Brainscape's Knowledge GenomeTM

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


See full index

Y2 - CPT > Lecture 25 - Anaesthetics > Flashcards

Lecture 25 - Anaesthetics Flashcards

You may prefer our related Brainscape-certified flashcards:
NASM ® CPT flashcards
1
Q

What are the 2 main methods that anaesthetics act?

A

General
Local

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

What are the 2 ways by which general anaesthesia can be administered?

A

Inhaled or volatile

Intravenous

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

What are the ways by which local anaesthesia is given?

A

Regionally so injection

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

What is conscious sedation?

A

When a small amount of anaesthetic or benzodiazepines to produce a sleepy-like state

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

What type of drug is give as a premedication (to help calm a patient down before surgery) for anaesthesia?

A

Hypnotic-benzodiazepine

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

How can you induce anaesthesia?

A

IV
Inhalational

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

What type of drug is often given as an Intra operative analgesic?

A

Opioid like fentanyl

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

What type of drug needs to be given to allow for intubation?

A

Muscle relaxant

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

What drugs need to be given to a patient after surgery?

A

Reverse muscle relaxants so can breathe again
Post op analgesia
Anti-emetic

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

How does inhaational volatile general anaesthesia work?

A

Liquid containing anaesthetic gets vaporised into a gas and so gets delivered to lungs via an agent specific vaporiser

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

What is the most common anaesthetic delivered intravenously to induce anaesthesia?

A

Propofol
Barbiturates
Etomidate
Ketamine

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

What are some gases/volatiles that can be delivered to induce anaesthetics?

A

Xenon
Fluorxene
Halothane
Nitrous oxide (N2O)
Chloroform
Desflurane

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

What are the 3 main features that are observed as a patient goes under anaesthesia?

A

Muscle tone
Breathing
Eye movement

Guedels signs

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

What are the 4 stages of anaesthesia? (Guedels signs)

A

1 = analgesia and consciousness (muscle normal and slight eye movement)
2 = uncosncosius, erratic breathing, delirium (moderate eye movment and increased muscle tone)
3 = surgical anaesthesia muscles become increasingly relaxed and eye movment. Becomes zero
4 = flaccid muscles, respiratory paralysis

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

What is achieved in anaesthesia?

A

Analgesia
Hypnosis (loss of consciousness)
Depression of spinal reflexes
Muscle relaxes

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

As anaesthetic concentration increases, what repsonse are lost first to last?

A

First:
Memory
Consciousness
Movement
Cardiovascualr response
Last

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

How do you measure potentcy of a volatile aneasthetic?

A

MAC
Minimum Alveolar Concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is Minimum Alveolar Concentration (MAC)?

A

The alveolar concentration of a volatile anaesthetic at which 50% of patients fail to move to a surgical stimulus

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

How is the concentration of volatile anaesthetic in the alveoli at equilibrium related to the conc at the spinal cord?

A

They are equal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the anatomical site/substrate for MAC (Minimum ALveolar Concentrtation)?

A

Spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What values determine how fast induction and recovery will be?

A

BLood:Gas partition coefficient (measure of solubility/how it partitions into the blood)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What partition coefficient determines the potentcy of an anaesthetic?

A

Oil:Gas partition
(How it partitions into fat)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are some factors affecting Minimum Alveolar Concentration of a volatile anaesthetic?

A

Age (high in infants, low in elderly)
Hyperthermia (inc)
Hypothermia (dec)
Pregancy (inc)
Alcoholism (inc)
Central stimulants (inc)
Other anaesthetics and sedatives (dec)
Opioids (dec)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Why is Nitrous Oxide often added to other volatile anaesthetics?

A

To reduce the required dosing/ MAC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What determines the potency of an anaesthetic?

A

Lipid solubility

26
Q

How are potency and lipid solubility related?

A

Higher lipid solubility = higher potency

27
Q

What receptor do most anaesthetics interact with to provide effects?

A

GABA(a)

28
Q

What is the major method of action of most anaesthetics causing anaesthesia?

A

Anaesthetics bind to and potentiate GABA(a) receptors leading to enhanced Cl- influx leading to hyperpolarisation. Of neurones

29
Q

What is the effect of most anaesthetics potentiating GABA activity?

A

Anxiolytics
Sedation
Anaesthesia

30
Q

Which anaesthetics dont potentiate GABA activity?

A

Xenon
Argon
N2O
Ketamine

31
Q

What receptor do Xe, Argon, N2O and ketamine act on?

What neurotransmitter is involved?

A

NMDA receptors
Glutamate

32
Q

The balance of activity of what 2 receptors determines the aneasthetic status?

