Test 2 ch 6 Flashcards
Afferent
towards CNS
Efferent
away from CNS
CNS neurotransmitters
ACh, GABA, dopamine, epinephrine, norepinephrine, serotonin, glutamate.
Primary PNS neurotransmitters
ACh, norepinephrine
Sympathetic nervous system transmitters
ACh, norepinephrine, dopamine, glutamine, epinephrine
Parasympathetic nervous system transmitters
ACh
alpha receptors
vasoconstriction, raises blood pressure, decongestion
beta-1 receptors
increase heart rate and contractive force of the heart.
beta-2 receptors
influence bronchodilation
Anticholinergic side effects
decreased GI motility decreased sweating decreased urination dilated pupil and blurred vision dry eyes dry mouth
Goals of anesthesia
amnesia
adequate muscle relaxation
adequate ventilation
pain control
malignant hyperthermia
rare but serious side effect of anesthesia that is associated with an increase in intracellular calcium levels causing a rapid rise in body temperature
dantrolene (Dantrium)
IV drug used to treat malignant hyperthermia, as well as a skeletal muscle relaxant to treat MS, stroke, cerebral palsy, and spinal cord injuries. Is thought to reduce muscle tone and metabolism. Is required to be in OR drug kits.
midazolam (Versed)
benzodiazepine that is used for induction, short procedures, and dental procedures. Has the fastest onset, greatest potency, and most rapid elimination of the benzodiazepines.
flumazenil (Romazicon)
antagonizes benzodiazepines by competing for receptor sites. it is used for complete or partial reversal of anesthesia.
naloxone (Narcan)
antagonizes benzodiazepines by competing for the opiate receptor sites. It has a greater affinity for the receptor than the narcotic, but its action is much shorter. Therefore this drug has to be administered repeated to obtain the desired effect.
nitrous oxide
Inhalant anesthetic, but not a very potent anesthetic. It is usually used with other agents. It reduces blood pressure and provides only analgesia. Is typically used in dental procedures
enflurane (Ethrane)
Inhalant anesthetic that has rapid induction and recovery Causes uterine relaxation so it cannot be used during labor.
propofol (Diprivan)
Injectable anesthetic, used for the maintenance of anesthesia, sedation, or treatment of agitation of patients.
changes urine color pink, green, or brown
its a white emulsion
fentanyl (Sublimaze)
Injectable anesthetic that is used extensively for open-heart surgery. Lozenge is used extensively with children and IV form in the OR. Has greater potency than morphine. Can also be administered as a patch which releases the drug into the bodies fat where it is slowly released.
alfentanil (Alfenta)
fentanyl derivative that is ultrashort acting (5-10 mins)
sufentanil (Sufenta)
fentanyl derivative five to ten times more potent than fentanyl
remifentanil (Ultiva)
fentanyl derivative that is the shortest acting opioid with a rapid offset.