Pharmacology Of Inhaled Surgical General Anesthetics Flashcards

1
Q

General anesthesia definition

A

Loss of consciousness, feeling and protective reflexes

Side effects:

  • analgesia
  • amnesia
  • skeletal muscle relaxations
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2
Q

What was the first anesthesia?

A

Diethyl ether inhalation

- nitrous oxide

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3
Q

stages of general anesthesia

A

1) stage of analgesia
- loss of conscious w/ loss of pain
- amnesia can be developed here
- inhibits cerebral cortex

2) stage of excitement
- patient is delirious/excited
- respiration is irregular
- can vomit and or incontinent
- elevated blood pressure and heart rate
- once the hypothalamus takes over this stage occurs
* this is the stage to avoid, or minimize during anesthesia treatment*

3) stage of surgical anesthesia
- regular respiration and blood pressure occurs
- continues until regular respiration ceases
- subdivided into 4 phases based on eye movements and pupil reflexes
- ventilators must be present
* you have to try to keep patient in this stage*

4) stage of medullary depression
- severe depression of vasomotor and respiratory centers
- kills patient
* DONT get in this stage*

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4
Q

Induction vs maintenance in anesthesia

A

Induction:
- time required to take a patient from consciousness -> stage 3

Maintenance:
- ability to keep patient safely in stage 3

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5
Q

Examples of inhaled anesthetics

A

Nitrous oxide

Flurane agents

MOA:

  • inhibt excitatory synapses by blocking NMDA receptors
  • enhance inhibitory synapses in CNS by agonist activity to GABAa receptors
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6
Q

What determines the rate of induction

A

Time required for therapeutic Concentration of inhaled anesthetic that gets into the CNS

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7
Q

Solubility in anesthesia

A

Most important factor effecting transfer of general anesthesia from lung -> blood

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8
Q

Blood:Gas partition coefficient

A

Determines the solubility of an inhaled drug

High coefficients indicate the drug is more soluble in blood
- higher solubility in blood = slower onset for action (this is bad)

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9
Q

How to combat high blood:gas partition agents

A

Administer at higher dose intitally and reduce for maintenance

Also can give in conjunction with a low solubility agent (nitrous oxide)

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10
Q

What determines the time to recovery from anesthesia?

A

Rate of elimination of general anesthesia from the brain

measured by the brain: blood coefficient
- lower number = quicker recovery

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