IV anesthetics Flashcards
Barbiturates:
name 3 short acting barbs
thiopental (penthothal)
Mexohexital (brevital)
Thiamylal (surital)
Barbiturates:
they have many CNS actions but, depression on the _____ undoubtablly contributes to the sedative and hypnotic actions of IV agents
Reticular Activating System (RAS)
Barbiturates:Thiopental
has what 2 actions
anticonvulsant
Amnestic
Barbiturates:Thiopental
what can occur in small doses
poor analgesic- may increase the reaction to painful stimuli, may be hyperalgesic
Barbiturates:Thiopental
does what to respiratory system
depresses it
Barbiturates:Thiopental
does what to myocardial contractility
depresses it.- decreases SV, CO, Arterial BP
Barbiturates:Thiopental
does what to HR
Increases it
Barbiturates:Thiopental
does what to cerebral vascular resistance? what does that mean?
increases CVR
hence decreases cerebral blood flow and ICP
Barbiturates:Thiopental
contraintidated in what pts?
porphoria (a neuro dz caused by inadequate porphyrin metabolism)
Barbiturates:Thiopental
what would u not use with asthmatics
histamine release
Barbiturates: methohexital has excitatory effects. what are they
hiccups
myoclonus
Propofol:
what is the 1/2 time to elimination
0.5-1.5 hrs
Propofol:
which causes a bigger drop in BP prop or thiopental
prop
Propofol:
which has bigger respiratory depression prop or thiopental
prop
Propofol:
has antiemetic effects b/c it works where
Chemorecptor trigger zone (CRTZ)
Propofol:
does it have antipruritic effects?
yes
Propofol:
does it produce analgesia
no
Propofol:
does it have anticonvulsant effects
yes
Propofol:
does what to CBF and CMRo2
decreases it
benzodiazepines:
enhance the action of what receptors
GABA
benzodiazepines:
GABA are what?
the brains major inhibitory transmitter
benzodiazepines:
name 3 short acting benzos
Diazepam (valium)
Lorazepam (ativan)
Midazolam (versed)
benzodiazepines:
do they produce analgesia?
no
benzodiazepines:
name 5 CNS effects
Antianxiety Amnestic Sedative Hypnotic anticonvulsant
benzodiazepines:
what CV effects
none unless pt is volume depleted then maybe hypotension
benzodiazepines:
does what to brain
cerebral vasoconstriction- lowers CBF and ICP
Ketamine:
produces anmesia and profound analgesia by interacting with what receptor
NMDA
Ketamine:
Does what to cerebral vasculature
Dilates it
so CBF increases and ICP increases
Ketamine:
does what to cerebral metabolism
increases it
Ketamine:
does what to eyes and tone
hypertonus and nystagmus
Ketamine:
what does it do to CV
Stimulates the SNS which promotes CV enhancement- increased HR, CO, and BP
Ketamine:
what pts are good canidates
trauma
elderly
Ketamine:
avoid in what pts
CAD
Glaucoma
Increased ICP
Ketamine:
emergence can be horrible explain to bad side effects
bad dreams
Hallucinations
n/v
Opioids:
why is morphine rarely used for anesthesia
histamine release
Opioids:
do what to respiratory system
depress it
Opioids:
are they cardiac stable
yep
Opioids:
can they produce treacle rigidity
yep
Opioids:
what do they do to cerebral blood flow
cerebral vasoconstricor
decreased CBF and ICP
Opioids:
why do they cause nausea
stimulate CRTZ
Opioids:
how do synthetic opioids cause bradycardia
stimulate the vagal nerve
Opioids:
if it caused sphincter of do spasm what can be given to relax it
glucagon 1-2mg
Etomidate:
cv effects
minimal
Etomidate:
how our it’s analgesic and amnestic properties
poor
Etomidate:
does what to CBF and ICP
decreases it
Etomidate:
what should you look for on injection
pain
Etomidate:
what can it cause and how in pts with catecholamine depletion
adrenal cortical suppression
directly depresses cortisol output from the adrenal cortex
Etomidate:
does what to the immune system
depresses it
the CNS effects after bolus of an IV anesthestic are terminated primarily how
redistribution
