General Anesthetics Flashcards
Nitrous Oxide
Inhalable Anesthetic
Rapid onset and recovery
Good analgesia, safe
Insufficient potency
2nd gas effect: ↓ induction time, ↓ required concentration, ↓ toxicity of primary agent
Diffusion hypoxia: NO quickly diffuses out of body into alveoli, diluting O2
Halothane
Inhalable Anesthetic
Complete anesthetic, poor analgesia, muscle relaxation
Systemic: Decreased Cardiac Output; Hypotension
SE: High incidence of post-op hepatitis
Enflurane
Inhalable Anesthetic
Systemic: respiratory depression, reduced cardiac contractility and HR
can depress brain areas: EEG convulsive pattern, jerking, twitching
Avoid in patients w/ seizures
pungent odor
Isoflurane
Inhalable Anesthetic
Used for MAINTENANCE
Pungency limits mask induction use
Very long duration, slow release from fat hours post op
Lower toxicity (can be used w/ impaired liver/kidney func.)
Desflurane
Inhalable Anesthetic
Fastest onset and recovery
Excellent minute-minute control
More irritating to respiratory passages than others (Bronchial irritation w/ cough and laryngeal spasm)
Sevoflurane
Inhalable Anesthetic
Most commonly used
Rapid onset and recovery
Very potent
Excellent controllability due to low solubility and high potency
Low airway irritation (used for mask induction and those w/ irritable airway)
Propofol
IV Anesthetic
Nearly ALL inductions
Excellent recovery quality
Ketamine
IV Anesthetic
Dissociative Anesthesia
MOA: non-competitive glutamate NMDA receptor antagonist
Rx: excellent for patients w/ compromised cardiac status
Emergenct phenomenon: unpleasant dreams, hallucinations, disorientation
Midazolam
Adjuvant Anesthetic
MOA: potentiation of GABA-A receptors
Good for sedation, amnesia, anxiolytic
Rx: sedation for painful procedures, as induction agent, substitute for thiopental/propofol in high-risk patients
Thiopental
IV Anesthetic (Barbiturate) Very common induction agent
No analgesia
Redistribution to other tissues
