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Anesthesia Pharm (Spring 2023) > Introduction to Anesthesia Pharmacology (Exam I) > Flashcards

Introduction to Anesthesia Pharmacology (Exam I) Flashcards

1
Q

Does general anesthesia, by definition, necessitate the use of an artificial airway or ventilator?

A
  • No, it is just most often required.
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2
Q

How arousable would one be with the use of minimal sedation?

A
  • Arousable to verbal commands.
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3
Q

How arousable would one be with the use of moderate sedation?

A
  • Arousable to touch/loud verbal.
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4
Q

How arousable would one be with the use of deep sedation?

A
  • Arousable to painful stimulation.
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5
Q

Who developed the Materia Medica?
What was the Materia Medica?

A
  • Dioscorides
  • Materia Medica was a large volume of what essentially predated pharmacology with medical properties of plants, animals, minerals, etc.
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6
Q

What was wine combined with in ancient days to elicit a hallucinogenic effect?

A
  • Mandragora
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7
Q

What are soporifics?
What components made up a soporific?
What was the reversal?

A
  • Sponges soaked with premodern “anesthetics”.
  • opium, mandrake or hemlock juice, hyposcyamus
  • Reversal = vinegar
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8
Q

What drug was the first inhalation agent?
Who discovered it?
What was its use?

A
  • Diethyl Ether
  • Valerius Cordus
  • Recreational (replaced expensive whiskey)
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9
Q

Who invented IV access?
What material was used?

A
  • Wren & Boyle
  • Goose quill
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10
Q

Who first discovered oxygen and nitrous oxide?
Who suggested its use for surgical pain control and was laughed away?

A
  • Joseph Priestly
  • Humphry Davy
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11
Q

Which dentist used nitrous for extractions?
What was noted with these extractions?

A
  • Horace Wells
  • no recall of pain/injury
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12
Q

Which person mixed nitrous and oxygen?

A
  • Andrews
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13
Q

Who first utilized an anesthesia machine with nitrous/oxygen?

A
  • Hewitt
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14
Q

What was ether called when it was first commercialized?
Who ended up purifying ether?

A
  • Letheon
  • Dr. Robinson Squibb
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15
Q

What are the disadvantages of ether?

A
  • Flammable
  • Prolonged induction/emergence
  • Bad odor
  • PONV
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16
Q

Which person defined pain?
What was the definition?

A
  • Sir James Simpson
  • “Actual or potential tissue damage”
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17
Q

What was Dr. John Snow famous for?

A
  • Full time anesthetist & “discovered” epidemiology by tracing London cholera outbreak.
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18
Q

What were the downsides of chloroform use?

A
  • Hepatotoxicity in children (Guthrie)
  • Chloroform + adrenaline = fatal vfib (at least in animal studies) (Levy)
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19
Q

What drug was used for the 1st spinal anesthetic?
Who used it and what else did they develop?

A
  • Cocaine
  • Dr. August Bier (Bier Block)
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20
Q

Who was the “mother of nurse anesthesia”?
What did she do?

A
  • Alice Magaw
  • 14,000 open drop ether cases with no deaths
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21
Q

What was Agatha Hodgins notable for?

A
  • Opened 1st nurse anesthesia school
  • Taught France in WWI
  • Founded AANA
22
Q

What was the issue with Cyclopropane use?

A
  • Violently explosive
23
Q

Why is halothane obsolete?

A
  • Long induction/emergence
24
Q

Contrast Isoflurane, Sevoflurane, and Desflurane.

A
  • Isoflurane: longer onset/emergence
  • Sevoflurane: intermediate onset/emergence
  • Desflurane: rapid onset/emergence
25
Q

Which volatile anesthetic has the highest vapor pressure? What does this mean?

A
  • Desflurane
  • High vapor pressure means it evaporates very quickly.
26
Q

Which volatile anesthetic is unstable in soda lime? What does soda lime do?

A
  • Sevoflurane
  • Soda Lime is a CO₂ absorbent.
27
Q

What benefits does Sevoflurane offer compared to other volatile anesthetics?

A
  • Less airway irritation
28
Q

What is the “Triad” of anesthesia?

A
  • Amnesia, Analgesia, & Muscle Relaxation
29
Q

Regarding amnesia, what neurotransmitter inhibits stimulatory transmissions?

A
  • GABA
30
Q

Regarding amnesia, which neurotransmitter stimulates inhibitory transmissions?

A

ACh

31
Q

What is the primary benefit of muscle relaxants?

A
  • Decreases the amount of other anesthetics needed (thus overall decreasing mortality)
32
Q

What new factor was added to the anesthesia triad to form “balanced anesthesia”?

A
  • Homeostasis
33
Q

Which physician had three deaths in one operation?

A
  • Dr. Liston
34
Q

What was the practice of neurolept anesthesia?

A
  • Very high doses of amnestic drugs (droperidol, haldol, etc) vs volatiles or analgesics.
35
Q

What are the three stages of Anesthesia?

A
  1. Beginning of induction of general anesthesia to loss of consciousness
  2. Loss of consciousness to onset of automatic breathing
  3. Onset respiratory paralysis (surgical plane)
36
Q

What characterizes stage 1 of anesthesia?

A

Stage 1:
- 1st plane - no amnesia or analgesia
- 2nd plane - amnestic but only partial analgesic
- 3rd plane - complete analgesia & amnesia

37
Q

What characterizes stage 2 of anesthesia?

A

Stage 2
- eyelash reflex disappears
- coughing, N/V, struggling may occur
- irregular respirations

38
Q

What planes characterize stage 3 of anesthesia?

A

Stage 3
- 1st plane - automatic respiration → eyeball movement stops
- 2nd plane - ocular cessation → intercostals start to paralyze & tear secretion increases.
- 3rd plane - pupillary dilation, desired plane prior to muscle relaxants
- 4th plane - complete intercostal paralysis → diaphragmatic paralysis (apnea)

39
Q

What characterizes stage IV of anesthesia?

A
  • Death (via medullary paralysis)
40
Q

In what stage and/or plane of anesthesia would one expect to see lacrimation?

A

Stage 3 / 2nd plane

41
Q

In what stage and/or plane of anesthesia would one expect to see onset of diaphragmatic paralysis?

A

Stage 3 / 4th plane

42
Q

In what stage and/or plane of anesthesia would one expect the beginning of total amnesia/analgesia to occur?

A

Stage 1 / 3rd plane

43
Q

In what stage and/or plane of anesthesia would one expect for the eyelash reflex to disappear?

A

Stage 2

44
Q

In what stage and/or plane of anesthesia would one expect to see total and complete intercostal paralysis?

A

Stage 3 / 4th plane

45
Q

In what stage and/or plane of anesthesia would one expect to see pupillary dilation?

A

Stage 3 / 3rd plane

46
Q

In what stage and/or plane of anesthesia would one expect to see amnesia but only partial analgesia?

A

Stage 1 / 2nd plane

47
Q

Who used cocaine as an anesthetic for eye surgeries?

A
  • Koller
48
Q

Who used cocaine as a mandibular nerve block?

A
  • Halsted
48
Q

Who used cocaine as a mandibular nerve block?

A
  • Halsted
49
Q

What was Crile known for?

A
  • Preemptive procaine at surgical site
  • Lighter nitrous/oxygen
50
Q

What was Cushing known for?

A
  • Regional blocks before anesthetic emergence
  • Anesthetic records
51
Q

Who did extensive experiments with desflurane?
What else did this person do?

A
  • Egar
  • Develop MAC (minimal alveolar concentration)

Anesthesia Pharm (Spring 2023) (20 decks)

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