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Pharmacology > General Anesthetics > Flashcards

General Anesthetics Flashcards

1
Q

what are 3 effects of preanesthetic medication

A

decrease respiratory secretions
antiemetic effect
decrease gastric juice acidity and volume in case of aspiration

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2
Q

what are 2 mechanisms of action of general anesthetics

A

enhance inhibitory activity (GABA)
diminish excitatory activity

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3
Q

to achieve effective concentration in CNS, inhaled anesthetics require transfer from __ –>__–>__

A

alveoli–>blood–>brain

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4
Q

are general anesthetics with low blood:gas partition coefficient more or less soluble in blood

A

less

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5
Q

do general anesthetics with low blood:gas partition coefficient have slow or rapid induction and recovery

A

low= less soluble in blood= rapid induction and recovery

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6
Q

high blood:gas partition coefficient
=___ soluble (more or less)
=__ induction and recovery (faster or slowe)

A

high coefficient= more soluble= slower

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7
Q

the higher the lipid solubility, the more or less potent the general anesthetic

A

higher solubility= more potent

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8
Q

at low pulmonary flow rates, is general anesthesia onset faster or slower

A

faster

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9
Q

what is the form of elimination of most general anesthetics

A

through lungs

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10
Q

what general anesthesia undergoes partial metabolism in the liver, leading to hepatotoxicity

A

Halothane

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11
Q

what is the MAC value

A

median alveolar concentration that results in immobility in 50% of patients when exposed to pain

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12
Q

do highly lipid soluble anesthetics have higher or lower MAC

A

lower

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13
Q

does a lower MAC mean more or less potent

A

more

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14
Q

nitric oxide is a good __ but weak __

anesthetic or analgesic

A

good analgesic
weak anesthetic

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15
Q

what 2 effects are seen during recovery with NO

A

second gas effect
diffusional hypoxia

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16
Q

NO use is cautioned in those with __

A

pneumothorax

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17
Q

Halothane is a good __ but weak__

anesthetic or analgesic

A

good anesthetic
weak analgesic and muscle relaxant

18
Q

what inhaled analgesic is commonly used in children

A

Halothane

19
Q

what are 3 adverse effects of Halothane

A

hepatic necrosis
malignant hypertension
can induce arrhythmias

20
Q

what commonly used anesthetic maintains coronary circulation and does not provoke seizures

A

Isoflurane

21
Q

what is an adverse effect of Sevoflurane

A

nephrotoxicity

22
Q

what mode of general anesthetics have rapid induction and are used for maintenance of anesthesia when inhalational general anesthetics are contraindicated

A

IV

23
Q

recovery from intravenous general anesthetics is mainly by __

A

redistribution

24
Q

what characteristic of the IV anesthetic Thiopental provides a limitation

A

consciousness is regained in 10-20 minutes

25
Q

what is the main use of Thiopental

A

induction of anesthesia in neurosurgery

26
Q

what property of Thiopental allows it to be used in head injury

A

decreased cerebral blood flow so there is no increase in ICP

27
Q

Thiopental is contradicted in patients with __

A

porphyria

28
Q

what is the most commonly used IV anesthetic

A

Propofol

29
Q

why is Propofol the most commonly used IV anesthetic

A

produces a euphoric effect
less postanesthetic nausea and vomiting
short half life

30
Q

what is the mechanism of action of the IV general anesthetic Propofol

A

increases binding and affinity of GABA for GABA-A receptor

31
Q

what are 2 adverse effects of the IV general anesthetic Propofol

A

decreases BP
respiratory depression

32
Q

what is Propofol infusion syndrome (PRIS)

A

acute refractory bradycardia leading to asystole

33
Q

what is the mechanism of action of the IV general anesthetic Etomidate

A

GABA like effects with potentiation of GABA-A mediated chloride channels

34
Q

what is the effect of repeated administration of IV Etomidate

A

suppresses steroid production

35
Q

what IV general anesthetic induces dissociative anesthesia in which the patient is conscious without feeling pain

A

Ketamine

36
Q

what is the mechanism of action of Ketamine

A

blocks NMDA receptors

37
Q

what is the effect of Ketamine on cerebral blood flow

A

increases cerebral blood flow and ICP

38
Q

what general anesthetic produces hallucinations during the postoperative/recovery stage

A

Ketamine

39
Q

one of the main uses of ketamine as an anesthetic agent is for what

A

burn dressing and trauma surgery

40
Q

what anesthetic can be used to manage acute severe asthma in children

A

Ketamine

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