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pharmacology > Week 8 - CNS Anaesthetics > Flashcards

Week 8 - CNS Anaesthetics Flashcards

1
Q

What are the 3 main effects of Anaesthesia?

A

Unconsciousness
Loss of response to painful stimuli
Loss of reflexes

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2
Q

What are the 3 main targets of Anaesthesia?

A

Thalamus
Cortex
Hippocampus

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3
Q

What are the 4 stages of anaesthesia?

A

1 - Analgesia
2 - Delerium
3 - Surgical anaesthesia (4 planes)
4 - Medullary paralysis (multi-systems failure)

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4
Q

What are the characteristics of Stage 1: Analgesia?

A
  • conscious
  • all reflexes
  • inability to feel pain
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5
Q

What are the characteristics of Stage 2: Delerium?

A
  • Vomiting, Salivation, Coughing
  • Increased tone, BP, HR
  • loss of awareness
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6
Q

What are the characteristics of Stage 3: Surgical anaesthesia; Phase 1 & 2?

A
  • regular breathing rhythm
  • progressive reduction in tidal vol
  • pupils larger
  • depressed vomoting, withdrawal, corneal reflex
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7
Q

What are the characteristics of Stage 3: Surgical anaesthesia; Phase 3?

A
  • Used for surgery
  • Regular breathing rhythm
  • Small tidal vol
  • pupils 3/4 dilated
  • depression of laryngeal (gag) reflex
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8
Q

What are the characteristics of Stage 3: Surgical anaesthesia; Phase 4?

A
  • irregular, diaphragmatic shallow breathing
  • pupils fully dilated
  • depression of cranial and anal sphincter reflex
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9
Q

What are the characteristics of Stage 4: Medullary paralysis?

A
  • Respiratory failure
  • Cardiovascular failure
  • Lack of pupillary reflex
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10
Q

What is the aim of surgical anaesthesia regarding the 4 Stages?

A

To move from Stage 1 to 3 quickly, avoiding stage 2.

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11
Q

How is moving from Stage 1 to 3 quickly and avoiding stage 2 acheived?

A
  • By a combination of inhalation and IV

- a rapid IV induction, maintained by inhalation

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12
Q

What are the type of anaesthetics?

A
  • opiates and alcohol (used for centuries)
  • inhalation (maintenance)
  • Parentally/IV (induction)
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13
Q

What are the main types of Inhalation anaesthetics??

A

-Nitours Oxide (gas)
-Halogenated hydrocarbons (liquid)
Eg Halothane

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14
Q

What are the main types of Intravenous anaesthetics?

A
  • Barbiturates
  • Propofol
  • Ketamine
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15
Q

What are the characteristics of Inhalation Anaesthetics?

A

-most common
-takes minutes to act
-depth of anaesthesia realted to amount in CNS
–hard to predict with gas
- clearance via lungs
Eg. Halothane, Nitrous Oxide, Xenon

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16
Q

What are the characteristics of Nitrous Oxide?

A
  • poor anaesthetic
  • good analgesic
  • low toxicity for acute usage
17
Q

What are the characteristics of Halothane?

A

-used with nitrous oxide
-deep anaesthesia at low [] (2%)
Can cause
-dysrhythmias
-liver damage

18
Q

What are the characteristics of IV anaesthetics?

A
  • used for induction
  • act rapidly (20s)
    eg. thiopental, propofol
19
Q

What are the characterisitics of Thiopental?

A
  • Barbituate CNS depressant
  • highly lipid soluble = pass BBB
  • Blood [] decrease rapidly (80% in 2mins)
  • Long duration effect due to leeching from adipose tissue.
20
Q

What are the characteristics of Propofol?

A
  • similar to Thiopental
  • fast acting w/ rapid metabolism
  • rapid recovery, less hangover
21
Q

What are the characteristics of Ketamine?

A
  • not a barbituate
  • Blocks glutamate receptors
  • blocks ion channels opened by ACh
  • muscle tone and respiration remain normal.
22
Q

What are 3 types pre-anaesthetic adjuvants?

A
  • Benzodiazapines
  • Analgesics
  • Antimuscurinics
23
Q

What is the aim of using Benzodiazapines as a pre-anaesthetic adjuvant?

A
  • Relieve anxiety

- Produces some amnesia

24
Q

What is the aim of using Analgesics as a pre-anaesthetic adjuvant?

A

Relieves anxiety

Provides post op. analgesia

25
Q

What is the aim of using Antimuscurinics as a pre-anaesthetic adjuvant?

A

Reduce bronchial and salivary secretions

Also gives some amnesia

26
Q

What are 3 types post-operative adjuvants?

A
  • Analgesics
  • Cholinergic agonists
  • Antagonists of neuromuscular blockers
27
Q

What is the aim of using Analgesics as a post-operative adjuvant?

A

Reduce pain

28
Q

What is the aim of using Cholinergic agonists as a post-operative adjuvant?

A

treat post-operative constipation and urinary retention

29
Q

What is the aim of using Antagonists of neuromuscular blockers as a post-operative adjuvant?

A

Used if spontaneous breathing does not recommence

pharmacology (37 decks)

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