[PHARM] General and Local Anesthetic Drugs [Kruse] Flashcards
Suffix for inhaled anesthetics?
-flurane
Suffix for local anesthetics?
-caine
What is the one inhaled anesthetic that does NOT end in “-flurane”?
Nitrous oxide
What are the inhibitory ion channel types that general anesthetics work on?
Chloride channels
Potassium channels
What are the excitatory ion channel types that general anesthetics work on?
Acetylcholine
Excitatory amino acids
Serotonin
Of the inhaled anesthetics; what are most of them at room temperature?
MOST inhaled anesthetics (halothane, enflurane, isoflurane, desflurane, sevoflurane)
are liquids at room temperature
Nitrous oxide is a _____ at room temperature
GAS
What does the blood:gas partition coefficient define?
The relative affinity of an anesthetic for the blood compared with that of inspired gas
(i.e. blood solubility)
Agents with low blood solubility have a
____________ onset of action
Agents with low blood solubility have a
RAPID onset of action

Name an example of an inhaled anesthetic that has a low blood solubility
Nitrous oxide
Desflurane
Agents with high blood solubility have a
____________ onset of action
Agents with high blood solubility have a
SLOW onset of action

What does the minimal alveolar concentration (MAC) measure?
Anesthetic potency
–> The concentration that prevents movement in reponse to surgical stimulation in 50% of subjects
What is the major toxicity of halothane?
Hepatitis
“H”
What are the toxicities of enflurane and sevoflurane?
Renal toxicity
*They are both florinated
When inhaled anesthetics are combined with ___________, your patient can get malignant hyperthermia
Succinylcholine
What is the antidote for malignant hyperthermia?
Dantrolene
What IV anesthetics provide cardiovascular stability?
Etomidate
Midazolam
Propofol
MOA
Pharmacokinetic
GABA(A) agonist
30 seconds for onset of action, 3-10 min duration of action; rapid rate of onset, rapid recovery
Toxicities of propofol?
Hypotension
Respiratory depression
Etomidate
MOA
Downside vs propofol
Useful in what patients
GABA(A) agonist
Less rapid recovery rate compared to propofol
Useful in patients with impaired CV or respiratory sysetms
Ketamine
MOA
Toxicities
Special
NMDA antagonist
Emergence reactions (vivid colorful dreams, hallucinations etc)
Only IV anesthetic to produce profound analgesia
Dexmedetomidine
MOA
Clinical application
Alpha2 adrenergic agonist
Short term sedation of intubated and ventilated patients in an ICU setting
What are (3) classes of drugs used as anesthesia adjuncts?
Opioids
Barbiturates
Banzodiazepines
What is the MOA of local anesthetics?
Block voltage gated sodium channels
What is the “number of I’s rule”?
If the drug name has 2 I’s in the name = AMIDE
If the drug name has 1 I in the name = ESTER

What is the ONLY local anesthetic drug with surface use only indication?
Benzocaine
What should you consider coadministering with a local anesthetic?
Vasoconstrictor
Why do we care about ester vs amide?
Ester-type local anesthetics are more likely to have allergies!!!
Remember ester-type only have one “i” in their name