General Anesthetics

Question 1

What are the 5 desired effects for ideal GA

Answer 1

unconsciousness, amnesia, analgesia, inhibition of autonomic reflexes, and skeletal muscle relaxation

Question 2

Why are pre anesthetics used

Answer 2

to make it safer and pleasant
releives anxiety -benzo
amnesia pre and post
supplement analgesic so that less anaesthetic is needed
decrease resp secretion
antiemetic
decreases acidity, volume of gastric juice -H2 blockers

Question 3

Guedel’s sign/stages of anesthesia

Answer 3

Stage I : Analgesia
Stage II : Excitement, Combative behavior – dangerous state
Stage III: Surgical anesthesia
Stage IV: Medullary Paralysis –respiratory and vasomotor control ceases

Question 4

3 stages of the state of anesthesia

Answer 4

Induction:
period of time from the onset of admin. of the anesthetic to the development of effective surgical anesthesia

Induction of anesthesia depends on how fast effective concentrations of the anesthetic drugs reach brain

Maintenance:
Provides sustained surgical anesthesia

Recovery:
Time from discontinuation of administration of anesthesia until consciousness and protective physiologic reflexes are regained

Recovery is the reverse of induction and depends on how fast the anesthetic drug diffuses back from brain

Question 5

Inhibitory ion channels targeted

Answer 5

chloride channels (γ-aminobutyric acid-A [GABAA] & glycine receptors & potassium channels (K2P, possibly KV, and KATP channels).

Question 6

Excitatory ion channel

Answer 6

are activated by Acetylcholine (nicotinic and muscarinic receptors), by glutamate (amino-3-hydroxy-5-methyl-4-isoxazol-propionic acid [AMPA], kainate, and N-methyl-d-aspartate [NMDA] receptors), or by serotonin (5-HT2 and 5-HT3 receptors).

Question 7

Halogenated agents, propofol, barbiturates, and etomidate activate

Answer 7

Halogenated agents, propofol, barbiturates, and etomidate activated chloride channels which act on inhibitory GABAA receptors