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Physical Therapy > Pharmacology Anasthetics > Flashcards

Pharmacology Anasthetics Flashcards

1
Q

What is the goal of anesthesia

A

The absence of all perceived sensations. Usually used for major surgeries with minimal harm to patient

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2
Q

What was used in the past before anesthesia

A

Blunt blows to the head to knock them out, strangulation, alcohol, physical restraint

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3
Q

When was anesthesia introduced

A

1846

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4
Q

What was the first anesthesia and who discovered it

A

Ether was the first, but it was rather toxic. It was first used by a dentist

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5
Q

What makes the ideal general aesthetic (5)

A 
Want a rapid onset and recovery 
Want them unconscious 
Want skeletal muscle to relax 
Don't want them to recall procedure 
Minimal adverse effects
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6
Q

What are the stages of anesthesia

A

1) Analgesia
2) Excitement
3) Surgical anesthesia
4) Medullary Paralysis

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7
Q

What is the desired level of anesthesia

A

Third stage surgical anesthesia. Want to get them here quick but not long enough to enter Medullary paralysis

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8
Q

What are the two types of anesthetics

A

Inhaled and intravenous (IV)

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9
Q

What are some inhalation agents for anesthesia

A

Halogenated liquids

Nitrous Oxide

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10
Q

What are some intravenous agents for anesthesia

A

Barbiturates
Benzodiazepines
Opioids

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11
Q

What is the traditional method of using anesthesia

A

First use intravenous to get them to stage 3 fast and then use inhalation for the remainder of the procedure.

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12
Q

What is the mechanism for anesthetics

A

Increase inhibition or decrease excitement throughout CNS by direct effect on libido bilayer, protein ion channels, or a combination of both

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13
Q

How do anesthetics effect the lipid bilayer

A

Embeds within the bilayer and effects the opening and closing of the bilayer.

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14
Q

Neuromuscular Juncture blockers

A

Used to block the excitability of the skeletal muscles. Can be either de-polarizing or non-depolarizing based on patients needs

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15
Q

Drawbacks of NMJ blockers

A

Some patients don’t have the enzymes that are used to digest the drug. If this is the case it could stay in their system until the drug is excreted.

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16
Q

Why must you take anesthetics with NMJ blockers

A

The NMJ blockers alone won’t block pain only spasms. The anesthesia is to assure no pain is felt

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17
Q

What is dissociative anesthesia

A

Patient is under anesthesia but it seems like they are conscious. Could even be talking, but will be unaware of what is going on

18
Q

When would you use dissociated anesthesia

A

If vomiting is an issue
Diagnostic/radiologic readings
Dressing changes
Emergency surgeries

19
Q

When to use general anesthesia

A

Burn Debridement
Dressing changes
Surgery

20
Q

What are some rehab concerns with general anesthetics

A

Redistribution where drug is absorbed in fat tissue and released later.
Hallucination effects
Cognition effects that could have a gradual onset lasting months. (personality)

21
Q

What are local anesthetics

A

Different set of drugs that are administered at the site of the problem

22
Q

Goal of local anesthesia

A

Interrupt the nerve conduction at the site of application

23
Q

What is the purpose of local anesthesia

A

To prevent or release pain without the loss of conciousness

24
Q

What are the typical local anesthetics

A

-caine drugs.

Idocaine, profane, bupivicane

25
Q

What is the mechanism of local anesthetics

A

It is like a key in a lock. It will lock the doorway of Na

Channels so Na can’t get into the membrane. No Na= no action potential

26
Q

Administration methods of anesthetics

A

Topical
Transdermal
Infiltration
Peripheral Nerve Block

27
Q

What is the infiltration administration method

A

Inject the anesthesia near the wound and let it filtrate in to decrease pain

28
Q

What is the nerve block method of anesthesia

A

Injected close to the plexus and it will dull the pain felt from the nerve

29
Q

Compare and contrast spinal and epidural blocks

A

Epidural is administered outside of the Dura mater.
Spinal is injected into the subarachnoid space. This will have stronger effect
Both are effective at treating pain below the level of the spinal leision/injury

30
Q

Explain the sympathetic block and what it is used for

A

Injected around sympathetic chain ganglia to decrees the excessive activation of the sympathetic nerve. Common in treating RSD or complex regional pain syndrome

31
Q

What is the intravenous regional or Beir block

A

Local anesthetic injected and then tourniquet placed proximal to injection site to keep drug localized for about an hour

32
Q

What is the Beir block used for

A

Complex regional pain syndrome, RSD, overactive empathetic ganglion

33
Q

What is a continuous nerve block

A

Small catheter is placed near the peripheral nerve and local anesthesia is dripped onto nerve

34
Q

What is the continuous nerve block often used for

A

Post op pain control

35
Q

What are some precautions with the continuous nerve block

A

Will not feel the extremity
No pain feedback
Need to be careful with PROM because they have no pain feedback

36
Q

When using a continuous nerve block on a TKR when would we have them weight bear

A

Needs to be able to actively contract the quads, should wear a brace.

37
Q

What is the differential nerve block

A

Will not effect all fibers. Effects small fibers first and then the larger fibers

38
Q

What is the order of nerve fibers from smallest to largest

A 
Pain, 
Temp, 
Touch, 
Proprioception,
Motor
39
Q

What is LAST

A

Local anesthetic systemic toxicity

40
Q

What are the sx of LAST

A

Tinnitus,
Agitation/Seizures,
Decreased sensation,
Depression

41
Q

What is associated with cardiotoxicity

A

Change in HR
ECG abnormalities
Depression/dizzyness
Cardiac arrest

Physical Therapy (18 decks)

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