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Test 7 > Pharm 11 Anesthetics > Flashcards

Pharm 11 Anesthetics Flashcards

1
Q

General Anesthetic definition

A

Loss of awareness, memory, and perception, not actual loss of sensation

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2
Q

Stage 1 of anesthesia

A

Analgesia

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3
Q

Stage 2

A

Excitement
Irregular respiration
Vomiting

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4
Q

Stage 3

A

Surgical
Regular respiration
Reflexes (eyelash) are abolished

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5
Q

Stage 4

A

Medullary depression

Need full circulatory and respiratory support

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6
Q

Speed of induction correlations:

  1. Gas concentration
  2. Pulmonary ventilation
  3. Blood solubility
  4. Pulmonary circulation
  5. A-V concentration gradient
A
  1. Direct
  2. Direct
  3. Inverse
  4. Inverse
  5. Inverse
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7
Q

Blood:gas partition coefficient

A

High solubility = high coefficient = slow induction

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8
Q

Redistribution

A

Gas solubility in other body tissues, important for determining elimination from the brain

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9
Q

Minimum Alveolar Concentration

A

Low MAC = High Potency

-Concentration that produces absence of response in 50% of patients

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10
Q

Elderly MAC

A

Lower than normal

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11
Q

Halothane effect on heart

A

Sensitization to catecholamines -> arrhythmias

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12
Q

Halothane effect on liver

A

Occasional severe hepatitis

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13
Q

Drug causing nephrotoxic effect

A

Methoxyflurane (due to inorganic fluoride release)

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14
Q

Effect on pregnancy

A

Increase in abortions, no mutations

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15
Q

-Thiopental-
Speed
Elimination

A

30s onset, 10m duration

Redistribution

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16
Q

-Thiopental-
Action
SE

A

Sedative (barbiturate), poor analgesia

Decrease HR (Hypotension)
Decrease Resp
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17
Q

-Benzodiazepines-

Speed

A

Slower than Thiopental

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18
Q

-Benzodiazepines-
Action
SE

A

Sedative, no analgesia
Anterograde amnesia

Prolong recovery

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19
Q

-Narcotics-
Action
SE

A

Good analgesia, no anesthesia

Respiratory depression

20
Q

-Ketamine-
Action
MOA
SE

A

Dissociative Anesthesia
NMDA antagonist

CV stimulation
Post-op illusions

21
Q

-Propofol-
Action
Speed

A

Anestesia (most popular)
Anti-emetic
Fast

22
Q

-Propofol-

SE

A

Respiratory depression

23
Q

-Etomidate-
Action
SE

A

Rapid hypnotic
No analgesia

Nausea, Vomiting

24
Q

-Promazine-

A

Adjunct

  • Anti-emetic
  • Sedation
25
Q

-Promethazine-

A

Adjunct

  • Anti-emetic
  • Sedation
26
Q

Local anesthetic basic action

A

Prevent pain by interruption nerve conduction

27
Q

Local anesthetic specific action

A

Block voltage-gated sodium channels

28
Q

Local anesthetic pH effects

A

Weak base

  • Uncharged at body pH (for uptake)
  • Cationic and higher pKa (for action)
29
Q

Differential sensitivity

A

Attack fast firing channels (pain) first because Na channel needs to be open for action

30
Q

Ester metabolism

A

Rapidly hydrolyzed in blood by pseudocholinesterase

31
Q

Amide metabolism

A

Redistributed first, then hydrolyzed in liver by CYP450. Liver disease causes toxicity

32
Q

Local anesthetic problem

A

Vasodilation leads to systemic absorption. Give with epinephrine

33
Q

Lidocaine (amide) CNS effect

A

Drowsiness -> Activation -> Depression -> Respiratory failure

34
Q

Local anesthetic CV problem

A

Decrease excitability -> antiarrhythmic

35
Q

Epidural LA issues

A

Hypotension due to sympathetic blockade

36
Q

Cocaine toxicity

A

Hypertensive vasoconstriction

Arrhythmias

37
Q

LA hypersensitivity

A

Esters metabolized to PABA - some patients allergic

38
Q

LA for burn patients

A

Benzocaine - hydrophobic, stays on wound

39
Q

LA for arrhythmia

A

Lidocaine and Procainamide

40
Q 
-Cocaine-
E/A
Use
action
SE
A

Ester
Useful for vasoconstriction
Medium
Systemic toxicity

41
Q 
-Procaine-
E/A
Use
action
SE
A

Ester
Novicaine
Short
few

42
Q 
-Tetracaine-
E/A
Use
action
SE
A

Ester
Topical, spinal
Long
Toxic (lipophilic)

43
Q 
-Benzocaine-
E/A
Use
action
SE
A

Ester
Surface only (wounds)
surface only
surface only

44
Q 
-Lidocaine-
E/A
Use
action
SE
A

Amide
Patients with Ester Sensitivity, better than procaine
Medium
none

45
Q 
-Mepivacaine-
E/A
Use
action
SE
A

Amide
Obstetrics
Medium
neuro effects in baby

46
Q 
-Bupivacaine-
E/A
Use
action
SE
A 
Amide
Post-op nerve blocks, obstetric epidural
Long
Toxic (lipophilic)
better for baby

Test 7 (26 decks)

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