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Pharm Unit 3 Drugs > General Anesthetics > Flashcards

General Anesthetics Flashcards

1
Q

Propofol (Diprivan) Other SE

A

Painful injection site; supports bacterial growth

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2
Q

Nitrous Oxide Class

A

Inorganic gas

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3
Q

Isoflurane (Forane) Class

A

Volatile anesthetic

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4
Q

Propofol (Diprivan) Class

A

Alkylphenol (a fatty acid)

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5
Q

Etomidate (Amidate) Class

A

Carboxylated imidazole

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6
Q

Ketamine (Ketalar) Class

A

Phencyclidine

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7
Q

Succinylcholine (Anectine) Class

A

Depolarizing NMB

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8
Q

Pancuronium (Pavulon) Class

A

Amino steroid non-depolarizing NMB

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9
Q

Vecuronium (Norcuron) Class

A

Amino steroid non-depolarizing NMB

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10
Q

Edrophonium (Enlon) Class

A

AChE-I

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11
Q

Neostigmine (Prostigmin) Class

A

AChE-I

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12
Q

Pyridostigmine (Mestinon) Class

A

AChE-I

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13
Q

Glycopyrrolate (Robinul) Class

A

Anti-muscarinic

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14
Q

Nitrous Oxide MOA

A

NMDA receptor antagonist

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15
Q

Isoflurane (Forane) MOA

A

Most potent

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16
Q

Propofol (Diprivan) MOA

A

GABAa receptor agonist, antagonist of NMDA-glutamate receptor; some a2 receptor activity; rapid onset and offset

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17
Q

Etomidate (Amidate) MOA

A

GABAa receptor agonist (only D-isomer)

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18
Q

Ketamine (Ketalar) MOA

A

NMDA receptor antagonist, kappa opiate agonist; leads to dose-dependent unconsciousness, amnesia, analgesia

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19
Q

Succinylcholine (Anectine) MOA

A

Divalent ACh molecule; attaches to all ACh receptors, overstimulating them (first seen as disorganized muscular contractions (fasiculations), then paralysis)

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20
Q

Pancuronium (Pavulon) MOA

A

Competitive blockade of ACh (no depolarization); vagolytic

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21
Q

Vecuronium (Norcuron) MOA

A

Competitive blockade of ACh (no depolarization)

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22
Q

Edrophonium (Enlon) Class

A
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23
Q

Neostigmine (Prostigmin) Class

A
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24
Q

Pyridostigmine (Mestinon) Class

A
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25
Q

Glycopyrrolate (Robinul) Class

A
26
Q

Nitrous Oxide Therapeutics

A

Mask induction in children; adjuvant to volatile anesthetics, opioids

27
Q

Isoflurane (Forane) Therapeutics

A

Gold standard for maintenance of anesthesia

28
Q

Propofol (Diprivan) Therapeutics

A

Anti-emetic at low doses; induction and maintenance of general anesthesia; sedation in ICU, procedural sedation

29
Q

Etomidate (Amidate) Therapeutics

A

Hypnosis; no analgesic activity

30
Q

Ketamine (Ketalar) Therapeutics

A

Sedative/anesthetic for pediatric/developmentally delayed patients; induction in patients with reactive airway disease, hypovolemia (trauma patients), cardiac disease; with propofol for IV procedural sedation; adjuvant during and after surgery to reduce opiod use; part of multimodal pain therapy regimen; depression treatment

31
Q

Succinylcholine (Anectine) Therapeutics

A

Skeletal muscle relaxant (intubation)

32
Q

Pancuronium (Pavulon) Therapeutics

A

Skeletal muscle relaxant; avoid in patients with renal insufficiency

33
Q

Vecuronium (Norcuron) Therapeutics

A

Skeletal muscle relaxant

34
Q

Edrophonium (Enlon) Therapeutics

A

Reversal of NMB

35
Q

Neostigmine (Prostigmin) Therapeutics

A

Reversal of NMB (most commonly used)

36
Q

Pyridostigmine (Mestinon) Mask induction in children; adjuvant to volatile anesthetics, opioids
Gold standard for maintenance of anesthesia

