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Pharm unit 3 > general anesthetics > Flashcards

general anesthetics Flashcards

0
Q

3 volatile anesthetic: from most potent to least potent

A
  1. isoflurane (most potent; gold std for maintenance of anesthesia)
  2. sevoflurane (not irritating)
  3. desflurane (least soluble and potent; most pungent)
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1
Q

NMDA receptor antagonist that is used for mask induction in children

A

nitrous oxide

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2
Q

which anesthetic induces PONV; inactivates vitB (abn baby development –> abortion); and bc it is INSOLUBLE in blood–>it accumulates in closed, air containing spaces (bowel, middle ear, pneumothoraces, air emboli),

A

nitrous oxide

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3
Q

-dose dependent decreases: CNS, BP, respiratory fnc,
-increases: cerebral blood flow, ICP, HR (reflex), body temp (malignant hyperthermia)
-relaxes sk mm
(3)

A

isoflurane, desflurane, sevoflurane

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4
Q

which anesthetic boils at RT, and thus is a dual gas blender?

A

desflurane

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5
Q

which anesthetic can for CO (canister fires!) if not combined with CO2 correctly; can also cause all the other volatile anesthetics SEs.
-used for mask induction in children and adults (sweet smelling)

A

sevoflurane

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6
Q

which anesthetic does not give you muscle relaxation at all?

A

nitrous oxide

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7
Q 
volatile anesthetics (2) for induction of anesthesia?
for maintenance?
A
  • nitrous oxide and sevoflurane

- isoflurane

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8
Q

barbiturate that is used to induce general anesthesia?

A

methohexital and thiopental

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9
Q

GABAa agonist
NMDA antagonist
produces hypnosis and sedation but are anti-analgesics

A

methohexital

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10
Q 
alkylphenol (fatty acid) that is a:
GABAa receptor agonist
NMDA-glutamate antagonist
some a2 receptor activity (sedation)
rapid onset, offset
A

propofol

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11
Q

only D-dimer is GABAa agonist

A

etomidate

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12
Q

a phencyclidine that is:
potent NMDA receptor antagonist
kappa opiate agonist
dose dependent unconsciousness, amnesia, analgesia

A

ketamine

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13
Q

a2 adrenergic agonist (binds a2a and a2b in locus coeruleus and spinal cord (sedation, sympatholysis, analgesia)

A

dexmedetomidine

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14
Q

this anesthetic is redistributed from brain to mm and fat;
-metabolized by liver
and u dose based on lean body mass

A

methohexital (barb)

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15
Q

at low dose, its an anti-emetic
-induction and maintenance of general anesthesia
used for sedation in ICU, and procedural sedation
SE: worry about ___sd: (days on this –> MAcid, rhabdo, renal failure, dec BP, brady, death (likely due to FA oxidation)

A

propofol

16
Q

painful injection site (2)

A

propofol and etomidate

17
Q

induction agent that produces hypnosis and no analgesic activity
-GOOD to use in pts w. min cardiac reserve bc this drug has min cardiorespiratory depression
SE: involuntary myoclonic movmt (subcortical disinhibited), PONV, single dose inhibits cortisol synthesis.

A

etomidate

18
Q

used for sedation in the ICU and for procedural sedation that does not induce malignant hyperthermia

A

propofol

19
Q
  • for sedating/anesthetizing kids/developmentally delayed pts,
  • reactive aw dz
  • hypovol (trauma pts)
  • cardiac dz
  • with propofol for sedation
  • during and after surgery to reduce opioid use, MULTIMODAL pain therapy regiment; depression tx
A

ketamine

20
Q

for awake intubations and awake craniotomies

  • adjunct ot general anesthesia in pts susceptible to narcotic-induced post-op resp depression
  • for w/d and detox
A

dexxmedetomidine

21
Q

stimulates SNS outflow (inc pul BP, sysBP, inc cerebral bf, inc ICP
-delerium, nystagmus, lacrimation, salivation, dissociative anesthesia (cataleptic state)

A

ketamine

22
Q

when is ketamine CI?

what does it also produce that’s great?

A

pts with CAD and intracranial lesions

-bronchodilation

23
Q

how is ketamine metabolized?

A

p450

24
Q
  • produces limited resp depression (wide safety margin)
  • does not hit GABA –> sedation is easier to wake up from and similar to non-REM sleep.
  • FDA approved only for ventilation of ICU pts for under 24hrs
A

dexmedetomide

Pharm unit 3 (19 decks)

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