General Anesthetics

Question 1

MOA: Inhalation anesthetic (vapor), potent (MAC 0.7-0.9)

Answer 1

Halothane

Question 2

Advantages: Rapid induction & recovery, inexpensive, no laryngospasm

Answer 2

Halothane

Question 3

Disadvantages: Inadequate analgesia & muscle contraction,  CO and BP, sensitizes myocardium to catecholamines, respiratory dep, hepatic toxicity (“halothane hepatitis”), malignant hyperthermia

Answer 3

Halothane

Question 4

Most soluble in blood (slowest onset, most potent)

Answer 4

Halothane

Question 5

MOA: Inhalation anesthetic (vapor), potent

Answer 5

Isoflurane

Question 6

Advantages: Induction

Answer 6

Isoflurane

Question 7

Disadvantages: Arrhythmias, pungent odor, potential for malignant hypothermia, respiratory depression

Answer 7

Isoflurane

Question 8

MOA: Inhalation anesthetic (vapor), high potency

Answer 8

Sevoflurane

Question 9

Advantages:Low blood solubility  rapid onset & recovery, almost perfect inhalation anesthetic

Answer 9

Sevoflurane

Question 10

Disadvantages: Advantages of nitrous oxide (rapid onset) + halothane (potency) without AE

Answer 10

Sevoflurane

Question 11

MOA: Inhalation anesthetic (GAS), MAC is 104 (can’t be used alone)

Answer 11

Nitrous Oxide

Question 12

Advantages: Low blood solubility rapid onset, 2nd gas effect can reduce time for induction and recovery, little effect on CV function, mild-moderate analgesic activity

Answer 12

Nitrous Oxide

Question 13

Disadvantages: Diffusion hypoxia during recovery, no muscle relaxing effect

Answer 13

Nitrous Oxide

Question 14

Only inhalation anesthetic that is a gas

Answer 14

Nitrous Oxide

Question 15

MOA: Injectable anesthetic, facilitates GABA induced Cl- entry into neurons (depolarization)&raquo_space;  CNS depression

Answer 15

Barbiturates
(Thiopental)
and 
Benzodiazepines
(Midazolam)

Question 16

Advantages: Rapid onset, short action  quick recovery

Answer 16

Barbiturates

Thiopental

Question 17

Disadvantages: High toxicity – anesthetic dose is between 50-75% of LD50

Answer 17

Barbiturates

Thiopental

Question 18

Advantages: Less CV and respiratory depression than barbiturates

Answer 18

Benzodiazepines

Midazolam

Question 19

Disadvantages: Insufficient anesthesia when given alone (never unconscious)

Answer 19

Benzodiazepines

Midazolam

Question 20

Amnestic action = used as induction agent

Answer 20

Benzodiazepines

Midazolam

Question 21

MOA: Injectable anesthetic, must be given as emulsion

Answer 21

Propofol

Diprivan

Question 22

Advantages: Rapid induction and recovery, pts awaken feeling clear headed and are not nauseous

Answer 22

Propofol

Diprivan

Question 23

Disadvantages: Apnea (Michael Jackson), injection site pain, abuse among anesthesiologists

Answer 23

Propofol

Diprivan

Question 24

May be given alone to maintain anesthesia or used for induction as part of balanced anesthesia

Answer 24

Propofol

Diprivan

Question 25

MOA: Injectable anesthetic, NMDA glutamate receptor, rapid onset and short duration of action

Answer 25

Ketamine

Ketalar

Question 26

Advantages: Analgesic, amnestic, sedative, airway reflexes maintained, CV system not depressed

Answer 26

Ketamine

Ketalar

Question 27

Disadvantages: Occurrence of emergence rxns (delirium, hallucinations), problem with abuse (Special K)

Answer 27

Ketamine

Ketalar

Question 28

Dissociative anesthetic
high TI
Could treat depression??

Answer 28

Ketamine

Ketalar

Question 29

MOA: Injectable anesthetic, high potency and short acting

Answer 29

Opioids

Fentanyl, Sulfentanil

Question 30

Advantages: Analgesia & anesthesia, hemodynamic stability

Answer 30

Opioids

Fentanyl, Sulfentanil

Question 31

Disadvantages: Respiration must be maintained artificially (can be depressed)

Answer 31

Opioids

Fentanyl, Sulfentanil

Question 32

Usually supplemented with inhalation anesthetic

Answer 32

Opioids

Fentanyl, Sulfentanil