General Anesthetics, Local Anesthetics, and Muscle Relaxants

Question 1

What are the stages of general anesthesia and what stage do we want pts to be in as quickly as possible and for the whole procedure?

Answer 1

Stage 1: analgesia
Stage 2: Excitement or delirium
Stage 3: Surgical Anesthesia-> want them in this stage
Stage 4: Medullary Paralysis ->respiration is impacted and pt can die

Question 2

Which type of intravenous anesthetics are most commonly used to induce or maintain general anesthesia?

Answer 2

benzodiazepines, opioid analgesics, ketamine, propofol (diprivan)

Question 3

Which intravenous anesthetic is used in short procedures and invasive procedures in children?

Answer 3

ketamine

Question 4

Which is the drug of choice for general anesthesia as it allows for rapid recovery and early mobilization?

Answer 4

propofol/Diprivan

Question 5

How are anesthetics stored and eliminated?

Answer 5

stored in adipose tissues and can then be re-released or washed out as the pt recovers from surgery/ eliminated through lungs and transformed in the liver

Question 6

How do anesthetics generally work?

Answer 6

inhibit the neuronal activity throughout the CNS (in RAS) and in spinal cord which causes immobility and inhibits response to pain, or bind to specific receptors located on the outer surface of CNS neurons enhancing CNS inhibition

Question 7

Which drugs are administered with general anesthetics to enhance the effects and what 2 types are there?

Answer 7

adjuvants
1. preoperative medications
2. neuromuscular blockers

Question 8

_____ are given with anesthetics to ensure skeletal mm paralysis

Answer 8

neuromuscular blockers

Question 9

You notice a pt had a neuromuscular blocker during surgery, what could you expect to see if you saw them for therapy?

Answer 9

residual paralysis may occur and skeletal mm contractions remain depressed for several hours

Question 10

What are things you have to be aware of when a pt has had general anesthesia?

Answer 10

PT should work on early mobilization and breathing and postural drainage since mucous may have accumulated, and be aware that pt may be woozy, delirious or have mm weakness

Question 11

What doe local anesthetics name end in?

Answer 11

-caine

Question 12

_____: drug is injected into the epidural space between the vertebral column and dura mater

Answer 12

epidural nerve block

Question 13

______: drug is injected within the subarachnoid space between the arachnoid membrane and pia mater

Answer 13

spinal nerve blockade

Question 14

_ _ _ are used whenever analgesia is needed for a large region: common during obstetrics

Answer 14

central nerve blockade

Question 15

This type of block interrupts sympathetic nerve discharge to an affected extremity

Answer 15

sympathetic blockade

Question 16

t/f goal of a sympathetic blockade is not to provide analgesia but to reduce excessive sympathetic outflow to an affected extremity

Answer 16

true

Question 17

MOA of local anesthetics

Answer 17

inhibit opening of sodium channels located on nerve membranes which blocks action potential progression along a nerve axon

Question 18

What is your concern with someone with a transdermal patch?

Answer 18

don’t disturb it during exercise and do not place heat modalities over it

Question 19

What is your main concern with someone who has a continuous nerve block?

Answer 19

pt will not feel if they over stress their joint during exercise

Question 20

What are you concerned with if a pt has a central nerve block?

Answer 20

LEs could buckle with ambulation

Question 21

t/f skeletal mm relaxants prevent mm contractions

Answer 21

false, do not prevent mm contractions

Question 22

Which antispasm medication is ideal for short term acute mm spasm management but not for long term use?

Answer 22

diazepam (valium)

Question 23

What is a common antispasticity drug with few side effects?

Answer 23

baclofen

Question 24

What is the only antispasticity drug/ mm relaxant that effects the skeletal mm cell directly?

Answer 24

dantrolene sodium

Question 25

What are medications used for antispasticity/mm relaxants?

Answer 25

baclofen, dantrolene sodium, diazepam, gabapentin, tizanidine, botulinum toxin