Lecture 6.5 - Anesthesia Drugs

Question 1

N2O:
\_\_\_\_ onset;
diffusion \_\_\_\_\_ on emergence
\_\_\_\_ skeletal muscle relaxation
can cause \_\_\_\_\_;
\_\_\_\_\_\_ of trapped gas in body cavity

Answer 1

rapid;
hypoxia
no;
nausea
expansion

Question 2

diethyl ether:
extremely ____;
_____ onset
respiratory ____

Answer 2

flammable;
slow;
irritant

its a complete anesthetic

Question 3

adding N2O along with another volatile gas _____ induction speed and ____ MAC

Answer 3

increases, decreases (ie increased potency)

Question 4

halothane:
important side effect to know = _____ toxicity;
cardiovascular ____, respiratory _____,
sensitizes myocardium to _____

Answer 4

liver (ie fulminant necrosis);
depression, depression;
catecholamines

Question 5

enflurane:
____ induction and recovery;
CNS ____, which can cause ____ at high doses;
___toxic

Answer 5

rapid;
excitation, seizures;
nephro

Question 6

isoflurane:

_____ blood pressure by _____ SVR

Answer 6

decreases, decreasing

Question 7

desflurane:
____ relaxant;
extremely _____ recovery and awakening;
large ____ in CO and BP

Answer 7

uterine;
rapid;
decrease

Question 8

anesthetics (Resp effects):

_____ _____ clearance –> increased risk of post-op _____

Answer 8

decreased mucociliary;

atelectasis

Question 9

anesthetics (CNS effects):

most ____ cerebral blood flow –> can cause a ____ in ICP. how to counteract this, somewhat ?

Answer 9

increase, increase;

hyperventilation

Question 10

besides enflurane, what other inhaled anesthetic is nephrotoxic

Answer 10

methoxyflurane

Question 11

malignant hyperthermia:

mutations in _______ receptor cause increased ____ release from the _____

Answer 11

voltage-sensitive ryanodine receptor (RyR);
calcium;
sarcoplasmic reticulum

Question 12

malignant hyperthermia:
besides inhaled anesthetics, what other drug can cause this?
___ bp, ____ HR, ___ temperature, muscle ____; ___ CO2

Answer 12

succinylcholine;
increased, increased, increased, rigidity;
excess

Question 13

treatment of malignant hyperthermia?

mechanism of action?

Answer 13

dantrolene;

RyR antagonist

Question 14

inheritance of malignant hyperthermia?

Answer 14

autosomal dominant with incomplete penetrance

Question 15

barbituates:
main one used for anesthesia?
____ of anesthesia;
can be used for treatment of increased _____

Answer 15

thiopental;
induction;
ICP

(decreases cerebral blood flow)

Question 16

ketamine:
mechanism of action?
act as ____ anesthetics;
cardiovascular _____

Answer 16

NMDA antagonist;
dissociative;
stimulant (sympathomimetic)

copius salivation

Question 17

ketamine:
causes ____ ____ ie auditory hallucinations, vivid dreams;
visual effects?
relieve side effects with _____

Answer 17

emergence delirium;
nystagmus
benzos

Question 18

propofol:
mechanism of action?
\_\_\_\_ onset and duration;
\_\_\_\_ blood pressure
increased or decreased nausea?
non-analgesic

Answer 18

potentiates GABA A;
rapid;
decreases;
decreased

pain on injection

Question 19

etomidate:
mech of action?
cardiac effects?
what musclar effect?
non-analgesic

Answer 19

GABA A potentiation;
very little;
myoclonus

Question 20

benzos:
which 2 ones are used most often for anesthesia?
more or less cardiac depression than barbituates?

Answer 20

diazepam, midazolam; also lorazepam;

less

Question 21

benzo’s:
mainly used for ____;
also used for ____ of anesthesia;
causes ____ amensia

Answer 21

endoscopy;
induction;
anterograde