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Neuroscience 2.0 > Pharm - General Anaesthesia > Flashcards

Pharm - General Anaesthesia Flashcards

1
Q

What are the physiological state induced by General anaesthesia ?

A
  • Analgesia
  • Amnesia
  • Loss of consciousness
  • Inhibition of sensory & autonomic reflexes
  • Skeletal muscle relaxation
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2
Q

What type of drugs are given prior to general anaesthesia?

A
  • To relieve anxiety – benzodiazepines.
  • To prevent allergic reactions – anti-histamines.
  • To prevent nausea & vomiting – anti-emetics
  • To provide analgesia – opioids.
  • To prevent bradycardia & secretion – atropine
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3
Q

What are the two categories of Anaethesic agents ?

A
  • Inhalation - for maintenance

*Intravenous - For Induction & short procedures

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4
Q

What is Induction of General anaesthesia?

A

This is the time from administration of GA to achievement of surgical anaesthesia.

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5
Q

What is Recovery of General anaesthesia?

A

This is the reverse of induction.

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6
Q

What are the types of Inhaled general anaesthetics?

A
  • Halogenated Hydrocarbon
  • Non-halogenated gas
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7
Q

What are examples of Halogenated hydrocarbons?

A

Desflurane
Isoflurane
Sevoflurane
Halothane

” DISH “

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8
Q

What is an example of Non-Halogenated gas?

A

Nitrous Oxide

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9
Q

How are inhaled general anaesthetics measured?

A

Their partial pressure or “tension” in the inhaled air or in the blood or other tissue is a measure of their concentration

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10
Q

Fill in the blanks. “ 50% nitrous oxide in inhaled air would have a partial pressure of
__________.”

A

380 mm Hg

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11
Q

What are the factors influencing the rate at which the therapeutic concentration of inhaled anaesthetics achieved in brain?

A
  • Solubility
  • Pulmonary ventilation
  • Partial pressure of inhaled gas.
  • Alveolar blood flow
  • Arteriovenous concentration gradient
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12
Q

What are the most important characteristics of Inhalation GA which govern anaethesia?

A
  • Solubility in the blood (blood : gas partition co-efficient).
  • Solubility in the fat
    (oil : gas partition co-efficient)
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13
Q

Fill in the blanks.” In regards to the Inhalation agent, _________________ is the single most important factor in determining speed of induction & recovery.”

A

Solubility in the blood

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14
Q

True or False? “ The more soluble an agent is in the blood the more must be dissolved to raise its partial pressure.”

A

TRUE!!

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15
Q

True or False? Agents that are less soluble in blood (ex. nitrous oxide) provide a rapid induction because the blood reservoir is small & anaesthetic is available to pass into the brain sooner.

A

TRUE!!

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16
Q

True or False? The higher the lipid solubility the potent the anaesthetic ex Halothane.

A

TRUE !!

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17
Q

What is the minimum alveolar concentration (MAC)?

A

This is defined as the concentration of inhaled anaesthetic, (as a % of inspired air), at which 50% of patients do not respond to a surgical stimulus

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18
Q

True or False? The more lipid soluble the anaesthetic , the lower the MAC and the greater the potency.

A

TRUE!!

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19
Q

In the event of Malignant hyperthermia caused by the use of Inhaled Anaesthetics except Nitric oxide , what is the drug choice of treatment ?

A

Dantrolene

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20
Q

What is an Adverse effect of Nitrous oxide?

A

Risk of bone marrow depression w prolonged administration(›6hr) causes inactivation of methionine synthase, needed for DNA & protein synthesis→ bone marrow depression.

21
Q

What is the MAC for Nitrous oxide?

A

100%

22
Q

Which halogenated hydrocarbon inhaled anaesthetics is a powerful coronary vasodilator?

A

Isoflurane

23
Q

What is the MAC of Isoflurane ?

A

1.4%

24
Q

Which halogenated hydrocarbon inhaled anaesthetics is used for GA especially in children, b/cause it is not irritating to airways?

A

Sevoflurane

25
Q

What is the MAC for Sevoflurane?

A

3%

26
Q

Which inhaled anaesthetics is a Respiratory tract irritant → coughing & bronchospasm?

A

Desflurane

27
Q

What is the MAC for Desflurane?

A

6 %

28
Q

Which inhaled anaesthetic can have levels of Fluoride detected after use?

A

Sevoflurane

29
Q

Which Inhaled anaesthetic causes a potential for Malignant Hyperthermia?

A

Desflurane , Isoflurane & Halothane

30
Q

What are the Adverse effects pf Halothane?

A
  • Hepatotoxicity – halothane hepatitis (fulminant hepatic necrosis)
  • Cardiac arrhythmias, * Hypotension
  • Malignant hyperthermia
31
Q

What is the MAC for Halothane ?

A

0.75 %

32
Q

What are the Types of Intravenous General Anaesthetics used ?

A

Barbituates
Benzodiazepines
Dissociative - Ketamine
Opioids
Miscellaneous- Etomidate , Propofol

33
Q

What is the MOA of Thiopental?

A

It binds to GABA A receptor which results in prolonged opening of the chloride channel.

34
Q

What are the adverse effects of Thiopental?

A
  • Depresses cerebral blood flow & oxygen consumption by brain.
  • May induce laryngospasm & bronchospasm
35
Q

What happens if Benzodiazepines are used with Opioids?

A

Cardiovascular collapse & respiratory arrest can occur

36
Q

What are the Clinical functions of Benzodiazepines ?

A
  • Pre-operative Sedation.
  • Intraoperative Sedation.
  • Part of balanced anaesthesia.
37
Q

How can the effects of Benzodiazepines be reversed?

A

Giving the drug Flumazenil

38
Q

Which Benzodiazepines is the preferred choice for induction and maintenance of Anaesthesia?

A

Midazolam

39
Q

Which drug is an analogue of phencyclidine (PCP, “angel dust”) w/ similar properties?

A

Ketamine

40
Q

What happens when a patient is given a Dissociative anaesthetic?

A

The patient may remain conscious although amnesic & insensitive to pain.

41
Q

What are the adverse effects of Ketamine?

A

Disorientation, sensory & perceptual illusions, vivid & unpleasant dreams

42
Q

What is the treatment for Opioid overdose?

A

Naloxone

43
Q

Which Intravenous general anaesthetic is used in critical care setting as continuous infusion to provide prolonged sedation?

A

Propofol

44
Q

What are the adverse effects of Propofol?

A

Hypotension
Negative inotropic effects
Apnoea

45
Q

Which drug can be used for for induction of anaesthesia in patients with limited cardiovascular reserve?

A

Etomidate

46
Q

Which drug with a prolonged Prolonged infusion can cause possible risk of adrenocortical suppression ?

A

Etomidate

47
Q

What is the MOA of Ketamine?

A

Inhibits NMDA receptor

48
Q
A

Neuroscience 2.0 (29 decks)

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