Pharm Anesthetics, Kinder I

Question 1

What are the inhaled anesthetics

Answer 1

desflurane
enflurane
halothane
isoflurane
sevoflurane
NO

Question 2

what inhaled anesthetic is not volatile

Answer 2

NO

Question 3

what are the IV anesthetics

Answer 3

propofol
fospropofol
barbituates
benzos
etomidate
ketamine
desmedetomidine

Question 4

what are the local anesthetics

Answer 4

esters: benzocaine, cocaine, procaine, tetracaine
amides: articaine
bupivicaine
lidocaine
mepivacaine
ropivacaine

Question 5

What are the 5 primary effects produced by general anesthesia

Answer 5

unconsciousness
amnesia
analgesia
inhibition of autonomic reflexes
skel muscle relaxation

Question 6

monitored anesthesia care

Answer 6

oral or parenteral sedatives with local anesthetics

profound analgesia with retention of ariway and response to verbal commands

Question 7

anesthetic combination used for extensive surgical procedures

Answer 7

preoperative benzos with IV agent then maintained with inhaled or IV drugs or both

Question 8

the higher the blood:gas ratio of inhaled anesthetics

Answer 8

slower the uptake

Question 9

the higher the brain: blood ratio inhaled anesthetics

Answer 9

higher affinity to stay in CNS

Question 10

if MAC>100 required

Answer 10

need to combine with other drug to achieve anesthesia

Question 11

volatile

Answer 11

liquid at room temp

Question 12

where are inhaled anesthetics taken up

Answer 12

lungs, gas exchange in alveoli

Question 13

what is the driving force for uptake inhaled anesthetic

Answer 13

alveolar concentration

Question 14

what determines how alveolar concentration changes

Answer 14

inspired concentration or partial P

alveolar ventilation

Question 15

faster Fa (alveolar concentration) / Fi (inspired concentration) approaches 1

Answer 15

faster anesthesia will occur during inhaled induction

Question 16

how does increased CO change inhaled anesthesia

Answer 16

increases uptake but distributes to all parts of body, not just CNS. decrease the rate of induction of anesthesia

Question 17

if venous blood to lungs have less anesthetic than arterial (big difference)

Answer 17

more time to achieve equilibrium

Question 18

which inhaled anesthetics are eliminated faster

Answer 18

the ones that are insoluble in blood and brain

Question 19

how do anesthesiologists speed up recovery from anesthesia

Answer 19

hyperventilation

Question 20

main route elimination of anesthetics

Answer 20

lungs

Question 21

which inhaled anesthetics have the most hepatic metabolism component

Answer 21

halothane?enflurane>sevoflurane>isoflurane>desoflurane

Question 22

Anesthetic potency is measured out

Answer 22

MAC minimum alveolar [ ]

Question 23

1.0 MAC

Answer 23

partial P of inhaled anesthetic in alveoli which 50% population remained immobile at time of skin incision

Question 24

range of MAC for successful anesthesia

Answer 24

0.5-2.0

Question 25

4 stages of CNS depression

Answer 25

1 analgesia
2excitement
3 surgical anesthesia
4 medullary depression

Question 26

stage 1: analgesia

Answer 26

begining only have analgesia

end have analgesia and amnesia

Question 27

stage 2: excitement

Answer 27

patient delerious

respirations rapid, HR and BP increase

Question 28

stage 3: surgical anesthesia

Answer 28

slow RR and HR until complete cessation spontaneous respiration
4 planes of ocular movements, eye reflexes and pupil sizes indicating increased depth anesthesia

Question 29

stage 4: medullary depression

Answer 29

severe CNS depression including vasomotor in medulla and resp center
without circulatory/resp support would die

Question 30

indications that in stage 3 anesthesia

Answer 30

loss of responsiveness to painful stimuli

Question 31

patient has increased cranial P, don’t give what anesthetic

Answer 31

volatile anesthetics

Question 32

Which anesthetics depress normal cardiac contractility

Answer 32

volatile inhaled ones

halothane and enflurane more so

Question 33

which volatile inhaled anesthetics increase HR

Answer 33

desflurane and isoflurane

Question 34

what causes the postoperative respiratory complications like hypoxemia and resp infections

Answer 34

prolong exposure to inhaled anesthetics (resp depressors) cause mucus pooling and plugging leading to atelectasis

Question 35

side effects inhaled anesthetics

Answer 35

nausea and vomiting
halothane– hepattiis after previous 1st time exposure
renal toxicity– sevoflurane
malignant hyperthermia!!!

Question 36

Tx malignant hyperthermia

Answer 36

dantrolene

Question 37

what caues rapid onset action IV anesthetics

Answer 37

highly lipophilic and thus bind to brain and spinal cord

Question 38

MOA propofol

Answer 38

potentiation of Cl mediated thorugh GABA a

Question 39

how is propofol made for infusion

Answer 39

lipid emulsion with egg yolk phosphate fraction (watch for allergies!!)

Question 40

PK propofol

Answer 40

fast onset fast plasma clearance

Question 41

what is context sensitive half time

Answer 41

elimination half time after discontinuation of continuous infusion as function of the duration of infusion

Question 42

CNS effects propofol

Answer 42

general suppression
decreased cerebral blood flow
decreased intracranial and intraocular P
burst suppression in EEG

Question 43

CV effects propofol

Answer 43

most pronounced dec in systemic BP from vasodilation

hypotensive effects from inhibition of normal baroreflex

Question 44

respiratory effects propofol

Answer 44

respiratory depressant

Question 45

painful injection

Answer 45

propofol

Question 46

therapeutic use propofol

Answer 46

anesthesia induction, continous infusions, maintenance anesthesia, sedation ICU, consciou sedation, short duration general anesthesia
antiemetic!!!!

Question 47

paresthesia in perianal area

Answer 47

fospropofol