A

Reversal of NMB

37
Q

Glycopyrrolate (Robinul) Mask induction in children; adjuvant to volatile anesthetics, opioids
Gold standard for maintenance of anesthesia

A

Reversal of neuromuscular blockade’s muscaranic effects

38
Q

Nitrous Oxide Important SE

A

Post-operative nausea and vomiting; inactivates vitamin B (leading to abnormal embryonic development, abortion); accumulates in closed, air-containing spaces (bowel, middle ear, pneumothoraces, air emboli) because N2O insoluble in blood

39
Q

Isoflurane (Forane) Important SE

A

Pungent; dose dependent CNS depression, increase in cerebral blood flow and intracranial pressure; dose dependent decrease in systemic BP, decrease in respiratory function; relaxes skeletal muscle; increase in HR; malignant hyperthermia

40
Q

Propofol (Diprivan) Important SE

A

Propofol infusion syndrome: being given for several days leads to metabolic acidosis, rhabdomyolysis, heart & renal failure, lowering of BP, bradycardia, and death (likely due to fatty acid oxidation)

41
Q

Etomidate (Amidate) Important SE

A

Pain on administration (due to solvent, propylene glycol); involuntary myoclonic movements due to subcortical disinhibition (not a seizure); post-operative nausea and vomiting; single dose inhibits cortisol synthesis

42
Q

Ketamine (Ketalar) Important SE

A

Stimulates sympathetic nervous system outflow; increases cerebral blood flow, ICP; emergence delerium; nystagmus, lacrimation, salivation, and dissociative anesthesia

43
Q

Succinylcholine (Anectine) Important SE

A

Malignant hyperthermia; cardiac dysrhythmias, hyperkalemia, increased intraocular pressure, increased intracranial pressure

44
Q

Pancuronium (Pavulon) Important SE

A

Increase in HR

45
Q

Vecuronium (Norcuron) Important SE

A

No cardiovascular effects

46
Q

Edrophonium (Enlon) Important SE

A
47
Q

Neostigmine (Prostigmin) Important SE

A
48
Q

Pyridostigmine (Mestinon) Important SE

A
49
Q

Glycopyrrolate (Robinul) Important SE

A

DUMBELLS

50
Q

Nitrous Oxide Misc

A

No muscle relaxant

51
Q

Isoflurane (Forane) Misc

A

..

52
Q

Propofol (Diprivan) Misc

A

Administered IV in a lipid emulsion (cause of pain); be aware of allergies (egg and soy in emulsion); no malignant hyperthermia

53
Q

Etomidate (Amidate) Misc

A

Minimal cardiorespiratory depression (good agent in patients with minimal cardiac reserve)

54
Q

Ketamine (Ketalar) Misc

A

Racemic mixture (S more potent); metabolized by P450 (norketamine, a third to a fifth as effective); great bronchodilator; contraindicated in CAD patients and those with with intracranial lesions

55
Q

Succinylcholine (Anectine) Misc

A

Hydrolyzed by pseudocholinesterase (in plasma); blockade cannot be reversed; only NMB with rapid onset and ultra-short duration of action

56
Q

Pancuronium (Pavulon) Misc

A

Only long acting non-depolarizing agent; supplied as liquid; 80% excreted unchanged in liver (low metabolism in liver); reverse with AChEI

57
Q

Vecuronium (Norcuron)Misc

A

Intermediate acting; supplied as a powder (reconstitute); hepatic metabolism, hepatic and renal excretion; reverse with AChEI

58
Q

Edrophonium (Enlon)Misc

A

Short-acting, fast onset

59
Q

Neostigmine (Prostigmin) Misc

A

More complete antagonism than edrophonium

60
Q

Pyridostigmine (Mestinon)Misc

A

Longer duration of action than neostigmine, edrophonium

61
Q

Glycopyrrolate (Robinul) Misc

A

Could also use atropine

62
Q

Succinylcholine (Anectine) Other SE

A

Increased intragastric pressure, myalgias, masseter spasm

Pharm Unit 3 Drugs (13 decks)

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