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Anesthesia Pharmacology > Introduction > Flashcards

Introduction Flashcards

1
Q

Anesthesia

A

Artificially induced loss of the ability to feel pain

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2
Q

General Anesthesia

A

A drug-induced loss of consciousness

Patients are not arousable; even by painful stimulation

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3
Q

Regional Anesthesia

A

insensibility caused by interrupting the sensory nerve conduction of a particular region of the body
Peripheral
Spinal
Epidural

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4
Q

Accommodate the operator
Avoid sinking down and turning away

A

Hippocrates

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5
Q

Wrote Materia Medica (pharmacology)
Authoritative for 15 centuries
5 volumes; plants, animal and mineral products
360 medical properties (antiseptic, anti-inflammatory)

A

Dioscorides

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6
Q

German botanist, physician
Made from sulfuric acid and ethyl alcohol
Named ether: greek for ignite
Tested on chickens

A

Valerius Cordus

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7
Q

Created IV therapy using a goose quill
Administered alcohol into a dog’s vein

A

Sir Christopher Wren and Robert Boyle

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8
Q

English chemist
Discovers oxygen and nitrous oxide
Discovered photosynthesis

A

Joseph Priestly

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9
Q

British chemist
Discovered potassium, sodium, calcium, magnesium….
Suggested its use (Nitrous) for surgical pain control

A

Humphry Davy

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10
Q

Noticed that a man under the influence of N2O had no recall of pain/injury
Self administered for tooth extraction and uses on several dental patients
1845 at Mass General….Arranged administration for amputation
“humbug”

A

Horace Wells

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11
Q

Chicago surgeon….Nitrous/oxygen anesthesia without cyanosis

A

Andrews

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12
Q

1st anesthesia machine with nitrous/oxygen
Common surgical anesthesia

A

Hewitt

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13
Q

Delivered ether for a patient with 2 vascular neck tumors
Continued use of whiskey

A

Crawford Long

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14
Q

Dentist
Needed anesthesia for denture fitting

A

William Morton

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15
Q

Developed process for pure ether (1856)
Founded Squibb pharmaceuticals….leading manufacturer

A

Dr. Robinson Squibb

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16
Q

Disadvantages of ether

A

Flammable

Prolonged induction

Unpleasant, persistent odor

High incidence of nausea/vomiting

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17
Q

Obstetrician in Scotland
Experimented chloroform following dinner party
Defined pain: “actual or potential tissue damage”
Religious opposition

A

Sir James Simpson

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18
Q

Full time anesthetist
Used chloroform for Queen Victoria’s childbrith….prince Leopold and princess Beatrice
“discovered” epidemiology when he traced London cholera outbreak to water source

A

Dr. John Snow

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19
Q

Hyderabad commissions

A

Discussed the possibility of Respiratory arrest vs cardiac paralysis from Chloroform

20
Q

Found delayed chloroform hepatotoxicity in children

A

Guthrie

21
Q

Light chloroform anesthesia and adrenaline….fatal vf in animals

A

Levy

22
Q

Viennese ophthalmologist (colleague of Sigmund Freud)
Used Cocaine for Anesthetic for eye surgery

A

Dr. Koller

23
Q

1st regional (mandibular) nerve block with cocaine

A

Dr. Halsted

24
Q

1st spinal anesthetic with cocaine

A

Dr. August Bier
Developed Bier block

25
Q

1st nurse anesthetist
Low pay
Intelligent
Focused on patient instead of surgery

A

Sister Mary Bernard

26
Q

“mother of anesthesia”
14,000 open drop ether cases without death

A

Alice Magaw

27
Q

Opened one of 1st nurse anesthesia schools
Taught in France
Developed nitrous/oxygen techniques
Founded AANA

A

Agatha Hodgins

28
Q

Cyclopropane

A

Violently explosive

29
Q

Halothane

A

Hepatitis
Slow onset

30
Q

Isoflurane

A

Relatively safe, still used today
Less nausea and vomiting
Quicker onset than halothane

31
Q

Desflurane

A

Rapid uptake and distribution! (most rapid onset and offset), so used for outpatient procedures
High vapor pressure
Large quantity to achieve anesthesia

32
Q

End-tidal concentration correlated to movement….MAC (Minimal alveolar concentration/dose of volatile anesthetic)
Also experimented a lot in Desflurane

A

Edmund Egar

33
Q

Sevoflurane

A

Intermediate action between isoflurane and desflurane
Unstable in soda lime; toxic degradation product concerns
No new inhaled anesthetics since

34
Q

The “triad”

A

Amnesia, Analgesia and Muscle Relaxation

35
Q

Amnesia cause by Stimulating inhibitory transmissions of

A

Acetylcholine

36
Q

Amnesia caused by Inhibiting stimulatory transmissions of

A

GABA

37
Q

Curare

A

Natural Muscle relaxants used by south American tribes

38
Q

Discovered Surgical cases > 20 minutes…death
3 deaths from 1 operation

A

Dr. Liston

39
Q

Cleveland clinic
Light nitrous/oxygen anesthesia
Local infiltration of procaine

A

George Crile

40
Q

Regional blocks prior to emergence from ether
Anesthetic records, BP/HR measurements

A

Harvey Cushing

41
Q

1959
Opioids, antipsychotics (Haldol, droperidol), nitrous
Blocked autonomic and endocrine response to stress
High incidence of awareness, dysphoria, extrapyramidal movements

A

neurolept anesthesia

42
Q

Phases of Anesthesia

A

Preoperative period
BZD, H1 and H2 blockers, bronchodilators

Induction of anesthesia
Etomidate, ketamine, propofol, narcotics

Maintenance of anesthesia
Inhalation drugs, neuromuscular blockers, pressors, blockers

Emergence from anesthesia
NMB reversal, local anesthetics

Postoperative period

43
Q

Stage I of Anesthesia

A

beginning of induction of general anesthesia to loss of consciousness

1st plane: no amnesia or analgesia
2nd plane: amnestic but only partially analgesic
3rd plane: complete analgesia and amnesia

44
Q

Stage 2 of Anesthesia

A

loss of consciousness to onset of automatic breathing

eyelash reflex disappears
coughing, vomiting, struggling may occur
irregular respirations with breath-holding

45
Q

Stage 3 of Anesthesia

A

onset of automatic respiration to respiratory paralysis (surgical plane)

1st plane: automatic respiration to cessation of eyeball movements
2nd plane: cessation of eyeball movements to beginning of intercostal muscle paralysis; secretion of tears increases
3rd plane: beginning to completion of intercostal muscle paralysis; pupils dilate; desired plane prior to muscle relaxants
4th plane: complete intercostal paralysis to diaphragmatic paralysis (apnea)

46
Q

Stage 4 of Anesthesia

A

stoppage of respiration till death

Anesthesia Pharmacology (3 decks)

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