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Pharmacology Pt. 2 > General anesthetics > Flashcards

General anesthetics Flashcards

1
Q

How do GABA agonists work?

A

They allow influx of Cl- into the cell to hyperpolarize the cell.

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2
Q

What is one prominent side effect of volatile general anesthetics?

A

Myocardial depression

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3
Q

Should you give nitrous oxide to a patient with a pneumothorax?

A

No way man

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4
Q

What is the definition of general anesthetic?

A

Reversible loss of consciousness

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5
Q

What is the anesthetic triad?

A

hypnosis, analgesia, muscle relaxation

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6
Q

If a patient moves in response to a painful stimulus while under general anesthesia, does it mean the patient is awake?

A

no

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7
Q

How do most general anesthetics work?

A

They are GABA agonists. GABA is an inhibitory neurotransmitter that hyperpolarizes the cell with Cl- ions.

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8
Q

What is one prominent general anesthetic that is not a GABA agonist but instead is an alpha-2 agonist?

A

Dexmedetomidine

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9
Q

How is CNS activity monitored in the OR?

A 
Bispectral index (BIS)
100 = awake and alert
60 = moderate hypnosis for surgery
etc.
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10
Q

What is erexon?

A

I don’t know. Some general anesthetics block it.

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11
Q

General anesthetic potency is proportional to _______.

A

lipid solubility.

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12
Q

What measurement allows for comparison of potency amongst general anesthetics?

A

MAC - alveolar concentration at which 50% of patients respond to superficial stimulus

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13
Q

Are general anesthetics metabolized? How are they cleared?

A

Not metabolized, exhaled out

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14
Q

Name four cardiovascular effects of general anesthesia.

A
  1. Myocardial depression
  2. Impaired baroreceptor reflexes
  3. Vasodilation due to decreased sympathetic tone
  4. Increased dysrhythmias
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15
Q

What do general anesthetics do to the respiratory system?

A

Bronchodilation, decreased response to hypoxia, decreased response to increased C02, low tidal volume, and higher respiratory rate that diminishes alveolar ventilation.

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16
Q

Which general anesthetic is more commonly used in pediatric anesthesia? Why?

A

Sevoflurane because it is not noxious to inhale while awake and they can make it smell like bubble gum and stuff.

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17
Q

What do narcotics do to CO2 responsiveness?

A

They blunt it

18
Q

Inhaled anesthetics two types

A
  1. volatile

2. Gas

19
Q

Inhaled Anesthetics: Gas

A

N2O

20
Q

inhaled anesthetics: volatile [3]

A
  1. desflurane
  2. isoflurane
  3. sevoflurane
21
Q

intravenous anesthetics [4]

A
  1. dexmedetomidine
  2. etomidate
  3. ketamine
  4. propofol
22
Q

what correlates well with the potency of an anesthetic?

A

hydrophobicity

23
Q

what does the hydrophobicity infer about the target?

A

proteins and lipid membranes

24
Q

target stie aappearss to have a degree of polarity may indicate

A

internal or interfacial protein cavities

25
Q

target site appears to have a degree of chirality indicates that

A

there is a phospholipid bilayer

26
Q

No single protein target, or even class or family of protein targets, has been proven to be both necessary and sufficient for inhaled anesthetic action

A

TRUE!!!!

27
Q

Potentiate inhibitory [3]

A
  1. GABA
  2. Glycine
  3. alpha2
28
Q

binds to α2 receptors on neurons from the locus ceruleus, inhibiting norepinephrine release in the ventrolateral preoptic nucleus.

A

Dexmedetomidine

29
Q

binds preferentially to NMDA receptors on inhibitory interneurons in the cortex, limbic system (amygdala), and hippocampus, promoting an uncoordinated increase in neural activity, an active electroencephalographic pattern, and unconsciousness.

A

Ketamine

30
Q

Ketamine results in a

A

disorder increase in neural activity leading to unconssciousness

31
Q

classic experiments, such as the rat and Goat, suggest

A

that anesthetic-induced immobility is more sensitive to direct actions within the spinal cord.

32
Q

The more potent the inhaled anesthetics

A

the lower the MAC is

33
Q

MAC

A

percent of a volume needed to produce a unconscious response in E50

34
Q

.25 MAC

A

anterograde amnesia

35
Q

.5 MAC

A

unconsciousness

36
Q

Factors affecting speed of onset:

A

MV (minute ventilation)
CO ( faster cardiac output prevents a quick onset)
Fi anesthetic
Solubility

37
Q

In equilibrium of the drug in blood and alveoli the

A

partial pressure are equal

38
Q

less soluble a drug is

A

the greater the speed of onset and offset

39
Q

which will have the fastest onset speed?

vibranium
dilithium
unobtanium

A

vibranium , not very soluble in blood compared with gas

40
Q

Most side effects are

A

cardiac oriented

41
Q

direct negative inotrope

A

ketamine

Pharmacology Pt. 2 (7 decks)

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