Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm II Exam 1 > Lecture 2: General Anesthetics (MOST QUESTIONS) > Flashcards

Lecture 2: General Anesthetics (MOST QUESTIONS) Flashcards

1
Q

What is the term used to describe relative potencies of anesthetic agents?

A

MAC (Minimum Alveolar Concentration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the definition of MAC?

A

MAC = alveolar concentration that renders 50% of subjects immobile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

At what MAC concentration does mild anesthesia begin?
When is amnesia present?
Goal for surgery?
Level MAC used for induction (not continued during procedure)?
At what level MAC do you worry about it becoming lethal?

A 
Mild anesthesia = 0.3 MAC 
Amnesia = 0.5 MAC 
Surgery = ~ 1.3 MAC 
Induction dose = 2 MAC 
Potentially lethal doses = above 2 MAC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is one major problem w/inhalation anesthetics?

A

Low safety margin/therapeutic index

LD 50/ED 50 = 2-4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Since the Unitary Theory is now generally disputed, what is now considered the target of anesthetics?

A

cellular membrane proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do Barbiturates and BZs differ in regards to enhancing GABA function?

A

Barbs - incr length of time Cl channels stay open

BZs - incr affinity of GABA for its binding site (GABA-A rec)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which two general anesthetics differ in that they inhibit glutamatergic channels rather than facilitating inhibitory GABAergic transmission?

A

NO and Ketamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What determines the index of solubility?

A

Blood: gas partition coefficient determines the index of solubility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If an anesthetic has low solubility what is the value of the partition coefficient and rate of induction/elimination?

Example?

A

Low solubility agents

  • low partition coefficient
  • fast induction/rate of elimination

Ex: NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is an example of an anesthetic with a high solubility?

A

Halothane - slow elimination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which anesthetic has the least difference b/t thin and obese people and has least potent MAC? What does the MAC value for it indicate?

A

Nitrous Oxide

MAC > 100 –> need more than 100% of it to reach anesthesia (1.3 MaC) –> it can never be used alone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If an anesthetic has a higher Fat: blood partition coefficient what does that mean and how does it affect the anesthetics onset/elimination?

A

higher Fat: blood partition coefficient –> more soluble in fat

Fat = low blood flow –> anesthetics more soluble in fat have slower onset and elimination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What type of drugs is malignant hyperthermia caused by?
Tx?

Note: MH = heritable disorder

A

Malignant hyperthermia caused by volatile anesthetics and some NM blockers (succinylcholine)

Tx = Dantrolene –> decr Ca release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is the SR affected in malignant hyperthermia and what it the result on the body?

A

Malignant hyperthermia caused by an inability of SR to sequester Ca –> sustained & prolonged rel of Ca and progressive muscle contraction, lactate production, and incr body temp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the blood: gas and Fat: blood partition coefficient for the ideal anesthetic?

A

LOW Blood: gas and Fat: blood partition coefficient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Major disadvantage for Haltothane? Result?

A

Halothane Hepatitis

- immune response –> hepatic necrosis, fever, N/V, rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

3 Major disadvantages for Enflurane?

A

“Enflurane SUCks”

  1. Seizures** (no perm damage)
  2. Uterine muscle relaxant
  3. CV depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which type of inhalation is MC used?

A

Isoflurane (low blood: gas coeff –> fast induction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which Inhalation anesthetic maintains CO, has small decr in BP, uncommonly provokes arrhythmias, and is a potent coronary vasodilator?

A

Isoflurane

advantages

20
Q

2 Major disadvantages for Isoflurane?

A
  1. pungent

2. progressive respiratory depression

21
Q

Which two inhalation anesthetics can be used for outpatient amnesia d/t rapid recovery profiles?

A
  1. Sevoflurane

2. Desflurane

22
Q

Desflurane has a low blood:gas partition coefficient, therefore what is a major advantage of it?

