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Nuero > Komiskey General Anesthesia > Flashcards

Komiskey General Anesthesia Flashcards

1
Q

Preanesthetic for sedation

A

Pentobarbital

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2
Q

Preanesthetic to prevent allergic rxns

A

Diphenhydramine

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3
Q

Preanesthetic for nausea

A

Ondanestron

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4
Q

Preanesthetic to provide analgesia

A

Fentanyl

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5
Q

Preanesthetic to knock out memory, prevent bradycardia, and fluid secretion

A

Scopolamine

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6
Q

Preanesthetic muscle relaxant reason

A

Facilitation of intubation

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7
Q

Speed of induction of anesthesia is dependent on

A

Inspired gas partial pressure
Ventilation rate
GA solubility- less soluble GAs equilibrate more quickly

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8
Q

What’s MAC

A 
Minimum Alveolar concentration 
Equilibrium concentration required to prevent response to pain in 50% of pts 
Easy comparison of anesthetics 
Easily measured
Important critical endpoints
Consistent and reproducible
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9
Q

MAC is increased by

A 
Hyperthermia
Elevated CNS catecholamine NT release
Chronic alcohol use 
Acute cocaine use
Hypernatremia
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10
Q

MAC is decreased by

A 
Hypothermia
Pregnancy
Shock
Increasing age
Acute alcohol ingestion 
CNS depressant drugs
Decreased CNS neurotransmitter release
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11
Q

Nitrous oxide

A 
MAC>100 incomplete anesthetic 
Good analgesia 
Rapid onset and recovery 
No metabolism 
Megaloblastic anemia may occur
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12
Q

Halothane

A

Not pungent -used in children
Medium rate onset and recovery
Sensitizes the heart to epi induced arrhythmias
Rare halothane induced hepatitis

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13
Q

Desflurane

A

Most rapid onset of action and recovery
Widely used for outpatient surgery
Irritating to the airway in awake patients and causes coughing, salivation, and bronchospasm
Used for maintenance of anesthesia

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14
Q

Sevoflurane

A

Very low blood gas partition coefficient w relatively rapid onset of action and recovery
Widely used for outpatient surgery
Not irritating to airway
Useful induction agent

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15
Q

Isoflurane

A

Medium rate of onset and recovery
Used for induction and maintenance of anesthesia
Damage to mitochondria

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16
Q

Methoxyflurane

A

Obsolete
Slow onset and recovery
Extensive hepatic and renal metabolism -renal dysfunction

17
Q

Halogenated GA toxicity used with succinylcholine

A

Malignant hyperthermia

Give Dantrolene

18
Q

Anesthetic associated with nausea and vomiting

A

Most likely associated with intravenous anesthetics
N20 is greatest culprit and isoflurane is least likely to cause nausea
Ondanestron -5ht3 antagonist
Avoidance of n20
Ketorolac vs opioid for analgesia
Droperidol, metaclopromide, dexmethasone -dopamine agonsit

19
Q

Thiopental

A 
Most freq used barbiturate 
Ultra short acting drug- long elimination half life 
Anesthetic lasts 5 minutes
- most commonly used induction agent 
Rapid unconsciousness, good amnesia, bad analgesia 
Poor muscle relaxation 
Pleasant induction for the patient 
MOA: GABA A agonist
20
Q

Thiopental organ system effects

A

CNS: reduces cerebral blood flow, intracranial pressure- protects brain against hypoxic/ischemic injury
Cardiovascular: bp, output decrease, hypotension
Heart rate increased
Depress respiration

21
Q

Benzodiazepines

A

Excellent anxiolytics, anticonvulsants, muscle relaxants
Binds to distinct spot on GABA a receptor
Water soluble in vial, then in plasma becomes unionized, increased lipid solubility
CNS: raises seriousness threshold, anterograde amnesia
Cv: hypotensive and minimal depression

22
Q

Opioids

A

Analgesic with hypnotic action, no amnesia
Used for premedication, induction, and maintenance of anesthesia and postoperative pain control
Pruritis
Chest wall rigidity
Patients forget to breathe

23
Q

Ketamine

A

MOA: non competitive NMDA antagonists- inhibits of stimulatory neuronal system
Dissociative anesthetic
CNS: fast acting antidepressants, increases intracranial disease
Nystagmus, increased tracheobronchial and salivary excretions
Not too bad in heart and lungs

24
Q

Etomidate

A 
Imidazole derivative 
CNS: lowers cerebral blood flow and metabolic rate 
Minimal lung depression 
Minimal cardiovascular 
Myoclonus
25
Q

Propofol

A 
Very potent, action at GABA a complex, may enhance Cl- conductance at glycine 
-reduces cerebral blood flow+metabolism
Decreased CV effects 
Fast acting 
Euphoric
26
Q

Dexmedetomidine

A

Brain (locus ceruleus) spinal cord, and autonomic nerves
Sedation, anxiolysis, analgesia
Decreased bp and hr , decreased release of NE
Alpha 2 agonist

27
Q

Preanesthetic to reduce anxiety

A

Midazolam and diazepam

Nuero (8 decks)

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