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GNURS625 Pharmacology for Anesthesia 1 > IV Induction Agents > Flashcards

IV Induction Agents Flashcards

1
Q

Sympathetic Nervous System evokes the

A 
fight or flight response
SEAN:
Sympathetic
Epi/Norepi
Adrenergic
Nicotinic
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2
Q

Parasympathetic Nervous System evokes the

A 
Rest and DIgest
Parasympathetic
Acetycholine
Cholinergic
Muscarinic
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3
Q

Most induction agents work at

A

the GABA receptor

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4
Q

Advantages of IV anesthesia/induction agents:

A

-Provide rapid onset of general anesthesia.

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5
Q

Disadvantages of IV induction/anesthesia agents

A

Lack of true “Ideal” IV anesthetic.

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6
Q

Balanced Anesthesia is the

A 
Use multiple drugs to achieve goal:   Inhalation agents
  IV induction agents
  Sedative/hypnotic agents
  Opioids
  Neuromuscular blocking drugs
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7
Q

All IV induction agents are

A

lipophilic, cross BBB

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8
Q

Recovery from a single dose of drug is caused by

A

redistribution of the drug to less perfused tissues.

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9
Q

T/F Single dose termination is determined by extent or speed of metabolism.

A

FALSE

Single dose termination IS NOT determined by extent or speed of metabolism.

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10
Q

Two of the most common barbiturates in Anesthesia:

A

Thiopental (no longer used, death penalty)

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11
Q

In Alpha 2 receptors, the medication binds to _______ and slows the release of _______, which slows fight or flight (sympathetic)
An agonist that slows down the body

A

norepinephrine, norepinephrine

Precedex

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12
Q

Mechanism of action for Barbiturates:

A

Post synaptic enhancement of GABA mediated neurotransmitters

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13
Q

Barbiturates are reversibly bound to

A

protein (plasma albumin)

an increased free level if albumin levels are low

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14
Q

Barbiturates have a prompt and predictable __________, but does not have any _________

A

loss of consciousness

NO analgesic properties

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15
Q

Barbiturates can abruptly stop

A

seizures

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16
Q

Barbiturates blunt the baroceptor relfex, which may cause a compensatory

A

increase in HR

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17
Q

Barbiturates cause a

A

histamine release

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18
Q

Barbiturate contraindications:

A

Porphyria

Allergy

19
Q

Benzodiazepines scope of properties include

A 
Anxiolytic
Sedation
Anticonvulsant
Muscle Relaxation
Amnesia
20
Q

Midazolam has a _______ and work on _______

A

imidazole ring, GABA

21
Q

Midazolam is highly

A

lipid soluble and protein bound

22
Q

Midazolam (is/ is not) neuroprotective

A

IS NOT

23
Q

Withdrawal of barbs/ benzos may last

A

weeks to months
must be tapered off
cause opposite symptoms, HTN, tachy

24
Q

Flumazenil reverses

A

benzos (benzo agonist) competitive

may precipitate withdrawal

25
Q

Propofol requires a

A

lipid vehicle, which makes it prone to bacterial growth

26
Q

some formulations of propofol have a

A

sulfite, which may cause allergic reactions

27
Q

Mechanism of action for propofol

A

GABA

28
Q

Propofol has/ does not have neuroprotective effects

A

HAS

29
Q

Side effects of propofol include

A

rare but potential for PE

30
Q

Propofol Infusion Syndrome is a

A

lactic acidosis seen generally at higher doses for >24 hours, causes Kidney Fx, Rhabdo, Cardiac Arrest
tx: stop propofol, tx acidosis, support organ fx

31
Q

Ketamine works on

A

NMDA receptors

32
Q

Ketamine requires a ______ with administration for amnesia

A

benzo

33
Q

Use of ketamine may cause _______ if not additionally given a benzo

A

emergence delirium

34
Q

The active metabolite of Ketamine is

A

norketamine

35
Q

Do not use ketamine in patients with

A

intracranial pathology

36
Q

Ketamine may be used for ______, when other drugs fail

A

status epilepticus

37
Q

Etomidate causes a depression of

A

adrenocortical function for 4-8 hours after a dose. Patients with sepsis/hemorrhage may be at a disadvantage receiving Etomidate if the cortisol response is compromised.

38
Q

Etomidate works on

A

the GABA receptor

39
Q

Etomidate is the drug of choice for

A

unstable cardiac patients. (provides cardiovascular stability)

40
Q

The use of etomidate increases incidence of _______ and dose not effect duration of induced seizure activity, good for _______, low incidence of ________

A

PONV
ECT
allergic reaction

41
Q

Dexmedetomidate is a

A

highly selective alpha-2 adrenergic agnonist

42
Q

With dexmedetomidate use, all other concentrations of anesthetic agents must be __________

A

decreased (synergistic effects with other anesthetics)

43
Q

With use of dexmedetomidate, there is a risk of ___________.

A

Tolerance

GNURS625 Pharmacology for Anesthesia 1 (5 decks)

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