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DIT Recommended Course Order > Video 14 Anesthetics > Flashcards

Video 14 Anesthetics Flashcards

1
Q

What are the two main characteristics of the inhaled anesthetics?

A

Lipid and blood solubility.

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2
Q

Which are the effects of the inhaled anesthetics?

A

Myocardial and respiratory depressions, nauseas/emesis, increased cerebral blood flow (decreased cerebral metabolic demand).

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3
Q

What is the toxicity effect of the Halothane?

A

Hepatotoxicity.

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4
Q

What is the toxicity effect of the methoxyflurane?

A

Nephrotoxicity.

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5
Q

What is the toxicity effect of the enflurane?

A

Proconvulsant

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6
Q

What is the toxicity effect of the N2O?

A

Expansion of trapped gas in a body cavity.

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7
Q

What is a malignant hyperthermia?

A

Rare, life-threatening hereditary condition in which inhaled anesthetics (except N2O) and Succinylcholine induce fever and sever muscle contractions.

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8
Q

What is the treatment for malignant hyperthermia?

A

Dantrolene

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9
Q

Which group of anesthetics induce unconsciousness but do not provide analgesia?

A

Intravenous anesthetics

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10
Q

Which are the characteristics of Propofol?

A

1) Used in sedation in ICU.
2) Rapid onset: 15 to 20 seconds.
3) Potentiates GABA.
4) High triglyceride content.

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11
Q

What is the mechanism of the Arylcyclohexylamines (Ketamine)?

A

PCP analogs that act as a dissociative anesthetics.

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12
Q

Which are the uses for ketamine?

A

Analgesia, conscious sedation, induction.

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13
Q

Whic are the characteristics of ketamine?

A

1) Dissociative anesthetics.
2) Block NMDA receptors.
3) Cardiovascular stiumlants.
4) Increased cerebral blood flow.

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14
Q

Which are the side effects of the ketamine?

A

At high doses cause disorientation, hallucination, bad dreams.

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15
Q

What is the IV anesthetic that increased duration of GABA receptor Cl- channel stays open?

A

Barbiturates.

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16
Q

Which are the characteristics of the thiopental?

A

High potency, high lipid solubility, rapid entry into brain.

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17
Q

What are the uses of the barbiturates?

A

Used for induction of anesthesia and short surgical procedures.

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18
Q

Which is the main characteristic of the barbiturates?

A

Decreased cerebral blood flow.

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19
Q

Which are the characteristics of the Phenobarbital?

A

1) Liver enzyme induction.

2) Treatment: Crigler-Najjar syndrome type II.

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20
Q

At what group of anesthetic belong diazepam, alprazolam, midazolam?

A

Benzodiazepines.

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21
Q

Which is the anesthetics that increased frequency of GABA receptor CI- channel opening and facilitate inhibitory effect of GABA?

A

Benzodiazepines

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22
Q

Which are the side effects of the benzodiazepines?

A

Conscious sedation, anesthesia, alcohol withdrawal, anxiety, seizures, insomnia and night terrors.

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23
Q

How do you treat the overdose of benzodiazepines?

A

Treat overdose with Flumazenil.

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24
Q

What is the most common drug used for endoscopy?

A

Midazolam

25
Q

Which are the 3 receptors of Opioid?

A

1) Mu.
2) Delta.
3) Kappa.

26
Q

What are the endogenous opioid agonists?

A

1) Mu receptor: Beta-Endorphin.
2) Delta receptor: Enkephalins.
3) Kappa receptor: Dynorphin.

27
Q

What is the opioid that causes less respiratory depression?

A

Buorphanol.

28
Q

What is the opioid that causes cough suppressant?

A

Dextromethorphan

29
Q

What is the opioid that is non-addictive analgesic?

A

Tramadol

30
Q

What are the opioids that are used as antidiarrheals?

A

Loperamide and diphenoxykate.

31
Q

Which are the antagonist opioid receptors?

A

Naloxone and Naltrexone.

32
Q

Which are the 6 non-depolarizing neuromuscular blockers?

A

1) Tubocurarine.
2) Atracurium.
3) Mivacurium.
4) Vecuronium.
5) Pancuronium.
6) Rocuronium.

