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Anaesthetics > Principles and Pharmacology > Flashcards

Principles and Pharmacology Flashcards

1
Q

What are the types of drugs used in anaesthetics ?

A 
Inhalational anaesthetics
Intravenous Anaesthetics
Muscle Relaxants
Local Anaesthetics
Analgesics
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2
Q

What are the techniques used in anaesthetics?

A

Tracheal Intubation
Ventilation
Fluid Therapy
Regional Anaesthesia

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3
Q

What is the triad of anaethesia?

A

Analgesia, Hypnosis and Relaxation

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4
Q

What are the problems of anaesthesia?

A

Polypharmacy may increase drug reactions

Muscle relaxants are required for artificial ventilation

Separation of relaxation and hypnosis can result in awareness

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5
Q

How do general anaesthetics work?

A

Interfere with neuronal ion channels and hyperpolarises them to make them less likely to fire

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6
Q

How do inhalational agents work?

A

They dissolve in membranes and give a direct physical effect

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7
Q

How do IV agents work?

A

Allosteric binding on GABA receptors open chloride channels

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8
Q

What effect does General Anaesthetics have on cerebral function?

A

It is “lost from top down” where the most complex processes are interrupted first
Loss of consciousness is early and hearing is lost later along with primitive functions

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9
Q

What are the immediate effects of IV anaesthetics?

A

Rapid unconsciousness with rapid recovery

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10
Q

What are inhalational anaesthetics?

A

Halogenated hydrocarbons

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11
Q

How are inhalational anaesthetics metabolised?

A

Uptake and excretion via lungs where concentration gradient is highest in lungs to blood to brain
Passes alveolar BM easily

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12
Q

When are muscle relaxants used ?

A

Ventilation and intubation
When immobility is essential
Body cavity surgery

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13
Q

What problems come with muscle relaxants?

A

Awareness
Incomplete reversal
Apnoea

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14
Q

Why use intraoperative analgesia?

A

Prevention of arousal
Opiates contribute to hypnotic effect of GA
Suppression of reflex responses to painful stimuli

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15
Q

What are local anaesthetics?

A

Sodium channel blockers
Pharmacologically “filthy”
Prevent propagation of action potential
LA molecules must pass into axon to block sodium channel from within.

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16
Q

What is the limiting factor in local anaesthetic ?

A

Toxicity

17
Q

What makes IV agents fast acting?

A

They are fat soluble and are therefore able to cross the membrane quickly

18
Q

How long do IV agents last in the body??

A

They quickly enter and leave the bloodstream
Muscles pick up the IV agents slowly but since a large percentage of the body is made of muscle, the effect is great nonetheless
Fat picks up IV agents the slowest but is able to store IV agents in large amounts due to fat soluble characteristics

19
Q

what does a low MAC value indicate?

A

A highly potent inhaled anaesthetic

i.e small dose to get big effect

bigger the MAC value, the more you need to produce the desired effect

20
Q

Why are inhaled agents useful?

A

They can prolong the time of anaesthesia easily if need be

They are slow acting and are therefore beneficial in maintenance of anaesthesia

21
Q

How are inhaled agents removed from the system?

A

By inhaling a gas without the anaesthetic in it and thus reversing the concentration gradient in the body

22
Q

How is General Anaesthetic maintained?

A

IV induction and inhalation maintenance

23
Q

How does GA depress the CV system?

A

It decreases sympathetic outflow which results in increased vasodilation, decreased SVR and a decreased CO

24
Q

How do General Anaesthetics repress the respiratory system?

A

Reducing hypoxic and hypercarbic drive of the brainstem which decreases tidal volume and increases rate

Paralyses cilia

25
Q

What must be done if lung volume is decreased for a prolonged period of time?

A

post op O2 must be given to minimise the effect of the VQ mismatch that has been created

26
Q

What system must be maintained and protected during muscle relaxant use?

A

The respiratory system

27
Q

What are the signs of Local Anaesthetic toxicity?

A

lingual numbness, light headedness, tinnitus, muscular twitching, CV depression, convulsions, coma, Cardiorespiratory arrest

Anaesthetics (5 decks)

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