General anesthetics

Question 0

Stages of anesthesia

Answer 0

1. analgesia
2. disinhibition
3. surgical anesthesia
4. medullary depression

Question 1

it is a state of unconsciousness, analgesia, amnesia, skeletal muscle relexation, areflexia

Answer 1

general anesthesia

Question 2

what is partial pressure of ‘tension’?

Answer 2

measure of concentration of inhaled anesthetics

Question 3

what is the best measure of potency of inhaled anesthetics?

Answer 3

Minimum Alveolar Concentration (MAC)

the alveolar concentration required to eliminate the response to painful stimulus in 50% of patients

Question 4

If the anesthetic drug has high potency, what is the expected level of MAC and effect on onset and recovery?

Answer 4

high potency – low MAC – slow onset and recovery (Methoxyflurane)
high PC

low potency – high MAC – rapid onset and recovery (Nitrous oxide)
low PC

Question 5

inhaled anesthetic with lowest MAC, highest partition coefficient

Answer 5

methoxyflurane

MAC 0.16
PC 12

Question 6

most inhaled anesthetics are bronchodilators EXCEPT

Answer 6

Desflurane

Question 7

inhaled anesthesia commonly used for dental surgery or minor procedures

Answer 7

Nitrous oxide

due to rapid onset and recovery
the least cardiotoxic

Question 8

Side effect of Nitrous oxide on prolonged exposure

Answer 8

megaloblastic anemia

Question 9

what is basic mechanism of action of inhaled anesthetics?

Answer 9

facilitate GABA-mediated inhibition; block brain NMDA and Ach-N receptors

Question 10

Inhaled anes causing bronchospasm

Answer 10

Desflurane

Question 11

drug that causes catecholamine-induced arrhythmias, peripheral vasodilation, coronary steal syndrome

Answer 11

Isoflurane

Question 12

unique side effect of enflurane?

Answer 12

spike-and-wave activity

Question 13

drug that can cause post operative hepatitis

Answer 13

halothane

Question 14

life threatening complication when halothane is mixed with a depolarazing NMB

Answer 14

malignant hyperthermia

halothane + succinylcholine

Question 15

what inhaled anesthetics can cause renal insufficiency?

Answer 15

SEM - sevoflurane / enflurane / methoxyflurane

Question 16

general anesthetic - barbiturate

Answer 16

Thiopental

for anesthesia induction, increased ICP

Question 17

general anesthetic -BDZ

for anesthesia induction and pre-op sedation

Answer 17

midazolam

Question 18

antidote for BDZ overdose?

Answer 18

flumazenil

Question 19

what is the condition of analgesia, amnesia and catatonia but with retained consciousness

what drug causes this?

Answer 19

dissociative anesthesia

ketamine

Question 20

unique side effect of ketamine

Answer 20

emergence delirium

reduce this SE by pretreatment with BDZ

Question 21

this drug is contraindicated in patients with intracranial tumors and increased ICP

Answer 21

ketamine

it will further increase ICP due to increase in cerebral blood flow

Question 22

what is the mechanism if action if Etomidate?

Answer 22

modulates GABAa receptors containing B3subunits

Question 23

what are the different Intravenous anesthetics?

Answer 23

1. barbiturates - thiopental
2. BDZ - midazolam
3. dissociative - ketamine
4. opioids - fentanyl / morphine
5. miscellaneous - etomidate / propofol

Question 24

IV anesthetic used in patients with limited cardiac or respiratory reserve

Answer 24

etomidate

Question 25

side effect is adrenocortical suppression

Answer 25

etomidate

Question 26

this is used for proloooonged sedation

also called ‘milk of amnesia’

Answer 26

propofol

Question 27

what is the mechanism of action of fentanyl?

Answer 27

interact with ù, d, k receptors for endogenous peptides

u - respiratory depression
d - tolerance
k- konstipation

Question 28

antidote for opioid analgesics

Answer 28

Naloxone

Question 29

NEUROLEPTANESTHESIA is achieved by combining??

Answer 29

fentanyl, droperidol, nitrous oxide

Question 30

what iv anes drug has minimal effects on CV and respiratory functions?

Answer 30

etomidate