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Block 3 pharm > General Anesthesia > Flashcards

General Anesthesia Flashcards

1
Q

Stages of Anesthesia

A

Analgesia
Excitement
Surgical Anesthesia
Medullary Paralysis

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2
Q

Inhalation Anesthetics

A 
- Gas
NOS
- Liquid
Halothane
Enflurane
Isoflurane
Desflurane
Sevoflurane
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3
Q

IV Anesthetics

A 
Barbs
BZDs
Propafol
Ketamine
Etomidate
Opioids
**BEST RESULT: COMBO OF IV AND INHALED
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4
Q

Partial Pressure Gradient

A
  • Important for speed of induction of inhaled anesthetic
  • Blood/Gas Partition coefficient
  • More soluble anesthetic is to blood, higher the Partial pressure, slower the onset of action
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5
Q

Minimum alveolar Concentration

A
  • Concentration of Anesthetic which produces immobility in 50% of subjects exposed to a noxious stimulus
  • Higher the MAC = Lower Potency = Faster Induction = Faster Recovery
  • INC MAC: Hyperthermia, Hypernatremia
  • DEC MAC: Hypothermia, Hyponatremia, Hypotension, pregnancy, Drugs (Lithium, Lidocaine, Opioids, Alpha 2 Agonists)
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6
Q

Nitrous Oxide

A
  • MAC > 100%: Incomplete Anesthetic
  • Good analgesia
  • Rapid onset/recovery
  • Safest
  • Used in combo w/ other anesthetic
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7
Q

Halothane

A
  • Not Pungent (used for kids)
  • Bronchodilator
  • Medium rate of onset and recovery
  • Sensitizes the heart to epi-induced arrhythmias
    SE: Hepatitis
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8
Q

Isoflurane

A
  • Medium rate of onset and recovery
  • Induction and maintenance of Anesthesia
  • Can induce irregular Arrhythmias
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9
Q

Desflurane

A
  • MOST RAPID ONSET AND RECOVERY OF HALOGENATED GASES
  • Outpatient surgery
  • Maintenance of Anesthesia
    SE: Irritates throat of awake patients, salivation, bronchospasm, cough
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10
Q

Sevoflurane

A
  • Low Blood/Gas coefficient
  • Rapid onset and recovery
  • Outpatient surgery
  • Doesn’t irritate throat
  • Bronchodilator
  • Useful induction agent (kids)
    SE: Nephrotoxicity
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11
Q

Inhaled Pharmokinetics

A
  • DEC BP
  • INC RR, DEC TV
  • INC Cerebral blood flow
  • DEC RBF
  • DEC Hepatic Blood Flow
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12
Q

Inhalation Gases SE

A
  • Nephrotoxicity (Methoxy/En/Sevoflurane)
  • Malignant Hyperthermia: Mutate RYR, Ca2+ released, Prlonged Ca2+ release = Muscle Rigidity = INC Metabolism = INC Heat
  • Normally a genetic disorder but Volatile Liquids can have this effect - Rx: Dantrolene
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13
Q

IV Anesthetics

A 
Barbs
BZDs
Propafol
Etomidate
Ketamine
Opioids
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14
Q

Barbs

A

Thiopental, Methohexital
- Can produce unconsciousness and surgical anesthesia in less than 1 min
- Emerge from anesthesia in 10 mins
- DEC in Cerebral metabolism, Oxygen Utilization, Cerebral Blood flow
SE: Porphyria

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15
Q

BZDs

A

Diazepam, Lorazepam, Midazolam

  • Premedication for GA
  • Anxiolysis, Amnesia, sedation
  • MIDAZOLAM: More rapid, Shorter elimination half life, Inducing agent
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16
Q

Propofol

A
  • Same rate of onset as Barbs but quicker recovery
  • Pts feel better post op
  • Ambulatory Surgery
  • Prolonged sedation in Critical Care
    SE: Apnea, Hypotension during induction, Hypotonus, clinical Infxns
17
Q

Etomidate

A
  • 1 min induction
  • Short Duration
  • Little Effect on CV and Resp
  • Good CV Stability
  • Can cause Post-OP Nausea
18
Q

Opioids

A

Morphine, Fentanyl, Sufentanil, Alfentanil, Remifentanil

  • High dose = Post-Op resp depression
  • Remifentanil: Potent but short half life
  • Fentanyl Disadvantage = Pt Recall
19
Q

Neuroleptanalgesia

A
  • State of Analgesia and Amnesia

Fentanyl + Droperidol

20
Q

Neuroleptanesthesia

A

Fentanyl + Droperidol + N2O

21
Q

Ketamine

A
  • Blocks NMDA
  • “Dissociative Anesthetic” that makes cataleptic state
  • INC HR, BP, CO
  • INC Cerebral Blood Flow, oxygen consumption and ICP
    SE: Post OP Vivid dreams and illusions
22
Q

Local Anesthetics: Esters

A

Benzocaine
Procaine
Dimethocaine
- Metabolized in Plasma cells

23
Q

Local Anesthetics: Amides

A 
Lignocaine
Bupavicaine
Mepivicaine
Ropovicaine
Prilocaine
- Metabolized in Liver
24
Q

Local Anesthetics: Natural

A

Menthol
Cocaine
Saxitoxin

25
Q

Local Anesthetics: MOA

A
  • Na+ Inactivation

- Nerve Inactivation

26
Q

Local Anesthetics: Clinical Use

A
  • Acute Pain
  • Chronic Pain
  • Invasive Procedures
  • Surgery
27
Q

Local Anesthetics: Routes of Administration

A
  • Topical
  • Infiltration
  • Block
28
Q

Local Anesthetics: SE

A
  • Local
  • CNS
  • CVS
  • Hypersensitivity
  • Methemoglobinemia

Block 3 pharm (10 decks)

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