General anesthetics

Question 1

How do GABA agonists work?

Answer 1

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

Question 2

What is one prominent side effect of volatile general anesthetics?

Answer 2

Myocardial depression

Question 3

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

Answer 3

No way man

Question 4

What is the definition of general anesthetic?

Answer 4

Reversible loss of consciousness

Question 5

What is the anesthetic triad?

Answer 5

hypnosis, analgesia, muscle relaxation

Question 6

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

Answer 6

no

Question 7

How do most general anesthetics work?

Answer 7

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

Question 8

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

Answer 8

Dexmedetomidine

Question 9

How is CNS activity monitored in the OR?

Answer 9

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

Question 10

What is erexon?

Answer 10

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

Question 11

General anesthetic potency is proportional to _______.

Answer 11

lipid solubility.

Question 12

What measurement allows for comparison of potency amongst general anesthetics?

Answer 12

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

Question 13

Are general anesthetics metabolized? How are they cleared?

Answer 13

Not metabolized, exhaled out

Question 14

Name four cardiovascular effects of general anesthesia.

Answer 14

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

Question 15

What do general anesthetics do to the respiratory system?

Answer 15

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

Question 16

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

Answer 16

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

Question 17

What do narcotics do to CO2 responsiveness?

Answer 17

They blunt it

Question 18

Inhaled anesthetics two types

Answer 18

1. volatile

2. Gas

Question 19

Inhaled Anesthetics: Gas

Answer 19

N2O

Question 20

inhaled anesthetics: volatile [3]

Answer 20

1. desflurane
2. isoflurane
3. sevoflurane

Question 21

intravenous anesthetics [4]

Answer 21

1. dexmedetomidine
2. etomidate
3. ketamine
4. propofol

Question 22

what correlates well with the potency of an anesthetic?

Answer 22

hydrophobicity

Question 23

what does the hydrophobicity infer about the target?

Answer 23

proteins and lipid membranes

Question 24

target stie aappearss to have a degree of polarity may indicate

Answer 24

internal or interfacial protein cavities

Question 25

target site appears to have a degree of chirality indicates that

Answer 25

there is a phospholipid bilayer

Question 26

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

Answer 26

TRUE!!!!

Question 27

Potentiate inhibitory [3]

Answer 27

1. GABA 2. Glycine 3. alpha2

Question 28

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

Answer 28

Dexmedetomidine

Question 29

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.

Answer 29

Ketamine

Question 30

Ketamine results in a

Answer 30

disorder increase in neural activity leading to unconssciousness

Question 31

classic experiments, such as the rat and Goat, suggest

Answer 31

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

Question 32

The more potent the inhaled anesthetics

Answer 32

the lower the MAC is

Question 33

MAC

Answer 33

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

Question 34

.25 MAC

Answer 34

anterograde amnesia

Question 35

.5 MAC

Answer 35

unconsciousness

Question 36

Factors affecting speed of onset:

Answer 36

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

Question 37

In equilibrium of the drug in blood and alveoli the

Answer 37

partial pressure are equal

Question 38

less soluble a drug is

Answer 38

the greater the speed of onset and offset

Question 39

which will have the fastest onset speed? vibranium dilithium unobtanium

Answer 39

vibranium , not very soluble in blood compared with gas

Question 40

Most side effects are

Answer 40

cardiac oriented

Question 41

direct negative inotrope

Answer 41

ketamine