A

Not very soluble in fat –> no big differences b/t lean and obese people

23
Q

Which inhalation anesthetic irritates the airway, has low volatility (need heated vaporizer) and can evoke tachycardia?

A

Desflurane

24
Q

Which inhalation anesthetic is very potent but has extensive metabolism, and can produce renal failure/nephrotoxicity?

A

Methoxyflurane

NOT USED ANYMORE

25
Q

What are the 3 major advantages of NO?

A
  1. rapid induction/recovery
  2. Little toxicity
  3. Analgesia before amnesia**
26
Q

When administering NO what can occur upon discontinuation of the agent? How to Tx?

A

Hypoxia can occur after D/C nitrous oxide

- Tx = give 100% O2 instead of air

27
Q

Why must NO be avoided in pneumothorax, obstructed middle ear, air embolus, obstructed bowel loop, intraocular air bubble and intracranial air?

A

closed air spaces may expand (NO exchanges w/N2)

28
Q

What are intravenous anesthetics primarily used for?

4 main IV anesthetics?

A

IV anesthetics = for induction

  1. Barbiturates (sodium thiopental)
  2. Propofol
  3. Etomidate
  4. Ketamine
29
Q

What are intravenous anesthetics primarily used for?

4 main IV anesthetics?

A
  1. Barbiturates (sodium thiopental)
  2. Propofol
  3. Etomidate
  4. Ketamine
30
Q

Two advantages of IV anesthetics & one disadvantage?

A

Adv
- rapid onset & awakening

Disadv
- danger of OD (cant undue IV once given)

31
Q

What determines the duration of action of IV anesthetics?

What are the 4 categories in order of fastest to slowest equilibration?

A

Redistribution

  1. Vessel rich group (CNS, visceral organs)
  2. Muscle group (also skin)
  3. Fat group
  4. Vessel poor group (bone cartilage, ligaments)
32
Q

Which IV anesthetic has: little post-anesthetic excitement or vomiting, is water soluble but has slow recovery?

A

Sodium Thiopental

33
Q

How are sodium thiopental and Propofol similar?

A

Both have: no antagonist, cardiorespiratory depression and no analgesia

34
Q

Which IV anesthetic: produces a hypnotic/forgetful rest, but is not water soluble and is a/w pain on injection?

A

Propofol

35
Q

Which IV anesthetic: causes analgesia, no respiratory depression and produces dissociative anesthesia as advantages?

A

Ketamine

36
Q

Which IV anesthetic is a/w: w/decreased muscle tone, invol movements, hallucinations as disadv?

A

Ketamine

Note: AEs less common in kids

37
Q

What is only IV anesthetic w/ an antagonist available?

A

Etomidate

38
Q

Which IV anesthetic has: anterograde amnesia and CV stability as adv?

A

Etomidate

39
Q

Which IV anesthetic has: slow recovery, pain on injection and no analgesia as disadv?

A

Etomidate

40
Q

Prototypes for BZs? Advs?

A

Midazolam, diazepam

- reduce anxiety, induce amnesia

41
Q

Prototype for Antihistamine? Advs?

A

Diphenhydramine

- prevents allergic rxns, some sedation

42
Q

Prototypes for Anti-emetics? Advs?

A

Ondansetrone (5-HT3 antagonist)

- prevents aspiration, reduce postop N/V

43
Q

Prototypes for opioids? Advs?

A

Fentanyl, morphine

- provide analgesia

44
Q

Prototypes for Anti-muscarinics? Advs?

A

scopalamine, atropine

- amnesia, prev bradycardia/fluid secretion

45
Q

Prototypes for Muscle relaxants? Advs?

A

Pancuronium

- facilitates intubation

46
Q

If a patient is hypotensive what is the best IV anesthetic to use? Worst?

A

Best for HoTN = etomidate

Worst for HoTN = Propofol

47
Q

What are inhalation anesthetics primarily used for?

A

maintenance phase of anesthesia

Pharm II Exam 1 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions