Brainscape's Knowledge GenomeTM

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


See full index

PMCOL 343 > pain 2 > Flashcards

pain 2 Flashcards

1
Q

what is anesthesia

A

loss of sensation

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

do all general anesthesias do analgesia

A

no

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

what are 5 things that lots of general anesthetics try to achieve

A
  • analgesia
  • amnesia
  • loss of consciousness
  • inhibit sensory &autonomic reflexes
  • skeletal muscle relaxation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are 3 things that are sought after in an ideal general anesthetic

A
  • smooth and rapid anesthetic induction, but permits rapid recovery when administration ceases (balanced anaesthesia)
  • wide margin of safety
  • devoid of adverse effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what does balanced amnesia mean

A

induce anesthesia smooth and rapidly, but permits rapid recovery when administration ceases

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

what are 5 common adverse effects of anesthesias

A
  • vomiting
  • cadiovasc depresion
  • resp depression
  • toxicity
  • respiratory irritant effevts of volatile anesthetics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how do they try to achieve balanced anesthesia

A

by combining drugs to maximize favorable effects and minimize untowards effects

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

what is the therapeutic index for general anesthetics

A

low

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

what do doctors do for minor procedures (2 things)

A

oral sedatives and regional local anesthetic

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

what do doctors do for conscious sedation (2 drugs)

A

benzos (IV) + opioid analgesics

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

what is conscious sedation

A

when patients can respond to verbal commands + open airway

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

what do they often give patients preoperatively (3)

A
  • sedatives (anxiolytic, amnesia)
  • muscle relaxants (d-tubocurarine like drugs)
  • atropine (limit mucous secretion)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

why do they give atropine preoperatively

A

because anesthetics are irritating so lungs secrete fluid and mucous, so this stops that

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

what are some drugs that are used to induce anaesthesia

A

thiopental propofol etomidate benzos (midazolam)

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

what do doctors use for deep anesthesia (2 types)

A

inhaled anaesthetics and maybe IV anesthetics

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

what are 3 examples of inhaled anesthetics

A

N2O
isoflurane
methoxyflurane

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

what is N2O

A

inhaled general anesthetic

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

what is isoflurane

A

inhaled general anesthetic

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

what is methoxyflurane

A

inhaled general anesthetic

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

what are inhaled general anesthetic (2 properties / descriptions)

A

volatile liquids, halogenated hydrocarbons

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

what is an example of a intravenous barbiturate used for general anesthetic

A

thiopental

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

what is an example of a intravenous benzodiazepine (2) used for general anesthetic

A

midazolam, diazepam

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

what is an example of a intravenous opioid agonist used for general anesthetic

A

fentanyl

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

what is the “dissociative” intravenous drug used for general anesthetic

A

KETAMINE

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

what is the “neurolept” intravenous drug used for general anesthetic

A

droperidol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is thiopental

A

intravenous barbiturate used for general anesthetic (fast acting)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is midazolam

A

intravenous benzo used for general anesthetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is diazepam

A

intravenous benzo used for general anesthetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is fentanyl

A

intravenous opioid agonist used for general anesthetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is ketamine

A

intravenous dissociative used for general anesthetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is droperidole

A

intravenous neurolept used for general anesthetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is propofol

A

intravenous general anesthetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is etomidate

A

intravenous general anesthetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what are 8 examples intravenous general anesthetics

A 
thiopental
midazolam
diazepam
fentanyl
propofol
etomidate
ketamine
droperidol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what are the 4 stages of anesthesia

A
  1. analgesia
  2. excitement
  3. surgical anesthesia
  4. medullary depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what is in the first stage of anesthesia

A

analgesia without amnesia –> analgesia with amnesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what is in the second stage of anesthesia

A

excitement: delirium, amnesia, retching, vomiting, irregular respiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what is in the third stage of anesthesia

A

irrecular respiration –> regular breathing –> cessation of breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what is in the fourth stage of anesthesia

A

medullary depression: cessation of spontaneous breathing, severe depression of medullary vasomotor center (hypotension) and resp center, DEATH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

which stage do they want you in

A

third stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

which stage do they want to limit your time in

A

second

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what stage kills you

A

fourth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

how do local anesthetics work (generally)

A

impair nerve conduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

how do general anesthetics work (generally)

A

primary effects on synaptic processes to decrease neuronal activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what is the mechanism of action of inhaled anesthetics

