General Anesthetics - Kruse Flashcards
excitatory ion channel targets
- those activated by ACh
- those activated by EAAs
- those activated by serotonin
primary focus of anesthetics
synapse
2 factors that determine how quickly [alveolar] changes
1) inspired concentration or PP
2) alveolar ventilation
PP alveoli
Fa/Fi; (alveolar conc)/(inspired conc)
major route of elimination of inhaled anesthetics
lungs
MAC
measurement used to describe anesthetic potency - prevents movement in response to surgical stimulation in 50% of patients
Halothane toxicity
can cause hepatitis
Enfluane & Sevoflurane toxicit
renal d/t metabolism to F- ions
succinlycholine + inhaled volatile anesthetic toxicity
malignant hyperthermia
5 desired changes in behavior for achieving anesthesia
unconsciousness, amnesia, analgesia, inhibition of autonomic reflexes, and skeletal mm relaxation
Etomidate: onset & recovery
rapid onset, fast recovery (IV); suppression lasts 4-8 hr
Ketamine: onset & recovery
moderately rapid onset and recovery (IV)
Methohexital: onset & recovery
rapid onset and recovery (IV)
Midazolam: onset & recovery
slow onset and recovery (IV), can recover w/ flumazenil
Propofol: onset & recovery
rapid onset and recovery (IV); 15-30 sec to set in
Thiopental: onset & recovery
rapid onset and recovery (bolus), slow following infusion
Fentanyl
slow onset and recovery (IV), can recover w/ naloxone
Etomidate MOA
enhances actions of GABA on GABA(a) receptors
Ketamine MOA
NMDA receptor antagonis
Dexmedethomidine MOA
alpha-2 andrenergic agonist (locus caeruleus)
Common opioid analgesics (IV)
- fetnayl
- sulfentanil
- remifentanil
- morphine
Opioid analgesics MOA
agonist at opiate receptors
Common barbituates
- thiopental
- methohexital
Barbituates MOA
acts on GABA(a) receptor to increase channel opening (agonist) and enhance inhibitory neurotransmission
Common benzodiazepines
- diazepam
- lorazepam
- midazolam
Benzodiazepine MOA
acts on GABA(a) receptor to increase channel opening (agonist) and enhance inhibitory neurotransmission
