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Neuro pharmacology > General Anesthetics > Flashcards

General Anesthetics Flashcards

1
Q

General anesthetics provide what?

A

Amnesia, analgesia and relaxation tailored for the intended medical procedure

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2
Q

What is analgesia?

A

The inability to feel pain

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3
Q

Does a single general anesthetic provide all desired objectives?

A

No, múltiple drugs are used

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4
Q

What are the three phases of general anesthesia?

A

Induction, Maintenance and Recovery

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5
Q

What drugs are given during the induction phase?

A

Anxiolytic (Helps the patient relax)
Opiods (Helps to reduce the pain and to block the sensation of the pain)
General Anesthesia
Muscular relaxant

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6
Q

In the maintenance phase, what drugs are continued?

A

Opiods + General anesthesia/Muscle relaxant

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7
Q

What happens during the recovery phase?

A

Full recovery of physiologic functions

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8
Q

The general anesthetics interact with..?

A

Neuronal membrane proteins via multiple and different mechanisms

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9
Q

As the concentration of the general anesthetic increases the switch from conscious to unconscious occurs over a very narrow …?

A

Concentration range

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10
Q

The ion channels bind to various what?

A

Proteins as well as lipids

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11
Q

The ion channels affect several different types of…

A

Ion channels

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12
Q

Almost all except which general anesthetics potentiate the action of GABA at GABA A receptors

A

cyclopropane, ketamine, Xenon

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13
Q

What is GABA A?

A

a ligand gated CL- channel that is made up of 5 subunits (generally compromising two alpha, two beta, and one gamma or delta subunit

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14
Q

Specific mutations of the alpha subunit inhibit what?

A

Volatile but not IV anesthetics

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15
Q

Mutations of the beta subunit inhibit both what?

A

Volatile and IV anesthetics

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16
Q

Volatile anesthetics may bind at the interface between the …

A

Alpha and beta subunit

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17
Q

The IV general anesthetic may bind only to the…

A

Beta subunit

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18
Q

Where are the potassium channels found?

A

In the cell membrane of virtually all cells

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19
Q

What role do potassium channels play?

A

regulation of cellular functions such as regulation of cell excitability, cell volume, cell growth, and proliferation, and even cell death

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20
Q

What are K2 channels?

A

A diverse family of K+ selective ion channels that contribute to background or leak currents in excitable and non-excitable tissues

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21
Q

Which potassium channels control the negative resting potential of eukaryotic cells and regulate cell excitability by conducting K+ ions across the plasma membrane?

A

K2P channels

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22
Q

What are some physiological and/or pathological roles of the K2P2 channels?

A

Depression, ischemia, nociception, myelinated axons, general anesthesia, ventricular tachycardia, cardiac fibrosis, migraine

23
Q

Where are the K2P4 channels expressed?

A

Myelinated axons

24
Q

The K2P4 channels are involved in what?

A

Post surgical neuropathic pain

25
Q

The K2P5 channels are involved in what processes?

A

Renal volume control, migraines, Balkan endemic nephropathy

26
Q

The K2P9 channels are involved in which physiological processes?

A

Aldosterone secretion, respiratory stimulation, cancer, BBMRS, inflammation, pain, general anesthesia, sleep duration

27
Q

The K2P10 channels are involved in which physiological process?

A

Nociception

28
Q

The K2P18 channels are involved in which physiologic processes?

A

Migraine, nociception

29
Q

The K2P18 channels are expressed in the …

A

C fibers of the dorsal root ganglion neurons and on the trigéminal root ganglion

30
Q

How many subunits does the K2P channel have?

A

2 each with 4 helical transmembrane domains, two pore forming loops (P1 and P2) and a large intracellular region

31
Q

The subunits of the K2P channels dimerize to create what?

A

A selectivity filter containing 4 pore-loop domains

32
Q

Which K2P channels are activated by volatile general anesthetics at clinically relevant concentrations?

A

TREK-1, TREK-2 (not TRAAK), TASK-1, TASK-3, and TRESK

33
Q

Which general anesthetic is particularly effective at activating the TREK-1,2 TASK-1, 3 and TRESK channels?

A

Halothane

34
Q

Nitrous oxide, cyclopropane, and xenon tend to activate which channels?

A

TREK and TRESK channels ( not TASK channels)

35
Q

Certain K2P channels are regarded as the molecular entities underlying the leak K channels that are responsible for?

A

Anesthetic-evoked membrane hyperpolarization in various neurons

36
Q

what is a defining characteristic of the THIK channels?

A

They are inhibited by halothane

37
Q

Halothane inhibits which K2P channel?

A

THIK-1

38
Q

At high concentrations, isoflurane inhibits which K2P channel?

A

TASK-1

39
Q

Chloroform activates which K2P receptors?

A

TREK-1, 2 and TRESK

40
Q

Nitrous oxide activates which K2P channel?

A

TREK-1 and TRESK

41
Q

Which K2P channel does xenon activate?

A

TREK-1

42
Q

Dorsal root ganglia neurons compromise a heterologous population of?

A

Primary afterent, somatosensory nociceptive neurons

43
Q

K2P cub ales appear to be important in the mitigation of?

A

inflammatory pain

44
Q

Mutations in the KCNK18 gene which codes for the K2P28 channel are associated with what?

A

Migraines

45
Q

The K2P18 channels mediate the largest component of the what?

A

background K+ current in dorsal root ganglion neurons

46
Q

The K2P18 channels are associated with what?

A

significantly decreased thresholds for withstanding mechanical pain (allodynia), activation of Astrocytes and microglia, and up regulation of connexin-43 and 36, components of neuronal and astrocyte-oligodendrocyte gap junctions respectively

47
Q

Nerve injury can influence what?

A

Changes in the activity of the K2P channels

48
Q

What do the TREK family channels (K2P2, K2P4, and K2P10) do?

A

They decrease the thermal sensitivity of the dorsal root ganglia neurons

49
Q

Glutamate is a

A

Major excitatory neurotransmitter

50
Q

Which receptors does glutamate activate?

A

AMPA, kainate, and NMDA receptors

51
Q

NMDA receptors are an important site of action for?

A

The action of nitrous oxide, xenon, and ketamine

52
Q

Xenon inhibits which receptor by competing with which compound?

A

NMDA receptor by competing with glycine

53
Q

Ketamine block what?

A

The pore of the NMDA channel

Neuro pharmacology (4 decks)

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