GENERAL ANESTHETICS Flashcards
STAGES OF ANESTHESIA (GUEDEL’S SIGNS)
ADSM
Stage 1: Analgesia
Stage 2: Disinhibition
Stage 3. Surgical anesthesia
Stage 4: Medullary depression
Measure of concentration of inhaled anesthetics
Partial pressure or “tension”
Best measure of potency of inhaled anesthetics
Minimum Alveolar Anesthetic Concentration
Inhalation anesthetic that has a characteristic PUNGENT ODOR
Desflurane
Inhalation anesthetic that has a characteristic SWEET ODOR
Sevoflurane
Inhalation anesthetic contraindicated in asthmatic patients
Desflurane
Inhalation anesthetic contraindicated in patients with asthma
Desflurane
Inhalation anesthetic preferred in patients with asthma
Sevoflurane
Inhalation anesthetic that presents with CORONARY STEAL SYNDROME
Isoflurane
Inhalation anesthetic with characteristic spike-and-wave activity in EEG
Enflurane
Inhalation anesthetic with the highest propensity to cause HEPATITIS
Halothane
Inhalation anesthetic with the highest potency and lowest MAC
Methoxyflurane
Inhalation anesthetic for minor surgery and dental procedures
Nitric oxide
Inhalation anesthetic with the least potency and lest cardiotoxic effects
Nitrous oxide
Laughing gas (euphoria)
Nitrous oxide
Inhalation anesthetic are undesirable for patients with increased ICP except:
Nitrous oxide
ALL inhaled anesthetics depress normal cardiac contractility > decrease MAP via different mechanisms. Except:
Nitrous oxide
ALL inhaled anesthetics have a BRONCHODILATING properties except:
DESFLURANE
This condition results from mutation of RYANODINE RECEPTOR of the skeletal muscle that results to uncontrolled release of Ca2+ from SR. Occurs when susceptible individual are exposed to volatile anesthetics and succinylcholine
MALIGNANT HYPERTHERMIA
Most reliable test to establish susceptibility to malignant hyperthermia:
Caffeine-Halothane contracture test
Treatment for Malignant hyperthermia:
Dantrolene
IV anesthetic used for identification of epileptic foci
Barbiturates
IV anesthetic that is a potent vasoconstrictor best for patients with increased ICP
Barbiturates
IV anesthetic that causes ACUTE INTERMITTENT PORPHYRIA
Barbiturates
Intraarterial injection of this IV anesthetic can lead to gangrene
Barbiturate
IV anesthetic that causes HYPERALGESIA
Barbiturates
IV anesthetic that causes post-operative respiratory depression (PORD)
Benzodiazepines
Used as adjunct to inhalational anesthetics and IV opioid
Midazolam
NMDA antagonist used for DISSOCIATIVE ANESTHESIA
Ketamine
Causes post-op disorientation, hallucination, and excitation
Ketamine
Pretreated with anticholinergic since this IV anesthetic causes lacrimation and salivation
Ketamine
IV anesthetic used in asthmatic patients
Ketamine
IV anesthetic that may be used in patients with limited cardiac or respiratory reserve
Etomidate
IV anesthetic that causes ADRENOCORTICAL SUPPRESSION
Etomidate
IV anesthetic used as induction agent of choice for unstable patients
Etomidate
MOA of opioid
Interact with mu, delta, and kappa receptors for endogenous opioid peptides
S/E of OPIOIDS
Respiratory depression
Opioid analgesic that has a faster recovery among types
Remifentanil
Antidote for opioid overdose
Naloxone
Alcohol + Opioid = Naltrexone
Happens when FENTANYL, DROPERIDOL, NITROUS OXIDE are given together
Neuroleptanesthesia (analgesia + amnesia)
IV anesthetic induction of choice (ICU and outpatient)
Propofol (Milk of Amnesia)
IV anesthetic that causes pain at injection site and hypotension at induction
Propofol
IV anesthetic that causes PARESTHESIA IN THE PERIANAL REGION
Fosprofolol
May causes allergic reaction to asthmatic patients and patients with sulfa allergies
Propofol
Alternative general anesthetic maintenance for patients susceptible to malignant hyperthermia
Propofol
Has zero analgesic properties
Propofol
Ester local anesthetic with the shortest half-life
Procaine
Ester LA that causes METHEMOGLOBINEMIA
Benzocaine
Present for TOPICAL use only
Benzocaine
Cocaine
Used for surgeries involving ENT procedures
Cocaine
ALL local anesthetics are vasodilators EXCEPT
Cocaine
Causes mood elevation due to its dopamine receptor action
Cocaine
Has intrinsic sympathomimetic activity (vasoconstriction)
Cocaine
LA used for spinal anesthesia
Tetracaine
LA that is Class 1B anti-arrhythmic drug, used for post-MI and for digitalis toxicity
LIDOCAINE!!!
Limits systemic absorption of Lidocaine:
+ Epinephrine
Commonly used in OPHTHALMIC preprations
Proparacaine
Amide LA that causes METHEMOGLOBINEMIA
Prilocaine
Ester: Benzocaine
Use with caution in pregnant patients and patients with cardiac disease because it may cause heart block, arrhythmia, and hypotension
Bupivacaine
Most cardiotoxic amide LA
Bupivacaine
Used to treat cardiotoxicity of Bupivacaine
Intralipid/Liposomal forms
S(-) enantiomer of Bupivacaine > less cardiotoxic
Ropivacaine
Amide LA with the longest half-life
Ropivacaine
