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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
William "the dentist" Morton 1819-1868 credit
**Ether** anesthesia for **denture fitting** "Morton's Mouthful of Ether"
26
Boston Massachusetts 1846
First successful **public demonstration of ether** (**Letheon**)
27
Robinson Squibb 1856 credit
Developed **pure ether process** **Refined Steps** for pure ether process.
28
Ether disadvantages (3)
1. Flammable 2. prolonged induction/emergence 3. odor = N/V
29
Sir James Simpson 1847 credit
**Chloroform** experimentation "actual or potential tissue damage" James Simpson - **Joyously Studied chloroform**.
30
Dr John Snow credit
* delivered **queen victoria** * Traced **cholera** outbreak, **epidemiology**
31
**Hyderabad** commissions 1888-1891
Determined that **respiratory monitoring** to prevent apnea would **prevent deaths** during anesthesia
32
Guthrie 1894 credit
delayed **chloroform** **hepatotoxicity** in children Guthrie Guards Children
33
Le**v**y 1900 credit
**low dose chloroform** associated with **vfib** in animals levy vfib
34
Dr Ko(ke)ller credit
**Cocaine** anesthetic for eye surgery
35
Dr Halstead (man...) credit
First regional **mandibular nerve block** with cocaine
36
Dr August Bier credit
* **First spinal anesthetic with cocaine** * developed **Bier block** (tourniquet extremity + lidocaine)
37
Sister Mary Bernard 1877 credit
**First** recognized **nurse anesthetist**
38
Alice Magaw 1860-1928 credit
**Mother of anesthesia** **14k open drop ether** cases with no death
39
Agatha Hodgins 1877-1945 credit
Open **first nurse anesthesia school** **Founded AANA**
40
Cyclopropane 1934 history
-**Explosive** -Not much benefit over **ether** cyclical explosion, not much benefit over ether
41
**H**alothane 1956 history
* hepatitis * Slow onset hepatitis, hangover
42
Isoflurane 1981 history
* safe * less N/V * quicker onset than halothane ideal safe, less nausea, quick onset
43
Desflurane 1992 history
* Most **rapid** onset and offset * Need **large quantity** to achieve anesthesia * **high vapor** pressure dynamic, demanding, dangerous pressure
44
Sevoflurane 1995 history
* **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
Edmund Egar credit
Defined **Minimum Alveolar Concentration (MAC)**
46
how does amnesia occur (cellular level)
1. stimulate inhibitory transmission 2. inhibit stimulatory transmission Through **aCh** and **GABA**
47
First opioid? Where did it come from?
**Morphine** from **opium** in 1805
48
What are analgesics used today? (5) "C-PANG"
1. narcotics 2. COX inhibitors 3. gabapentin 4. Acetaminophen 5. P. Nerve blocks
49
Where are muscle relaxants derived from? Benefits?
Curare 1942 reduced anesthetic requirement
50
Balanced anesthesia adds ____ to the anesthesia triad
Homestasis
51
Dr Liston credit
3 deaths in one operation In attempt to minimize surgical time
52
George Crile credit
Cleveland clinic Infiltration of procaine
53
Harvey Cushing credit
Known for keeping **anesthetic records** (BP/HR) **Regional blocks** prior to emergence from ether
54
Neurolept anesthesia 1959 history
Use of high dose **antipsychotics** as anesthesia High incidence of **awareness, dysphoria, and extrapyramidal movements**
55
What was notable with the high dose opioid technique used in 1981?
although surgical stimulation induced no movement, pain manifested as: * **Tachycardia** * **HTN** this would be masked if patient was on **beta-blockers**
56
Phases of anesthesia administration (5)
1. Preoperative 2. Induction 3. Maintenance 4. Emergence 5. Postoperative
57
Drugs for phase 1 (3)
1. Benzos 2. H1/H2 blockers 3. bronchodilators
58
Drugs for phase 2 (4)
1. etomidate 2. ketamine 3. propofol 4. narcotics
59
Drugs for phase 3 (4)
1. volatiles 2. NMBs 3. vasopressors 4. blockers
60
Drugs for phase 4 (2)
1. Reversals 2. local anesthetics
61
Stage 1 of anesthesia
Induction - loss of consciousness **3 planes**
62
What are the three planes of anesthesia during stage 1?
plane 1: **no amnesia** or analgesia plane 2: amnesia and **partial** analgesia plane 3: **complete** analgesia and amnesia
63
Stage 2 of anesthesia
Loss of consciousness - onset of **auto breathing** * **eyelash reflex** disappears * cough, vomit, **struggling** * **irregular respirations** with **breath-holding**
64
Stage 3 of anesthesia
auto breathing - **respiratory paralysis** (**surgical plane**) **4 planes**
65
What is **stage 3 plane 4** of anesthesia?
Plane 4: **complete IC muscle paralysis**, **apnea**
66
What is **stage 3 plane 1** of anesthesia?
Plane 1: automatic respiration - **eyeball movements stop**
67
What is **stage 3 plane 2** of anesthesia?
Plane 2: cessation of eyeball movements - start of IC muscle **paralysis, secretion of tears**
68
What is **stage 3 plane 3** of anesthesia?
Plane 3: moderate IC muscle paralysis, **pupils dilate**, **NMBs ideal at this plane**
69
Stage 4 of anesthesia
Stoppage of respiration till death

TxWes Spring '25: Anesthesia Pharm (13 decks)

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