Pharmacology VI Flashcards

1
Q

What is the mechanism of action of inhaled anesthetics?

A

Unknown mechanism (p.453)

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2
Q

Name four effects of inhaled anesthetics.

A

Myocardial depression, respiratory depression, nausea/emesis, increased cerebral blood flow (decreased cerebral metabolic demand) (p.453)

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3
Q

What toxicities are associated with Halothane use?

A

Hepatotoxicity (p.453)

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4
Q

What toxicities are associated with methoxyflurane use?

A

Nephrotoxicity (p.453)

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5
Q

What toxicities are associated with enflurane use?

A

It is a proconvulsant (p.453)

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6
Q

What toxicity is associated with inhaled anesthetic use?

A

Malignant hyperthermia in all but nitrous oxide (rare, lifethreatening, inherited susceptability) (p.453)

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7
Q

What toxicity is associated with use of nitrous oxide?

A

Expansion of trapped gas in the body cavity (p.453)

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8
Q

What five types of anesthetic drugs are administered intravenously?

A

Barbiturates, benzodiazepines, arylcyclohexylamines (ketamine), opioids, propofol (p.454)

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9
Q

Describe the anesthetic properties of thiopental.

A

High potency, high lipid solubility, rapid entry to the brain; decreases cerebral blood flow (p.454)

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10
Q

What is thiopental used for?

A

Induction of anesthesia and short surgical procedures (p.454)

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11
Q

How is thiopental’s effect terminated?

A

By rapid redistribution of the drug into tissues (i.e. skeletal muscle) and fat (p.454)

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12
Q

What benzodiazepine is most commonly used for endoscopy?

A

Midazolam; used adjunctively with gaseous anesthetics and narcotics (p.454)

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13
Q

What toxicities are associated with benzodiazepine use as an IV anesthetic?

A

Severe postoperative respiratory depression, decreased blood pressure, amnesia; treat with flumazenil (p.454)

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14
Q

What are arylcyclohexylamines?

A

PCP analogues used as dissociative anesthetics (ketamine); cardiovascular stimulants; increase cerebral blood flow (p.454)

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15
Q

What is the mechanism of action of arylcyclohexylamines?

A

Block NMDA receptors (p.454)

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16
Q

Name the most frequently used arylcyclohexylamine.

A

Ketamine (p.454)

17
Q

What toxicities are associated with arylcyclohexylamines?

A

Disorientation, hallucination, bad dreams (p.454)

18
Q

Describe the role of opioids in general anesthesia.

A

Used with other CNS depressants during general anesthesia (p.454)

19
Q

What two opioids are most commonly used in general anesthesia?

A

Fentanyl, morphine (p.454)

20
Q

What is propofol used for?

A

Sedation in the ICU, rapid anesthesia induction, short procedures (p.454)

21
Q

What is the mechanism of action of propofol?

A

Potentiates GABA(a) (p.454)

22
Q

What is the advantage of using propofol over thiopental for anesthesia induction?

A

Less postoperative nausea (p.454)

23
Q

What are the two classes of local anesthetics?

A

Esters, amides (amides have 2 I’s) (p.454)

24
Q

Name three ester anesthetics.

A

Procaine, cocaine, tetracaine (p.454)

25
Q

Name three amide anesthetics.

A

Lidocaine, mepivacaine, bupivacaine (p.454)