthesia induction and maintenance, procedural sedation, post-op anti-emetic

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9
Q

Pharmacokinetics of propofol

A

onset 40sec duration 6 min

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10
Q

Side effects of propofol

A

hypotension and respiratory depression

Pain at injection site

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11
Q

MOA of etomidate

A

potentiation of GABA-A currents. Minimal cardiovascular and respiratory effects, not analgesic

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12
Q

Therapeutic use of etomidate

A

commonly used for induction and maitenance of general anesthesia, patients with hypotension

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13
Q

Side effects of etomidate

A

injection site pain, myoclonic movements, post-op nausea and vomiting, adrenal insufficiency with continuous infusion

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14
Q

Ketamine MOA

A

NMDA receptor antagonist, produces dissociative sedation, analgesia and bronchodilation. Minimal cardiovascular effects

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15
Q

Therapeutic use of ketamine

A

less often used due to emergence phenomenon. Usefull for induction of pediatric anesthesia.
procedural sedation for brief, painful procedures
patients with airway disease

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16
Q

Side effects of ketamine

A

CNS psychotomimetic-vivid dreams and hallucinations, can be countered in adults with benzodiazapines
Some nausea/vomiting, tachycardia and hypersalivation

17
Q

7 properties of an ideal general anesthetic

A 
anesthesia
analgesic and anxiolytic
amnesia
muscle relaxation
inhibition of reflex response to trauma
rapid, smooth onset and recovery
little or no systemic toxicity or hazard to healthcare personenel
18
Q

Cardivascular effects of anesthesia

A

decreases mean arterial blood pressure

19
Q

Respiratory effect of general anesthesia

A

reduced or eliminated ventilory drive

20
Q

Emergence effects

A

vomiting, treated with 5-HT3 antagonists
return of sympathetic tone- tachycardia and hypertension
shivering

21
Q

MOA of inhalation anesthetics

A

Enhances GABA-A activity
Inhibition of excitatory glutamate, nicotinic, 5-HT3 receptors
inhibits action potential propagation by Boltage gated ion channels
GPCRs

22
Q

Factors affecting anesthetic uptake (3)

A

blood solubility
aveolar blood flow
difference in PP of agent in aveolar gas vs blood

23
Q

A high blood:gas partition coefficient results in:

A

slow induction rate

24
Q

Mixture for second gas effect

A

70% nitrous oxide and 1% halothane

25
Q

What factors affect MAC in patients

A

increase mac in infancy and chronic alcohol intake

decreae MAC in elderly and acute alcohol intake

26
Q

Therapeutic use of Nitrous oxide

A 
alone as a sedative/analgesic for outpatient dental 
in combination (70%) for secondary gas effect
27
Q

Advantages of NO (4)

A

good analgesia and amnesia
rapid induction and recovery
minimal cardiovascular effects
reduced side effect of other inhalation agents

28
Q

Disadvantages of NO (5)

A 
Not a complete anesthetic
not a good muscle relaxant
can cause diffusion hypoxia 
myelosuppression- not good for chronic use
possible teratogen
29
Q

Therapeutic use of halothane

A

rarely used in US, low cost in developing countries

Used for children in US due to lack of pungency

30
Q

Advantages of halothane (4)

A

Non-pungent
rapid induction and recovery
muscle relaxant
bronchodilator

31
Q

Disadvantages of halothane (5)

A 
poor analgesic 
slow elimination 
significant cardiac depression
increased intracranial pressure 
halothane hepatitis
32
Q

Isoflurane therapeutic use

A

comonly used for maintenance at 1-2%

33
Q

Advantages of isoflurane

A

good cardiovascular profile, maintains cardiac function

34
Q

Disadvantages of isoflurane

A

pungent

35
Q

Therapeutic use of desflurane

A

widely used for maintenance 6-8% during outpatient surgery

36
Q

Advantages of desflurane

A

very rapid induction and emergence

good cardiovascular profile

37
Q

Disadvantages of desflurane

A

pungent, bronchial irritation, used with IV agent for induction

38
Q

Therapeutic use of sevoflurane

A

widely used 2-4%

39
Q

Advantages of sevoflurane

A

low pungency - good for pediatric patients

good cardiovascular profile

Pharmacology (35 decks)

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