A

block α7 nAChR, 5-HT3 receptor/ ion channel, open TASK channels (2 pore K+ channels), activate thalamic “extrasynaptic” GABA A R to cause polarizations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

where are 4 targets for inhaled anesthetics

A

α7 nAChR, 5-HT3, TASK (K+), GABA A R

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what do inhaled anesthetics do to α7 nAChR

A

block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what do inhaled anesthetics do to 5-HT3

A

block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what do inhaled anesthetics do to TASK channels

A

activate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what are TASK channels

A

2 pore domain K+ channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what do inhaled anesthetics do to GABA A receptors and what does it cause

A

activate to cause hyperpolarization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

where are the GABA A receptors that inhaled anesthetics activate

A

thalamic extrasynaptic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

why is the dose-response relationship difficult to determine

A

minimal response=pain

maximal response=death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what is minimum alveolar anesthetic concentration

A

concentration (ex:% of alveolar gas mix) that results in immobility in 50% of patients when exposed to noxious stimulus (like surgical insertion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

what does minimum alveolar anesthetic concentration (MAC) represent

A

ED50

56
Q

what is ED50

A

the dose of drug that produces an effect in 50% of the population

57
Q

what is minimum alveolar anesthetic concentration (MAC) used for

A

representing anesthetic dosages (expressed in multiples of MAC)

58
Q

how is anesthetic dosage expressed

A

in multiples of minimum alveolar anesthetic concentration (MAC)

59
Q

can minimum alveolar anesthetic concentration (MAC) exceed 100% and why

A

yes, for a weak anesthetic like N2O, it may not be enough to prevent immobility in patients

60
Q

what are 2 main organs that are affected by volatile inhaled anaesthetics

A

cardiovascular system and respiratory system

61
Q

what do volatile inhaled anaesthetics do to BP

A

lower

62
Q

what do volatile inhaled anaesthetics do to peripheral resistance

A

some will lower

63
Q

what do volatile inhaled anaesthetics do to cardiac output

A

it can be effected

64
Q

what are 4 things that volatile inhaled anaesthetics do to the cardiovascular system

A
  • lower BP
  • may influence cardiac output
  • may lower peripheral resistance
  • sensitize myocardium to catecholamines
65
Q

what do volatile inhaled anaesthetics do to myocardium

A

sensitize them to actions of catecholamines

66
Q

how can volatile inhaled anaesthetics cause ventricular dysrhythmias

A

they sensitize myocardium to actions of catecholamines, so now even endogenous NA can cause dysrhymia

67
Q

what do volatile inhaled anaesthetics do to respiratory system (3)

A
  • decrease minute respiration
  • decrease ventilatory reponse to hypoxia
  • decrease mucoliliary function (mucous pooling)
68
Q

which inhaled anesthetic doesnt effect the respiratory system

A

N2O

69
Q

what do volatile inhaled anaesthetics do to minute respiration

A

decrease

70
Q

what do volatile inhaled anaesthetics do to response to hypoxia

A

decreases ventilatory response

71
Q

what do volatile inhaled anaesthetics do to mucociliary function and what does thiscause

A

decreases function so there is mucous pooling

72
Q

What are 2 types of anesthetic toxicity

A
  • nephrotoxicity

- malignant hyperthermia

73
Q

what causes nephrotoxicity

A

from hepatic metabolism - fluoride ions from the anesthetics

74
Q

what causes malignant hyperthermia

A

genetic disorders where Ca++ handling by skeletal muscle is altered

75
Q

what is the mechanism of action of IV anesthetics

A

potentiate movement of Cl- ions through GABA A receptor channels

76
Q

what is the mechanism of action of barbiturates

A

potentiate Cl- movement through GABA A channel and increase duration of channel opening

77
Q

what is the mechanism of action of benzos

A

potentiate Cl- movement through GABA A channel and increase frequency of channel opening

78
Q

what is the mechanism of action of propofol

A

potentiate movement of Cl- ions through GABA A receptor channels

79
Q

what is the mechanism of action of etodimate

A

potentiate movement of Cl- ions through GABA A receptor channels

80
Q

what is the mechanism of action of ethanol

A

potentiate movement of Cl- ions through GABA A receptor channels

81
Q

where do benzos and barbs bind

A

at different sites of the GABA A receptor channel

82
Q

do benzos or barbs increase frequency of channel opening

A

benzos

83
Q

do benzos or barbs increase duration of channel opening

A

barbs

84
Q

what does GABA potentiation do to neuronal activity

A

decreases

85
Q

what is the rate of onset of thiopental

A

rapid

86
Q

what kind of solubility is thiopental

A

lipid soluble

87
Q

does thiopental cross the BBB and why

A

yes because its lipid soluble so it can enter brain

88
Q

what is a downside to thiopental

A

it is redistributed to other tissues like body fat, so its tough for obese people to have offset (like come-down or whatever)

