Principles and pharmacology

Question 1

triad of anaesthesia

Answer 1

hypnosis
paralysis
analgesia

Question 2

phase one induction

Answer 2

Inhalational - Volatile (sevoflurane)
/ Nitrous Oxide

Intravenous Propofol +/- opioid

+/- Muscle relaxant

Question 3

phase two maintenance

Answer 3

Inhalational volatile (sevoflurane) +/- opioid

Intravenous propofol +/- opioid = TIVA

+/- muscle relaxant

Question 4

what receptors does anaesthetic act on

Answer 4

GABA receptors

inhibits depolarisation

Question 5

where do opioids act in pain pathway

Answer 5

synapse of first and second neuron in spinal column

Question 6

opioid examples

Answer 6

Fentanyl

Alfentanyl potent, quick-acting, rapid offset

Remifentanyl
doesn’t accumulate, often used as part of TIVA

morphine

Question 7

where do muscle relaxants act on

Answer 7

NMJ site of Ach receptors

Question 8

types of muscle relaxants

Answer 8

Non-depolarising - competitive antagonists at acetylcholine receptor
- Rocuronium, atracurium

Depolarising - acetylcholine receptor agonist
- Suxamethonium

Question 9

reversal agents for non depolarizing muscle relaxants

Answer 9

Neostigmine - acetylcholinesterase inhibitor
glycopyrrolate - muscarinic anticholinergic

Suggamadex

Question 10

what is the effects of anaesthetists on MAP and CO

Answer 10

decrease (SV, HR, SVR additionally)

Question 11

Sympathetic nervous system agonists

thoracolumbar outflow tract

Answer 11

Alpha receptors - vasculature
- Beta receptors - heart

Question 12

malignant hyperthermia

Answer 12

Malignant hyperthermia is a severe reaction to certain drugs used for anesthesia. This severe reaction typically includes a dangerously high body temperature

mortality 90%

dantrolene to treat it

Question 13

alternate types anaesthesia

Answer 13

spinal block
epidural (neuraxial)
regional US guided anaesthetic
local - (pka, PH unionised to ionised)