A

NMDA glutamate receptor excitation
GABA(a) receptor inhibition

33
Q

What is the function of the reticular system?

What is the affect of depressing its connectivity to the cortex in anaesthesia?

A

The activating system which increases arousal keeping a person awake

Person loses consciousness

34
Q

What is the purpose of suppressing the connections from the thalamus to the cortex in anaesthesia?

A

Thalamus transmits and modifies sensory information so if depressed loss of sensation

35
Q

What is the purpose of suppressing the connections from the hippocampus to the cortex in anaesthesia?

A

Loss of memory

36
Q

What part of the body is depressed leading to analgesia?

A

Spinal cord-depression in dorsal horn

(Maybe periaqueductal grey too)

37
Q

What are the main IV anaesthetics?

A

Propofol (rapid)
Barbiturates (rapid)
Ketamine (slower)

38
Q

What is it called when IV anaesthetic is the sole method of anaesthesias?

A

TIVA
Total IntraVenous Anaesthesia

39
Q

How do we describe IV anaesthesia potency?

A

Plasma conc to a acheive a specific end point like loss of eyelash reflex or a certain BIS value (Bispectral index) 0= brain inactivity 100 = full brain function

40
Q

What is the process of induction in mixed anaesthesia?

A

IV bolus to end point then switch to the volatile

41
Q

What are some scenarios where local and regional aneasthetic issued?

A

Dentistry
Obstetrics
Regional surgery (patient awake)
Post-op (wound pain)
Chronic pain management

42
Q

What are some local anaesthetics?

A

Lidocaine
Bupivacaine
Ropivacaine
Procaine

43
Q

How is pKa (dissociation constant) related to the time of onset of local anaesthetic?

A

Lower pKa the faster the onset since theres more unionised drug which is present to access the site

44
Q

What leads to a local anaesthetic having a longer duration?

A

Higher protein binding

45
Q

What are the 2 types of chemical link which change how long anaesthetics last?

A

Ester link

Amide link

46
Q

Which chemical link takes longer to break down leading to the aneasthetic lasting longer, ester link or amide link?

A

Amide link

Most cells have esterases so ester links are gonna get broken down so dont last as long

47
Q

Are anaesthetics going to prefer blocking highly active neurones or inactive neurones?

A

Highly active

48
Q

What do local anaesthetics block to causes anaesthetic affect?

A

Voltage gated sodium channels

49
Q

What are the 2 pathways by which voltage gated sodium channels become blocked by local anaesthetics?

A

Hydrophobic pathway
Hydrophilic pathway

50
Q

What is the hydrophilic pathway of local anaesthesia?

A

Charged local aneasthetic directly goes in and blocks the channel of a open sodium voltage gated ion channel

51
Q

What is the hydrophobic pathway of local anaesthesia?

A

Uncharged local anaesthetic passes through plasma membrane into the cell
Becomes charged within the cell
Then goes into and blocks the open voltage gated Na+ channel

52
Q

What is the benefit of administering both local anaesthetic like lidocaine with adrenaline?

A

The adrenaline helps prolong the duration which the local anaesthetic is able to act at its intended site
Since adrenaline causes vasoconstriction

53
Q

What does a high value of pKa indicate?

A

Slow speed of onset of action

54
Q

How does bupivacaine differ in terms of potency and duration of action compared to procaine?

A

Bupivacaine is more potent and longer duration of action

55
Q

What is regional aneasthesia?

A

Selectively anaesthetising a part of the body causing a block of a nerve

56
Q

What types of drugs are used for regional anaesthesia?

A

Local anaesthetic
Opioid

57
Q

What is the point in the neck you can inject local anaesthetic to cause nerve block in. The upper limb?

A

Interscalene triangle (Erbs point)

58
Q

Where can local anaesthetic be injected to cause nerve block in the lower limb?

A

Femoral nerve
Sciatic nerve
Popliteal nerve
Spahenous nerve

59
Q

What side effects do opioids typically cause in anaesthesia?

A

Nausea and vomiting

60
Q

What are some side effects of general anaesthesia?

A

Post op nausea and vomiting (opioids)
CVS (HYPOTENSION)
Post op Congnitive dysfunction
Chest infection

61
Q

What are some side effects of local and regional anaesthetic?

A

Depends on agent use and usually occurs due to systemic spread

Locals that block Na+ VGC are cardiovascular toxic

62
Q

What type of hyeprsensitivty can occur due to anaesthesia?

A

Type I allergic reactions (Anaphylaxis)

Y2 - CPT (30 decks)

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