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Clinical Neuro Exam 3 > Pharm: General Anesthesia > Flashcards

Pharm: General Anesthesia Flashcards

0
Q

What is the MOA of general anesthetics based on the Lipid theory?

A

The meds inhibit the excitability of the neuronal cell membrane.

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1
Q

What are the 4 stages of anesthesia?

A
  1. Analgesia: analgesia, amnesia, euphoria
  2. Excitement: excitement, delerium, combative behavior
  3. Surgical Anesthesia: unconsciousness, regular respiration, decreased eye movement.
  4. Medullary Depression: respiratory arrest, cardiac depression/arrest, no eye movement.
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2
Q

What 3 things affect the rate of equilibration of inhaled anesthetics?

A
  1. Rate of ventilation: higher rate of ventilation will remove the anesthetic from the alveoli quicker and increase recovery
  2. Plasma solubility: drugs that do not dissolve in the blood keep the partial pressure of the anesthetic in the alveoli down allowing for a more rapid recovery.
  3. Lipophilic Character: drugs with less lipophilic character are more easily cleared from the body and allow a more rapid recovery.
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3
Q

Some drugs are given as premedications before general anesthetics are administerd. What is the reason for giving:
Clonidine
Dexmedetomidine
midazolam

A

Clonidine: moderate anesthesia and calming agent
Dexmedetomidine: moderate anesthesia and calming agent
Midazolam: calming agent mainly in pediatric patients

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4
Q 
Some drugs are given as premedications before general anesthetics are administerd.  What is the reason for giving:
Droperidol
Dexamethasone
Heparin
Enoxaparin
A

Droperidol: prevents nausea
Dexamethasone: prevents nausea
Heparin: anti-coagulation
Enoxaparin: anti-coagulation

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5
Q

Some drugs are given as premedications before general anesthetics are administerd. What is the reason for giving
metoclopramide?

A

Increase gastrokinetics and treat nausea and vomitting.

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6
Q

Propofol

A

MOA: enhances GABA transmission

Indication: induction and maintenance of anesthesia

AE: respiratory and cardiovascular depresssion

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7
Q

Barbiturates-thiopental

A

MOA: enhance GABA mediated chloride channel actvity (barbituate)

Indications: inductions of anesthesia, treats high ICP

AE: intense vasoconstriction leading to gangrene

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8
Q

Midazolam

A

MOA: enhance GABA-mediated chloride currents (BZ)

Indications: anxiolysis and anterograde amnesia

AE: not as much cardio or resp. depression as barbituates

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9
Q

Antidote for BZ overdose

A

Flumazenil

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10
Q

Ketamine

A

MOA: NMDA receptor inhibitor

Indications: analgesia and anesthesia, stimulation of sympathetics

AE: emergence reactions (hallucinations, vivd colorful dreams), lacrimation and salivation

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11
Q

Etomidate

A

MOA: enhance GABA transmission

Indications: alternative to propofol and Barbituates for rapid IV induction of anesthesia.

AE: pain at injection site (though less resp. and cardio effects)

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12
Q

Dexmedetomidine

A

MOA: alpha-2 selective antagonist

Indications: short term sedation of intubated and ventilated patients in ICU, sedation without respiratory depression

AE: heart block, severe bradycardia or asystole

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13
Q

Nitrous Oxide

A

MOA: unknown, effects ligand gated ions channels

Indications: analgesia and outpatient dentistry, adjunct to inhaled or IV anesthesia

AE: nausea, pneumothorax

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14
Q

Halothane

A

MOA: not fully understood

Indications: induction of anesthesia in children, maintenance of anesthesia in adults. Slow induction and recovery due to high blood solubility

AE: malignant hyperthermia

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15
Q

Enflurane

A

MOA: not fully understood

Indications: maintenance of anesthesia rather than induction, given as adjunct with Nitrous Oxide or opioids.

AE: muscle relaxant, hypotension, seizures

16
Q

Isoflurane

A

MOA: not fully understood

Indications: maintenance of anesthesia rather than induction, given as adjunct with Nitrous Oxide or opioids.

AE: muscle relaxant, hypotension, airway irritant

(more expensive but less AE than enflurane)

17
Q

Desflurane

A

MOA: not fully understood

Indications: maintenance of anesthesia

AE: airway irritant, salivation, coughing, bronchospasm

18
Q

Sevoflurane

A

MOA: not fully understood

Indications: outpatient anesthesia, NO airway irritation

AE: may react with baralyme (a CO2 absorbant) to irritate airways.

Clinical Neuro Exam 3 (15 decks)

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