Opiods Lecture Flashcards
Halothane
- inhaled anesthetic
- slower but more control
Barbiturates
IV anesthetic
Long half life
Increases time Cl channels are open
Benzodiazepines
Valium
Lorazepam
- more selective
Increases frequency that CI channels are open
Propofol
- most common anesthetic for surgery
- faster clearance
- less hangover effect
Ketamine
Causes dissociative amnesia
CV stimulant
Etomidate
Produces hypnotic anesthesia without SE
Opioids
Fentanyl and morphine
- used more post op for pain control
Post op meds
Barbiturates
Benzodiacepinas
Antihistamines
Antacids
- Valium most common
All to relax the patient
Neuromuscular blockers
Cause skeletal muscle paralysis to keep patient from moving during the procedure
- anti cholinergic — curare
- Depolarizing blocker — succinylcholine
Goal of local anesthetics
Block afferent neuro transmission at level of peripheral nerve or spinal cord
Advantages of local anesthetic
Rapid recovery
Absence of cog problems after surgery
Minimal effects on Cv, respiratory or renal function
- most have -Caine suffix
Lidocaine
Rapid onset
Intermediate duration
Used for infiltration, peripheral nerve block, epidural, spinal, transdermal, topical
Procaine
Novacaine
Slow onset
Short duration
Used for infiltration, peripheral nerve block, spinal
What is the mechanism of action of local anesthetics
Inhibit sodium channel opening
STOP the depolarization
Side effects of local anesthetics
- systemic effects —> anesthetic diffuses throughout the body
- CNS effects —> initial excitation , latent effects like CNS depression
- CV effects —> CV depression, decreased HR and BP
What are the physical therapy concerns
- local anesthetics may be useful when applied transfermally with ionto or phono
- patients with complex regional pain syndrome —> schedule PT after the patient has received ganglionic or nerve block to be maximally effective. Maximize use of the involved extremity
What are the endogenous opioids
Enkephalin
Dynorphin
Endorphins
Endogenous receptors are Mu, Kappa, and delta
Mu receptors.
Most portent for pain releif and in highest concentration in periaqueductal gray
- fentanyl
- meperidine
- morphine
Also have the most side effects
Effects of strong opioids
- binds primarily to Mu receptors
- greatest analgesic effect but greatest potential for OD
- oral, IM, SQ, IV, Intrathecal
Adverse side effects of opioids
Sedation, drowsiness, mental slowing.
Euphoria and confusion
Respiratory depression
OH
N+V
Constipation
Addiction
Dependence
Tolerance
Opioid withdrawal symptoms
Body aches
Diarrhea
Fever
Gooseflesh
Insomnia
Irritability
Loss of appetite
N+V
Shivering
Stomach cramps sweating
Tachy
Uncontrollable yawning
Weakness/fatigue