89
Q

can you use thiopental alone and why

A

yes for short procedures because it is potent and has a rapid onset of action

90
Q

does thiopental have analgesic effect

A

no

91
Q

what happens with large doses of thiopental

A

hypotension and resp depression

92
Q

what is thiopental often combined with

A

inhalation agent

93
Q

what is an example of a ultra-short acting barb

A

thiopental

94
Q

can midazolam and diazepam be used in induction of anesthesia and why

A

no because its onset is too slow

95
Q

what is midazolam and diazepam often given with and when

A

a mix of anesthetic mixtures as a premedication

96
Q

what is a useful use for midazolam and diazepam

A

producing anterograde amnesia (patient wont remember they’re about to have surgery)

97
Q

can midazolam and diazepam produce surgical anesthesia

A

no not alone, but good for amnesia

98
Q

what is flumazenil

A

benzo antagonist

99
Q

why do you use flumazenil

A

to speed up recovery from midazolam and diazepam

100
Q

can flumazenil work on midazolam and diazepam

A

yes thats what its for

101
Q

can flumazenil work on thiopental

A

no its a bard not a benzo

102
Q

what is the rate of onset for propofol

A

rapid

103
Q

what is the rate of offset for propofol

A

rapid

104
Q

where is propofol metabolized

A

in liver

105
Q

what happens with large doses of propofol

A

hypotension, respiratory depression

106
Q

what does propofol cause in children

A

acidosis

107
Q

what is a good thing about propofol

A

doesnt cause vomiting and patients feel better post operative

108
Q

what is the rate of onset for etomidate

A

rapid

109
Q

what is the use for etomidate and why

A

for induction because it causes a loss of consciousness within seconds

110
Q

does etomidate cause analgesia

A

no

111
Q

what are the pros of etomidate

A

it has minimal cardiovascular and resp depression

112
Q

what is a con for etomidate

A

causes nausea and vomiting

113
Q

why is etomidate good for old geisers

A

it doesnt cause much cardio and resp depression

114
Q

what are advantages to fentanyl (3)

A

cardio stability, sedative, analgesia

115
Q

what are disadvantages to fentanyl (3)

A

resp. depression, hypotension, postoperative recall

116
Q

what does fentanyl do to the cardio system

A

not much, keeps stable

117
Q

what does fentanyl do to the resp system

A

depression

118
Q

what does fentanyl do to the BP

A

lowers

119
Q

does fentanyl cause analgesia

A

yes

120
Q

What is naloxone and naltrexone

A

opioid antagonists

121
Q

why do they use naloxone and naltrexone

A

to speed up recovery phase

122
Q

what drugs do they use to speed up recovery phase from opioids

A

naloxone and naltrexone

123
Q

what is a common combination of drugs for sugery

A

fentanyl + benzo or barb +N2O

124
Q

what is in neuroleptanaesthesia

A

fentanyl + droperidol + N2O

125
Q

what is droperidol

A

D2 receptor antagonist

126
Q

what do all D2 antagonists do that is good for surgery

A

prevent vomiting

127
Q

what are 3 good things about droperidol

A
  • anti-emetic
  • reduce motor activity
  • reduce anxiety
128
Q

what are 2 things that ketamine does

A

catatonia, cardio stimulation

129
Q

are people conscious with ketamine

A

yes but they dont move

130
Q

what are some procedures that ketamine is good for

A

geriatrics, children and burn dressing

131
Q

what is the mechanism of action of ketamine

A

blocks glutamate NMDA receptors/ channels

132
Q

what are the untoward effects of ketamine

A

hallucinations and nightmares

133
Q

what is the mechanism of action of ethanol

A

blocks NMDA receptors and activates GABA A receptor (including extra synaptic receptors)

134
Q

is thiopental a strong analgesic

A

no

135
Q

does ketamine produce neurolept anesthesia

A

no

PMCOL 343 (31 decks)

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