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TxWes Spring '25: Anesthesia Pharm > History Exam 1 > Flashcards

History Exam 1 Flashcards

1
Q

Anesthesia definition

A
  • Lack of feeling or sensation
  • Artificially induced loss of the ability to feel pain
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2
Q

General anesthesia definition

A

Drug-Induced loss of consciousness
unarousable even by pain stimulation
impaired respiratory and cardiovascular function

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3
Q

Regional anesthesia definition

A

Interrupted sensory nerve conduction of a region resulting in loss of sensation
* Peripheral
* Spinal
* Epidural

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4
Q

Is consciousness affected with regional? Respiratory status?

A

No effect unless sedatives used
Vent/airway also maintained

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5
Q

Spinal anesthesia location

A

Intrathecal space

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6
Q

Epidural anesthesia location

A

Outside of the dura

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7
Q

Minimal sedation characteristics

A

Response: to verbal
Airway: unaffected
Resp: unaffected
CV: unaffected

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8
Q

Moderate sedation characteristics

A

Response: to verbal/touch
Airway: unaffected
Resp: Adequate
CV: maintained

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9
Q

Deep sedation characteristics

A

Response: repeated stimulation
Airway: assist
Resp: inadequate
CV: maintained

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10
Q

What were the earliest forms of anesthesia? (4000BC - 400BC) (5)

A
  • plants, poppy, coca leaves
  • acupuncture
  • ethylene fumes under Apollo’s temple
  • cannabis
  • carotid compression
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11
Q

Credited for creating the materia medica

A

Dioscorides (surgeon in Nero’s army)

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12
Q

Hallucinogenic plant leaves

A

Mandragora
(mandrake leaves)

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13
Q

Triad of anesthesia

A

Amnesia
Analgesia
Muscle relaxation

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14
Q

What are soporifics made of?

A
  1. opium
  2. mandrake leaves
  3. hemlock
  4. hyposcyamus (L-atropine)
  5. water
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15
Q

Soporifics reversal?

A

Vinegar

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16
Q

Valerius Cordus 1515-1544 is credited for

A

German botanist who created diethyl ether
sulfuric acid + ethyl alcohol

Valerius Cordus - Very Clever for discovering ether.

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17
Q

First volatile anesthetic 1515-1544

A

Diethyl ether
made from sulfuric acid and ethyl alcohol

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18
Q

Sir Christopher Wren and Robert Boyle in 1650s credited

A

Created IV therapy from goose quill

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19
Q

Joseph Priestly in 1773 is credited for

A

English chemist
discovered oxygen and nitrous oxide

Joseph Priestly - Jump Proudly for discovering O2 and N2O.

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20
Q

Humphry Davy 1800 credit

A

British chemist
discovered electrolytes

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21
Q

Horace Wells (omg!!!) 1815-1848 credit

A

Dentist
First to notice that N2O caused amnesia
used on dental patients

Horace Wells - He Was surprised by N2O’s amnesia.

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22
Q

Andrew’s (chicago surgeon) credit

A

Nitrous with oxygen administration reduced hypoxia
until 1868 it was administered with air

Andrews Avoids Hypoxia

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23
Q

Hewitt credit

A

First anesthesia MACHINE with nitrous/oxygen

“Hewit’s Healthy Machine”

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24
Q

Crawford Long 1842 credit

A

Used Ether for vascular neck tumor removal

Long Neck (surgery)

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25
Q

William “the dentist” Morton 1819-1868 credit

A

Ether anesthesia for denture fitting

“Morton’s Mouthful of Ether”

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26
Q

Boston Massachusetts 1846

A

First successful public demonstration of ether (Letheon)

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27
Q

Robinson Squibb 1856 credit

A

Developed pure ether process

Refined Steps for pure ether process.

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28
Q

Ether disadvantages (3)

A
  1. Flammable
  2. prolonged induction/emergence
  3. odor = N/V
29
Q

Sir James Simpson 1847 credit

A

Chloroform experimentation
“actual or potential tissue damage”

James Simpson - Joyously Studied chloroform.

