Lecture 17 / 18: Drugs in Anesthesiology

Question 1

Name 4 Parenteral Anesthetics

Answer 1

• Propofol
• Etomidate
• Ketamine
• Methohexital

Question 2

Name 5 Inhalation Anesthetics (common ending)

Answer 2

Flurane
* Isoflurane
* Enflurane
* Sevoflurane
* Desflurane
* Nitrous Oxide

Question 3

Name 3 Anesthetic Adjuncts

Answer 3

• Benzodiazepines
• Opioids
• NSAIDs

Question 4

2 Therapeutic Gases

Answer 4

• Oxygen
• Carbon Dioxide

Question 5

Alpha-2 Adrenergic Agonist

Answer 5

Dexmedetomidine (Precedex)

Question 6

Neuromuscular Blocking Agents (common ending)

Answer 6

• Succinylcholine
• Atracurium
• Vercuronium
• Pancuronium
• Pipercuronium
• Rocuronium
• d-Tubocurarine
• Sugammadex

Question 7

Local Anesthetics (Common Ending)

Answer 7

• Lidocaine (Xylocaine)
• Prilocaine (Citanest)
• Mepivacaine (Polocaine)
• Bupivacaine (Sensorcaine)
• Ropivacaine (Naropin)
• Levobupivacaine (Chirocaine)
• Articaine (Septocaine)
• Chlorprocaine (Nesacaine)
• Procaine (Novocain)
• Tetracaine (Dermocaine

Question 8

What is conscious sedation

airway / verbal commands

Answer 8

Alleviation of anxiety and pain
Less alteration to consciousness
Patient maintains a patent airway
Responsive to verbal commands

Question 9

What is deep sedation?

Answer 9

• Light state of general anesthesia
• Characterized by decreased consciousness (not easily aroused)
• Loss of verbal responsiveness, protective airway reflexes and ability to maintain airway

Question 10

General Anesthesia

Answer 10

• Depress CNS to sufficient degree to permit performance of surgery
• Complete loss of protective reflexes
• Loss of ability to maintain airway
• No response to physical stim

Question 11

5 primary effects of general anesthesia

Answer 11

• Unconsciousness
• Amnesia
• Analgesia
• Inhibition of autonomic reflexes
• Skeletal muscle relaxation

Question 12

Do any of the available anesthetics achieve all 5 primary effects?

Answer 12

No

Question 13

Guedel’s 4 stages of Anesthesia

Answer 13

1. Analgesia
2. Excitement
3. Surgical Anesthesia
4. Medullary Depression

Question 14

Stage I: analgesia

Answer 14

The
patient initially experiences
analgesia without amnesia.

Question 15

Stage II—excitement:

Answer 15

patient appears delirious and may vocalize but is completely
amnesic. Respiration is rapid, and heart rate and blood pressure increase

Question 16

Stage III—surgical
anesthesia:

Answer 16

Slowing of respiration and HR
Complete cessation of spontaneous respiration
Four planes of stage III

Question 17

Stage IV—medullary depression:

Answer 17

• Severe depression of CNS
• Vasomotor center in medulla and respiratory center in brainstem
• Needs circulator and respiratory support

Question 18

3 general objective of general anesthesia

Answer 18

1. Minimizing the potentially deleterious direct and indirect effects of anesthetic agents and techniques.
2. Sustaining physiologic homeostasis during surgical
   procedures
3. Improving postoperative outcomes

Question 19

5 effects of general anesthesia

Answer 19

1. Hemodynamic
2. Respiratory
3. Hypothermia
4. Nausea and Vomitting
5. Other Emergent and Postoperative Phenomena