General Anesthetics

Question 1

Halothane

Answer 1

mac from .7-.9.. Rapid induction and recovery. Inexpensive, no laryngeo irritation. Disadvatages are inadequeate analgesia and muscle relaxation. Depresses myocardium and baroreceptor reflexes dropping HR and BP, epi treatment leads to arrhythmias. Increased automaticity, respiratory depression, can cause hepatic toxicity. Malignant hyperthermia possible.

Question 2

Isoflurane

Answer 2

is a smelly gas anesthetic which is very potent and has induction in less than 10 minutes. It does not sensitize the myocardium to catecholamines, less hepatotoxicity and renal toxicity than halothane. Disadvantages are arrhythmias, odor, and potential malignant hyperthermia.

Question 3

Desflurane

Answer 3

General anesthetic which has similar action to halothane and sevoflurane, it has high potency and wasn’t talked about much. It is irritating.

Question 4

Sevoflurane

Answer 4

Newest approved inhalation agent for use. High potency due to low percent of inspired gas, low blood solubility for a rapid onset and rapid recovery. It is the best option for inhalation anesthetic.

Question 5

Nitrous Oxide

Answer 5

IS the only inhalation anesthetic which is a gas, it has low blood solubility for rapid onset, little effect on cardiovascular function, and causes the second gas effect. Its disadvantages are that its MAC is 104%, it has no muscle relaxing effect, diffusion hypoxia if rapid discontinued.

Question 6

Pentobarbital

Answer 6

Barbituate MOA is to facilitate GABA induced Cl- entry into neurons leading to CNS depression. Rapid onset after iv admin and short action means fast recovery.

Question 7

Thiopental

Answer 7

Barbituate MOA is to facilitate GABA induced Cl- entry into neurons leading to CNS depression. Rapid onset after iv admin and short action means fast recovery. Toxicity: anesthetic dose is between 50 and 75% of the LD50

Question 8

Propofol

Answer 8

rapid induction (50seconds) and recovery. It may be given alone to maintain anesthesia or used for induction as part of balanced anesthesia. It is anti-emetic(not nauseating), and most significant respiratory effect is apnea, may result in pain upon entry.

Question 9

Etomidate

Answer 9

Is a short acting injectable anesthetic with no alalgesic properties, modulates GABA inducing Cl entry into neurons leading to CNS depression.

Question 10

Midazolam

Answer 10

(versed) MOA is the facilitation of Cl through the GABA channel leading to CNS depression. Has less CV and respiratory depression than barbituates, most influential charachteristic is anterograde amnestic action. It is not sufficient for anesthesia alone.

Question 11

Ketamine

Answer 11

Very similar to PCP and is a dissociative anesthetic. Patient appears awake but is unaware of environment and does not feel pain. It is anesthetic, analgesic, amnestic and sedative. Cardiovascular system is not depressed and may be stimulated (ideal for patients with trouble CV function). MOA is thought to act on NMDA Glutamate receptors. Rapid onset, short duration of action (20min). Abuse potential.

Question 12

Fentanyl

Answer 12

Incredibly potent opioid, short acting.
High dose opioids lead to analgesia, anesthesia, hemodynamic stability- good for individuals with compromised CV function, but respiration must be maintained artificially.

Question 13

Sufentanyl

Answer 13

potent opioid , short acting.
High dose opioids lead to analgesia, anesthesia, hemodynamic stability- good for individuals with compromised CV function, but respiration must be maintained artificially.