30
Q

Dr John Snow credit

A
  • delivered queen victoria
  • Traced cholera outbreak, epidemiology
31
Q

Hyderabad commissions 1888-1891

A

Determined that respiratory monitoring to prevent apnea would prevent deaths during anesthesia

32
Q

Guthrie 1894 credit

A

delayed chloroform hepatotoxicity in children

Guthrie Guards Children

33
Q

Levy 1900 credit

A

low dose chloroform associated with vfib in animals

levy vfib

34
Q

Dr Ko(ke)ller credit

A

Cocaine anesthetic for eye surgery

35
Q

Dr Halstead (man…) credit

A

First regional mandibular nerve block with cocaine

36
Q

Dr August Bier credit

A
  • First spinal anesthetic with cocaine
  • developed Bier block (tourniquet extremity + lidocaine)
37
Q

Sister Mary Bernard 1877 credit

A

First recognized nurse anesthetist

38
Q

Alice Magaw 1860-1928 credit

A

Mother of anesthesia
14k open drop ether cases with no death

39
Q

Agatha Hodgins 1877-1945 credit

A

Open first nurse anesthesia school
Founded AANA

40
Q

Cyclopropane 1934 history

A

-Explosive
-Not much benefit over ether
cyclical explosion, not much benefit over ether

41
Q

Halothane 1956 history

A
  • hepatitis
  • Slow onset
    hepatitis, hangover
42
Q

Isoflurane 1981 history

A
  • safe
  • less N/V
  • quicker onset than halothane
    ideal safe, less nausea, quick onset
43
Q

Desflurane 1992 history

A
  • Most rapid onset and offset
  • Need large quantity to achieve anesthesia
  • high vapor pressure
    dynamic, demanding, dangerous pressure
44
Q

Sevoflurane 1995 history

A
  • Intermediate onset between Iso and Des
  • COMPOUND A: toxic metabolite when in exposed to soda lime
  • no new inhaled anesthetics since
    semi-new, compound A, newest
45
Q

Edmund Egar credit

A

Defined Minimum Alveolar Concentration (MAC)

46
Q

how does amnesia occur (cellular level)

A
  1. stimulate inhibitory transmission
  2. inhibit stimulatory transmission
    Through aCh and GABA
47
Q

First opioid? Where did it come from?

A

Morphine
from opium in 1805

48
Q

What are analgesics used today? (5)

“C-PANG”

A
  1. narcotics
  2. COX inhibitors
  3. gabapentin
  4. Acetaminophen
  5. P. Nerve blocks
49
Q

Where are muscle relaxants derived from? Benefits?

A

Curare 1942
reduced anesthetic requirement

50
Q

Balanced anesthesia adds ____ to the anesthesia triad

A

Homestasis

51
Q

Dr Liston credit

A

3 deaths in one operation
In attempt to minimize surgical time

52
Q

George Crile credit

A

Cleveland clinic
Infiltration of procaine

53
Q

Harvey Cushing credit

A

Known for keeping anesthetic records (BP/HR)
Regional blocks prior to emergence from ether

54
Q

Neurolept anesthesia 1959 history

A

Use of high dose antipsychotics as anesthesia
High incidence of awareness, dysphoria, and extrapyramidal movements

55
Q

What was notable with the high dose opioid technique used in 1981?

A

although surgical stimulation induced no movement, pain manifested as:
* Tachycardia
* HTN
this would be masked if patient was on beta-blockers

56
Q

Phases of anesthesia administration (5)

A
  1. Preoperative
  2. Induction
  3. Maintenance
  4. Emergence
  5. Postoperative
57
Q

Drugs for phase 1 (3)

A
  1. Benzos
  2. H1/H2 blockers
  3. bronchodilators
58
Q

Drugs for phase 2 (4)

A
  1. etomidate
  2. ketamine
  3. propofol
  4. narcotics
59
Q

Drugs for phase 3 (4)

A
  1. volatiles
  2. NMBs
  3. vasopressors
  4. blockers
60
Q

Drugs for phase 4 (2)

A
  1. Reversals
  2. local anesthetics
61
Q

Stage 1 of anesthesia

A

Induction - loss of consciousness
3 planes

62
Q

What are the three planes of anesthesia during stage 1?

A

plane 1: no amnesia or analgesia
plane 2: amnesia and partial analgesia
plane 3: complete analgesia and amnesia

63
Q

Stage 2 of anesthesia

A

Loss of consciousness - onset of auto breathing
* eyelash reflex disappears
* cough, vomit, struggling
* irregular respirations with breath-holding

64
Q

Stage 3 of anesthesia

A

auto breathing - respiratory paralysis (surgical plane)
4 planes

65
Q

What is stage 3 plane 4 of anesthesia?

A

Plane 4: complete IC muscle paralysis, apnea

66
Q

What is stage 3 plane 1 of anesthesia?

A

Plane 1: automatic respiration - eyeball movements stop

67
Q

What is stage 3 plane 2 of anesthesia?

A

Plane 2: cessation of eyeball movements - start of IC muscle paralysis, secretion of tears

68
Q

What is stage 3 plane 3 of anesthesia?

A

Plane 3: moderate IC muscle paralysis, pupils dilate, NMBs ideal at this plane

69
Q

Stage 4 of anesthesia

A

Stoppage of respiration till death

TxWes Spring '25: Anesthesia Pharm (12 decks)

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