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Pharmacology > Neuro: Inhalation Anesthetics > Flashcards

Neuro: Inhalation Anesthetics Flashcards

1
Q

Define MAC

A

MEDIAN ALVEOLAR CONCENTRATION:

  • standard reference for inhaled anesthetics
  • end-tidal concentration of inhaled anesthetics to eliminate movement in 50% of PTs
  • ***median effective dose (ED50) of the anesthetic drug
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2
Q

Nitrous Oxide

A

“laughing gas”

  • used in combo with oxygen
  • does not depress respiration
  • maintains CV hemodynamics and muscular strength
  • Can be used with inhalation agentf fg
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3
Q

Malignant Hyperthermia

  • exposure to waht causes this
  • comon/uncommon?
A

uncommon–in small percent of PTs

  • hapens when PT exposed to halogenated hydrocarbon anesthetics
  • rare life threatening condition
  • rxn only to the inhaled
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4
Q

TX for malignant Hyperthermia?

A

Dantrolene–muscle relaxant

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5
Q

IV anesthetics

-when to use

A
  • when CO is reduced, body compensaties by diverting more cardiac output
  • basically give a decreased dose of anesthetic when CO reduced
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6
Q

What is the first choice for induction of general anesthesia and sedation

A

Propofol

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7
Q

Propofol

  • what is it
  • onset of action
  • half life
  • what does it provide and not provide
  • what can sometimes occur with it
  • post-op complications?
  • cleared?
  • rely on tissue detistribution?
  • excreted?
A
  • IV sedative/hypnotic
  • smooth induction–30-40 seconds
  • T1/2: 2-4 minutes
  • does NOT provide analgesia ** supplement this with some narcotics
  • occasionally contributes to EXCITATORY PHENOM–muscle twitching, yawning, hiccups
  • post-op complications of N/V is low
  • not rely on tissue redistribution for recovery
  • cleared: LIVER —not rely on tissue redistribution
  • excreted KIDNEYS
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8
Q

Benzodiazepines

  • long medium or short acting?
  • routes of admin
  • induces what properties?
  • what does it not produce
  • what is it given with?
  • anatgonist??
A 
MIDAZOLAM: MC used 
-short acting CNS depressant 
-IV or rectal routes 
-Does not produce analgeisa 
-induces ***AMENSIA**** and sedation 
-given with neurmuscular blocking agents 
FLUMAZENIL---recepetor antagonist
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9
Q

Which benzo is the MC used for induction of anesthesia

A

Midazolam—-Versed

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10
Q

Opioids

A

-IND: analgeisa

MC one is fentanyl—if an analgesic is needed for GA

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11
Q

what is standard reference for inhaled anesthetics

A

MAC

Medium Minimal Alveolar Concentration

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12
Q

When is MAC less?

A

when intravenous anesthetics enhance inhibitory receptors and antagonize excitatory receptors

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13
Q

POTENCY of the drug=

A

smallest alveolar concentration of drug that keeps the PT immobile

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14
Q

MAC=

A

ED50

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15
Q

MAC wil be small for what kind of anesthetics

A

potent ones

*and MAC»»for less potent

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16
Q

The more lipid soluble an anesthetic….?

A

the lower the concentration needed to produce anesthesia

HIGHER THE POTENCY

17
Q

the higher the MAC means?

A

the PT is more resistant to the effects of the durg

18
Q

factors that raise MAC

A

hyperthermia
drugs that increase CNS catecholamines
chronic ETOH

19
Q

the lower the MAC means?

A

the PT is more sensitive to drug

20
Q

factors that lower MAC?

A 
hypothermia 
age 
pregnancy 
sepsis 
acute intoxication 
concurrent IV anesthetics 
alpha 2 recp agonists
21
Q

what hapens to body during MH?

A

uncontrolled increase in skel muscle oxidative metabolism–>overhwlems body;s oxygen supply/removal of co2–>cannot regulate temp—–leads to circulatory collapse and death it not tx

22
Q

Dantrolene

A

muscle relaxant to tx MH

**blocks CA

23
Q

Susceptible PTs to developing MH

A 
burn victs 
muscular dystrophy 
myopathy 
myotonia 
osteogenesis 
can be inherited as autosomal dominant disordr
24
Q

SE of opioids

A 
Sedation 
Euphoria 
Dysphoria----depression anxiety unease 
Miosis 
constipation
urinary retention 
N/V
Mood changes 
incease pressure on gall bladder
RESP DEPRESSION*
*do not depress cardiovascular system 
but can cause: 
BRADY AND HYPOT
25
Q 
Ketamine
-\_\_\_acting 
MOA
drug class 
produces?? does not produce? 
recovery pd s/s?

Good for wht PTs?

A

short acting DISSOCIATE anesthetic
produces good analgesia**
does not produce skel muscle relaxation

MOA:
-inhibits excitatory pathway via NMDA receptor, stimulates SNS (w/ incr BP and CO), BRONCHODILATOR (good for asthmatics)

recovery PD can have vivid dreams and hallucinations

26
Q

MOA for local anesthetics

low vs high doses

A

LOW DOSES:
-blocks nerve conduction of sensory impulses—reduces response to pain

HIGHER DOSES:
-blocks motor impulses from periphery to CNS—impairs motor nerve function

VASODILATOR **

27
Q

what happens when you add Epinephrine to local anesthetic?

A

reduces the rate of the local anesthetic absorption and diffusion

  • -minimizes toxicity and increase DOA of anesthetic***
  • –EPI IS A VASOCONTRICTOR!!
28
Q

List the ESTER local anesthetics

A 
Benzocarine
Procraine
Chloroprocaine 
Tetracaine
Cocaine
29
Q

AMIDE local anesthetics

A 
Lidocaine 
Bupivacaine
Prilocaine
Ropivacaine 
Mepivacaine
30
Q

How to remeber estehr vs amide local anesthetics

A

ESTER—-one “i” in each

AMIDE—two “i” in each

31
Q

Amide or Ester has longer DOA

A

Amide

32
Q

Amide or Ester metabolized by LIver? Enzymes in skin/blood?

A

met by liver=amides

enzymes in skin/blood=esters

33
Q

Onst of action is fast for ____anestetics and ____ for the other

A

FAST onset for AMIDES

SLOW onset for ESTER

Pharmacology (28 decks)

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