33
Q

Which are the two categories for neurmomuscular blockers drugs?

A

1) Depolarizing.

2) Nondepolarizing.

34
Q

What is the mechanism of the Nondepolarizing neuromuscular blocking drugs?

A

Competitive antagonist -compete with ACh for receptors.

35
Q

What is the neostigmine function?

A

Reversal of blockade.

36
Q

What is the succinylcholine mechanism?

A

It is an strong ACh receptor agonist; produces sustained depolarization and prevents muscle contraction.

37
Q

What are the reversal of blockade phases in Depolarizing neuromuscular blocking drugs?

A

1) Phase I (Prolonged depolarization) -No antidote. Block potentiated by cholinesterase inhibitors.
2) Phase II (repolarized but blocked; ACh receptors are available, but desensitized) -Antidote is cholinesterase inhibitors.

38
Q

Which are the complications of the Depolarizing neuromuscular blocking drugs?

A

Complications include hypercalcemia, hyperkalemia, malignant hyperthermia.

39
Q

What are the characteristics of the phase I block?

A

1) Normal dose.
2) Rapid onset.
3) Lasts about 10 minutes.
4) Cannot be antagonized.

40
Q

Which are the characteristics for phase II block?

A

1) Larger dose.
2) Characteristics similar to Nondepolarizing blockers.
3) Can be antagonized by cholinesterase inhibitors (neostigmine).
4) Can last from 20-30 minutes up to a few hours.

41
Q

What are the characteristics of the malignant hyperthermia?

A

1) Muscle rigidity.
2) Hyperthermia.
3) Caused by giving inhaled anesthetic + succinylcholine to susceptible patient (RYR1 gene mutation).

42
Q

What is the treatment for patients with malignant hyperthermia?

A

1) Cool patient.
2) Sedation.
3) Dantrolene.

43
Q

What is the mechanism of the Dantrolene?

A

Prevents the sarcoplasmic reticulum from releasing Ca2+ resulting in muscle relaxation.

44
Q

What is the clinical use of Dantrolene?

A

1) Malignant hyperthermia.

2) Neuroleptic malignant syndrome.

45
Q

Which are the local anesthetics?

A

Lidocaine, procaine and cocaine.

46
Q

What is the mechanism in the local anesthetics?

A

1) They do not work well in acidic tissue.
2) Order of blockade. ( 1st Small myelinated, 2nd Small unmyelinated and 3rd Large myelinated).
3) They give with a local vasoconstrictor.

47
Q

Which anesthetic, IV, assocIated with Hallucinations and bad dreams?

A

Ketamine

48
Q

Which anesthetic, IV, most common drug used for conscious sedation?

A

Midazolam

49
Q

Which anesthetic inhaled, side effect of hepatotoxicity?

A

Halothane.

50
Q

Which anesthetic,IV, used for rapid anesthesia induction and short duration of action?

A

Propofol.

51
Q

Which anesthetic, IV, decreased cerebral blood flow (important in brain surgery)?

A

Barbiturates

52
Q

Which anesthetic, opioid that dose not induce histamine release?

A

Fentanyl.

53
Q

Which anesthetic, high triglyceride content, increases the risk of pancreatitis with long-term use?

A

Propofol.

54
Q

What is the mechanism of action of Dantrolene?

A

Prevents of release of calcium from the sarcoplasmic reticulum of skeletal muscle.

55
Q

What is the mechanism of action of local anesthetics?

A

Block sodium channels

56
Q

Which nerve fibers are blocked first with local anesthesia?

A

1) Small myelinated.
2) Small unmyelinated.
3) Large myelinated.
4) Large unmyelinated.

57
Q

What drugs can be reverse neuromuscular blockade?

A

Cholinesterase inhibitors (neostigmine)

58
Q

What is the mechanism of action of Vecuronium?

A

Non-Depolarizing neuromuscular blocker that competitively inhibits cholinergic neurotransmission at the neuromuscular junction.

59
Q

Which are the 3 main components of any anesthesia?

A

1) Amnesia.
2) Analgesia.
3) immobilization.

DIT Recommended Course Order (21 decks)

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