Lilley Ch 11 (general and local anesthetics) Flashcards
Drugs that reduce or eliminate pain by depressing nerve function in the central nervous system (CNS) and peripheral nervous system
anesthetics
three types of anesthetics
- general
- local
- monitored anesthesia care
type of anesthesia: complete loss of consciousness and loss of body reflexes, including paralysis of respiratory muscles
general anesthesia
type of anesthesia: no paralysis of respiratory function; elimination of pain sensation in the tissues innervated by anesthetized nerves
local anesthesi
type of anesthesia: local anesthesia along with sedation and analgesia. Patients can answer questions and protect their airway.
monitored anesthesia care (MAC)
who can administer anesthesia
anesthesiologist
CRNA
anesthesia assistant
3 types of general anesthetics
- inhalational
- parenteral
- adjunct
which is true:
- fat-soluble drugs are stronger anesthetics than water-soluble drugs
- water-soluble drugs are stronger anesthetics than fat-soluble drugs
fat-soluble drugs are stronger than water-soluble
3 functions of general anesthetics during surgical procedure
- unconsciousness
- skeletal muscle relaxation
- visceral smooth muscle relaxation
important contraindication of general anesthesia
malignant hyperthermia (full body fever: greater than 104 F, tachycardia, muscle rigidity)
reversal agent to treat malignant hyperthermia
dantrolene (skeletal muscle relaxant)
med: Dose-dependent sedation, decreased anxiety, and analgesia without respiratory depression, short half life
precedex
med: rapid onset of action, used for anesthesia and moderate sedation, can cause hallucinations
ketamine
med: “laughing gas”, inhaled as general anesthetic, weak
nitrous oxide
med: general anesthestic, very short half-life, monitor tryglycerides because med is in lipid emulsion
propofol
med: rapid onset and elimination, commonly used in outpatient surgeries, nonirritating to airways
ultane
type of sedation: Does not cause complete loss of consciousness and does not normally cause respiratory arrest; combo of IV bendodiazepine or propofol and opioid analgesic; maintains airway
moderate sedation (conscious/procedural sedation)
med: topical analgesic, numbs skin
emla cream
types of local/regional anesthetics (5)
- spinal
- nerve block
- infiltration
- topical
- peripheral nerve catheter with pump
anesthetics ending in ‘aine’ are what type
local anesthetic
order that anesthetic affects body systems
- autonomic activity lost
- pain and sensory functions lost
- motor activity lost
adverse effect of local anesthetic and how to treat (deals with spinal injection)
spinal headache due to dural puncture
lay flat 6-12 hours
most common type of local anesthetic: can be combined with epinephrine, used for infiltration and nerve block
lidocaine
drug used with anesthetics during surgery: Prevent nerve transmission in skeletal and smooth muscle, resulting in muscle paralysis, and paralyze the skeletal muscles required for breathing (intercostal muscles and diaphragm). *don’t cause sedation or pain relief
neuromuscular blocking drugs (NMBDs)
antidotes for neuromuscular blocking drugs
anticholinisterase drugs (neostigmine, pyridostigmine, edrophonium)
depolarizing neuromuscular blocking drug: causes flaccid muscle paralysis, highly associated with malignant hyperthermia
syccinylcholine
nondepolarizing neuromuscular blocking drug: adjunct to general anesthesia, facilitates tracheal intubation, provides skeletal muscle relaxation
zemuron