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iv anes, gen anes, local anes Flashcards

0
Q

Ketamine antagonize what receptors

A

Nmda receptors

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1
Q

All IV anes acts on gaba receptor exc

A

Ketamine

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2
Q

Rate of transfer into the brain and the anesthetic effect is regulated by the ff factors

A
  1. Inbound drug
  2. Reduced cerebral blood flow
  3. Non-ionized
  4. Lipid soluble
  5. Rapid injection
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3
Q

Hyperventilation will increase/decrease protein binding

A

Decrease protein binding= increase unbound drug = increase anes effect

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4
Q

T or F: protein binding is affected by changes in ph

A

True

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5
Q

CBF is reduced becoz Of low/high CO

A

Low CO.

Anes effect is delayed but enhanced

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6
Q

T or F: rapid administration also affects the extent of cvs and respiratory side effects

A

True

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7
Q

Alkylthenol cmpd

A

Propofol

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8
Q

Propofol: insoluble/soluble in water

A

Insoluble.

Requires egg lecithin emulsion 1%

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9
Q

Propofol: pain / no pain on injection

A

Pain on injection

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10
Q

Feeling of week being andn euphoria

A

Propofol

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11
Q

Propofol: increase/decrease CMRCO2, CBF, ICP, cerebral perfusion rate

A

Decrease

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12
Q

Drug of choice if LMA is used

A

Propofol

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13
Q

With anticonvulsant and antiemetic prop

A

Propofol

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14
Q

Asso with release of histamine and anaphylactoid reaction

A

Propofol

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15
Q

Propofol EEG. Frequency and amplitude and duration of seizures

A

Increase amplitude
Decrease frequency
Decrease duration of seizure

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16
Q

Propofol anes is induced sec

A

40-60s

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17
Q

Ketamine anes induced sec

A

30-60s

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18
Q

Ketamine: soluble/insoluble to water

A

Soluble to water

Lipid soluble also

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19
Q

Phencyclidine

A

Ketamine

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20
Q

Dissociative anes.. Rather than generalized depression of cns

A

Ketamine

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21
Q

Ketamine EEG. Alpha and tetha

A

Loss of alpha waves

More tetha waves

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22
Q

Ketamine: increase/decrease CMRCO2, CBF, ICP, cerebral perfusion rate

A

Increase

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23
Q

Propofol: increase/decrease arterial P, HR

A

Decrease

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24
Ketamine: increase/decrease arterial P, HR
Increase
25
Inotropic effect of Propofol
(-) inotropic effect
26
Inotropic effect of ketamine
(+) inotropic
27
Propofol/ketamine: apnea is more common
Propofol
28
Propofol/ketamine: transient apnea, ventilation is maintained
Ketamine
29
Propofol/ketamine: no effect on bronchial ms tone
Propofol
30
Propofol/ketamine: bronchodilation
Ketamine
31
Propofol/ketamine: decrease ms tone, movement on stimulation
Propofol
32
Propofol/ketamine: increase ms tone, spont. Movement
Ketamine
33
Propofol/ketamine: no GI effect. N and V uncommon
Propofol
34
Propofol/ketamine: increase salivation
Ketamine
35
Propofol/ketamine: no uterine effect, cross PBB
Propofol
36
Propofol/ketamine: uterine relaxation, cross PBB
Ketamine
37
Propofol/ketamine: night,are and hallucination
Ketamine
38
Propofol/ketamine/etomidate/thiopental: delay disappearance of eyelash
Propofol
39
Propofol/ketamine/etomidate/thiopental: | overdosage may lead to loss of verbal contact
Propofol
40
Propofol/ketamine/etomidate/thiopental: | Recovery of consciousness is rapid
Propofol
41
Propofol/ketamine/etomidate/thiopental: | Minimal hang-over effect
Propofol
42
The pressor response to tracheal intubation is attenuated to a greater extend by
Propofol
43
T or F: ventilatory depression of Propofol is more marked if opioids are administered
True
44
Propofol/ketamine/etomidate/thiopental: | Decrease HBF and renal function
Propofol
45
Propofol/ketamine/etomidate/thiopental: | Liver function test not deranged
Propofol
46
Propofol/ketamine/etomidate/thiopental: | Decrease cortisol
Propofol
47
Metabolite of Propofol excreted by kidney
Glucoronide
48
Terminal elimination half life of Propofol
3-4.8hrs
49
Effective half life of Propofol
30-60mins
50
Distribution and clearance of Propofol are altered by admin of
Fentanyl
51
AE of Propofol
CV and respi depression Excitatory phenomena Pain on injection Allergic reaction
52
Propofol/ketamine/etomidate/thiopental: | Indicated if rapid recovery of consciousness is required
Propofol
53
T or F: rapid redistribution and metab of Propofol may increase risks of awareness during tracheal intubation
True
54
Most suitable TIVA
Propofol
55
Propofol/ketamine/etomidate/thiopental: | Potent somatic analgesic
Ketamine
56
Propofol/ketamine/etomidate/thiopental: | Amnesia persists for 1hr after recovery of consciousness
Ketamine
57
Positive inotropic effect of ketamine is due to
Ca influx and cAMP
58
Propofol/ketamine/etomidate/thiopental: | Increased myocardial sensitivity to epinephrine
Ketamine
59
Sympathetic stim in ketamine is decrease/increase
Decrease sympa VasoD alpha adrenergic receptor VasoC beta adrenergic receptor
60
Propofol/ketamine/etomidate/thiopental: | Transient Increase IOP
Ketamine
61
Propofol/ketamine/etomidate/thiopental: | Hypertension and tachycardia.
Ketamine
62
Propofol/ketamine/etomidate/thiopental: | Prolonged recovery
Ketamine
63
Propofol/ketamine/etomidate/thiopental: | Increase ICP
Ketamine
64
Propofol/ketamine/etomidate/thiopental: | Decrease ICO
Propofol
65
T or F: ketamine is unsuitable for pt with preexisting hypertension, IHD and severe cardiac decompensation
True
66
Lorazepam Diazepam Midazolam
Benzodiazepine
67
Benzo which is water insoluble
Diazepam | Lorazepam
68
Benzo which is water soluble
Midazolam
69
Benzo with pain in injection
Diazepam | Lorazepam
70
Benzo with minimal pain on injection
Midazolam
71
Benzo used for continuous infusion
Midazolam
72
Propofol/ketamine/etomidate/benzo: | Potent anticonvulsant, treatment status epilepticus
Benzodiazepine
73
Carboxylated imidazole
Etomidate
74
Propofol/ketamine/etomidate/thiopental: | Myo clonic movement are common
Etomidate
75
Propylene glycol means
Pain on injection | Diazepam, lorazepam, etomidate
76
Propofol/ketamine/etomidate/thiopental: | Maintain CBF
Etomidate
77
Propofol/ketamine/etomidate/thiopental: | Minimal depression of ventilation
Etomidate
78
Propofol/ketamine/etomidate/thiopental: | No release of histamine
Etomidate
79
Propofol/ketamine/etomidate/thiopental: | Inhibit plt function and prolong bleeding time
Etomidate
80
Drug of choice for pt with reactive airwax disease
Etomidate

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