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Anesthesia Pharm (Spring 2025) > 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
Which volatile anesthetic has the highest vapor pressure? What does this mean?
- Desflurane - High vapor pressure means it evaporates very quickly.
26
Which volatile anesthetic is unstable in soda lime? What does soda lime do?
- Sevoflurane - Soda Lime is a CO₂ absorbent.
27
What benefits does Sevoflurane offer compared to other volatile anesthetics?
- Less airway irritation
28
What is the "Triad" of anesthesia?
- Amnesia, Analgesia, & Muscle Relaxation
29
Regarding amnesia, what neurotransmitter inhibits stimulatory transmissions?
- GABA
30
Regarding amnesia, which neurotransmitter stimulates inhibitory transmissions?
ACh
31
What is the primary benefit of muscle relaxants?
- Decreases the amount of other anesthetics needed (thus overall decreasing mortality)
32
What new factor was added to the anesthesia triad to form "balanced anesthesia"?
- Homeostasis
33
Which physician had three deaths in one operation?
- Dr. Liston
34
What was the practice of neurolept anesthesia?
- Very high doses of amnestic drugs (droperidol, haldol, etc) vs volatiles or analgesics.
35
What are the three stages of Anesthesia?
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
What characterizes stage 1 of anesthesia?
Stage 1: - 1st plane - no amnesia or analgesia - 2nd plane - amnestic but only partial analgesic - 3rd plane - complete analgesia & amnesia
37
What characterizes stage 2 of anesthesia?
Stage 2 - eyelash reflex disappears - coughing, N/V, struggling may occur - irregular respirations
38
What planes characterize stage 3 of anesthesia?
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
What characterizes stage IV of anesthesia?
- Death (via medullary paralysis)
40
In what stage and/or plane of anesthesia would one expect to see lacrimation?
Stage 3 / 2nd plane
41
In what stage and/or plane of anesthesia would one expect to see onset of diaphragmatic paralysis?
Stage 3 / 4th plane
42
In what stage and/or plane of anesthesia would one expect the beginning of total amnesia/analgesia to occur?
Stage 1 / 3rd plane
43
In what stage and/or plane of anesthesia would one expect for the eyelash reflex to disappear?
Stage 2
44
In what stage and/or plane of anesthesia would one expect to see total and complete intercostal paralysis?
Stage 3 / 4th plane
45
In what stage and/or plane of anesthesia would one expect to see pupillary dilation?
Stage 3 / 3rd plane
46
In what stage and/or plane of anesthesia would one expect to see amnesia but only partial analgesia?
Stage 1 / 2nd plane
47
Who used cocaine as an anesthetic for eye surgeries?
- Koller
48
Who used cocaine as a mandibular nerve block?
- Halsted
49
What was Crile known for?
- Preemptive procaine at surgical site - Lighter nitrous/oxygen
50
What was Cushing known for?
- Regional blocks before anesthetic emergence - Anesthetic records
51
Who did extensive experiments with desflurane? What else did this person do?
- Egar - Develop MAC (minimal alveolar concentration)
52
Who used cocaine as a mandibular nerve block?
- Halsted

Anesthesia Pharm (Spring 2025) (20 decks)

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