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Pharm 2 > general anesthetics > Flashcards

general anesthetics Flashcards

1
Q

what is general anesthesia

A

medication induced unconsciousness with loss of protective reflexes

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2
Q

what are the goals of general anesthesia

A
  • amnesia: memory loss
  • analgesia: absence of pain
  • hypnosis: unconsciousness
  • immobility: muscle relaxation
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3
Q

what is balanced anesthesia

A

using several drugs to reach the anesthetic goal

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4
Q

what are the three phases of general anesthesia

A
  1. induction
  2. maintenance
  3. emergence
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5
Q

describe induction

A

patient becomes unconscious
- inhaled or IV anesthetics
- pt may have received benzos preop

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6
Q

describe maintenance

A

during procedure
- continuous inhaled or IV anesthetic
- may receive anti-emetics, opioids, or neuromuscular blocking agents

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7
Q

describe emergence

A

procedure ends
- meds wear off or reversal agents given

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8
Q

what are the five classess for balanced anesthesia

A
  1. benzos: amnesia (midazolam)
  2. analgesics: pain relief (opioids like fentanyl)
  3. inhaled anesthetics: hypnosis (isoflurane)
  4. IV anesthetics: hypnosis (propofol)
  5. neuromuscular blocking agents: muscle relaxation (vecuronium)
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9
Q

give an example of an inhaled anesthetic

A

isoflurane

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10
Q

describe the action of isoflurane

A

diffuses from the lungs, effecting neurotransmitters systemically

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11
Q

what is isoflurane used for

A

induction or maintenance of anesthesia
- amnesia
- muscle relaxation
- hypnosis

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12
Q

what are some adverse effects of isoflurane

A
  • CV and resp depression
  • airway irritation
  • malignant hyperthermia (tachycardia, body rigidity, increased temp, sweating, hyperkalemia, renal failure)
  • antidote is dantrolene
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13
Q

whats a cotraindication of isoflurane

A

hx/family gx of malignant hyperthermia

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14
Q

what are some nursing considerations for isoflurane

A
  • monitor BP and resp status closely - depression may last 30mins
  • have dantrolene available if needed
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15
Q

give and example of an IV anesthetic

A

propofol

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16
Q

describe the action of propofol

A

causes depression of the CNS, blocks perception of pain

17
Q

whats propofol used for

A
  • rapid induction of anesthesia (<1min)
  • amnesia
  • euphoria
  • hypnosis
  • 10min recovery time
  • can be used in mechanical ventilation (gtt)
18
Q

whats an adverse effect of propofol

A

pain and burning at IV site

19
Q

what are some contraindications of propofol

A

allergies to soy, eggs, or preservatives

20
Q

what are some nursing considerations for propofol

A
  • nurse may be managing drip in ICU
  • can be given IVP for procedures
  • have airway equipment nearby
  • rapid onset (<1min)
  • short duration (10mins)
21
Q

name some neuromuscular blocking agents

A

vercuronium, succinylcholine

22
Q

describe the action of neuromuscular blocking agents

A

suspends nerve impulses, leading to paralysis

23
Q

what are neuromuscular blocking agents used for

A

anesthetic paralysis
- muscle relaxation
- intubation and mechanical ventilation

24
Q

whats an adverse effect of neuromuscular blocking agents

A

allergic reactions

25
Q

whats a contraindication of neuromuscular blocking agents

A

allergy

26
Q

what are some nursing considerations for neuromuscular blocking agents

A
  • maintenance of airway and ventilation
  • can be given as drip or IVP
  • onset 3-5minutes
  • action 25-40mins
  • risk for return of weakness after presumed recovery - monitor closely
27
Q

describe benzos

A

example: midazolam
- produces amnesia
- reduces anxiety
- sedation
- high doses can cause hypnosis

monitor for resp depression

28
Q

whats the antidote for benzos

A

flumazenil

29
Q

describe analgesics used in anesthesia

A

example: fentanyl
- produce analgesia
- 100x stronger than morphine

monitor for resp depression

30
Q

whats the antidote for fentanyl

A

naloxone

31
Q

the nurse is circulating in the OR, the nurse anesthetist declares a malignant hyperthermia emergency! which of the following symptoms indicate malignant hyperthermia?

  1. muscle rigidity
  2. bradycardia
  3. hypokalemia
  4. increased urine output
A
  1. muscle rigidity

this is a genetic disorder, the symptoms are tachycardia, body rigidity, increased body temp, sweating, hyperkalemia, and renal failure

32
Q

a patient is admitted for a routine colonoscopy. propofol is th drug of choice for sedation. which of the food allergies should the nurse report?

  1. strawberries
  2. peanuts
  3. shrimp
  4. eggs
A
  1. eggs

propofol has many allergens in it. patient with allergies to soy, eggs, or preservatives should avoid this med

Pharm 2 (34 decks)

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