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Neuro II - Final Exam > General Anesthetics - 8/22 Kruse > Flashcards

General Anesthetics - 8/22 Kruse Flashcards

1
Q

What anesthetics can increase HR?

A

Desflurane

Isoflurane

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2
Q

What are the primary inhibitory channels of anesthetic action?

A

Cl (GABA and Gly)

K+

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3
Q

What anesthetic(s) have dramatic increase in context-sensitive half-life with prolonged infusion?

A

Diazepam

Thiopental

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4
Q

What agents have high blood solubility?

What does this mean abut their onset of action?

What about high arterial pressure?

A

Halothane

Slow onset

Reaches high P slowly

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5
Q

What are the effects of inhaled anesthetics on the cardiovascular system?

A

Decrease MAP in direct proportion to the [alveolar]

Increase RA pressure via depression of myocardial function

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6
Q

What may cause hepatitis?

A

Halothane

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7
Q

MOA of Propofol?

Metabolized how?

Rate of onset?

A

GABAa agonist and potentiates Cl current

Liver (phase I and II)

Rapid

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8
Q

What are the types of barbiturates?

MOA?

Cause what?

Effect on CYP450 enzymes?

A

Thiopental (prototype)
Methohexital

GABAa agonist

Respiratory depression

Inducers

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9
Q

Etomidate MOA?

Produces what?

Metabolized how?

A

GABA receptors

Rapid loss of consciousness w/less recovery time than Propofol

Liver and plasma

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10
Q

Are agents more soluble in the blood or brain?

A

Brain

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11
Q

Do gaseous anesthetics have a high or low vapor pressure?

BP?

What form at room temp?

A

High vp

Low BP

Gas

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12
Q

Do volatile anesthetics have a high or low vapor pressure?

BP?

What form at room temp?

A

Low vp

High BP

Liquid

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13
Q

Ketamine MOA?

What side effects?

A

NMDA antagonist

Lacrimation and salivation

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14
Q

What properties do benzodiazepines have?

A

Potent anticonvulsant

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15
Q

What adjunct may be preferred for short ambulatory procedures due to its rapid elimination?

A

Methohexital

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16
Q

What are the effects of inhaled anesthetics on the CNS?

A

Decrease BMR of the brain

Increase cerebral blood flow

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17
Q

What is the prodrug of Propofol?

What is the onset and recovery like?
Describe its administration

Adverse side effects?

A

Fospropofol

Prolonged onset and recovery
Less pain on admin

Parasthesias and pruritus

18
Q

What anesthetic produces a state characterized by catatonia, amnesia, analgesia, w/or w/out loss of consciousness and may induce a euphoric state?

A

Ketamine

19
Q

What is the blood:gas partition coefficient equal to?

A

Blood solubility

20
Q

High blood:gas coefficient means what?

A

High solubility, slow onset of action

21
Q

What are the benzodiazepines?

MOA?

When are they used?

A

Diazepam, lorazepam, midazolam

GABAa agonist

Perioperatively

22
Q

How can benzodiazepines actions be terminated?

A

Flumazenil

23
Q

What agents have low blood solubility?

What does this mean abut their onset of action?

What about high arterial pressure?

A

NO, desflurane

Rapid onset

Reaches high P rapidly

24
Q

What is the most commonly used parenteral anesthetic in the U.S.?

A

Propofol

25
Q

CNS effects of etomidate?

Endocrine effects?

A

Cerebral vasoconstrictor

Adrenocortical suppression (inhibits 11B-hydroxylase)

26
Q

What are the opioid analgesic adjuncts?

MOA?

A

MRFS
Morphine, remifentanil, fentanyl, sufentanil

Opiate agonist

27
Q

What are common side effects of inhaled anesthetics?

A

Nausea and vomiting

28
Q

What is described by MAC?

A

Anesthetic potency which is required to prevent a response to a surgical incision

29
Q

Succinylcholine combined with inhaled volatile anesthetics causes what?

What is the antidote?

A

Malignant hyperthermia

dantrolene

30
Q

Partial pressure in the alveoli equation?

What does a ratio of 1 mean?

A

FA/FI

Fastest anesthesia will occur during inhalation

31
Q

What are the effects of inhaled anesthetics on the respiratory system?

A

Respiratory depression

Depression of mucociliary function

32
Q

Dexmedetomidine MOA?

Affect on Cerebrovascular system?

Used commonly for what?

A

alpha-2 agonist

Decrease HR
Decreases systemic vascular resistance and BP

Short-term sedation of intubated patietns

33
Q

What is the only IV anesthetic to produce profound analgesia, stimulation of the SNS, bronchodilation, and minimal respiratory depression?

A

Ketamine

34
Q

What anesthetic can cause bradycardia?

A

Halothane

35
Q

1 MAC of idol furans is what volume %?

Halothane?

A

1.4 volume %

.75 volume %

36
Q

What benzodiazepine is the drug of choice for parenteral administration?

A

Midazolam

37
Q

What agents metabolized to produce fluoride ions may cause renal toxicity?

A

Enflurane

Sevoflurane

38
Q

What agent has useful antiemetic action and can cause hypotension?

A

Propofol

39
Q

Inhaled anesthetics may cause pooling of mucus and postoperative respiratory infections due to interaction of what system?

Depression of what fx?

A

Respiratory system

Mucociliary fx

40
Q

What are the main excitatory ion channels of anesthetic action?

How?

A

nAChR and mAChR

AMPA, NMDA, and serotonin (5-HT)

Neuro II - Final Exam (4 decks)

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