Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IC Part II > Anesthesia > Flashcards

Anesthesia Flashcards

1
Q

-from administration to loss of consciousness, decreased awareness of pain, may have some amnesia and decreased consciousness

A

stage1 - analgesia stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
  • from loss of consciousness to regular respiration
  • excitation and delirium may occur
  • amnesia occurs
  • vomiting and incontinence possible
A

stage 2 - disinhibition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
  • from regular respiration to respiratory arrest
  • patient unconscious, no pain reflexes
  • respiration and blood pressure maintained
A

stage 3 -surgical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
  • from respiratory arrest to death

- requires mechanical and pharmacological support

A

stage 4 - medullary paralysis stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
  • very controllable, readily reversible
  • induction not as fact or smooth as with fixed agents
  • depress spontaneous and evoked neuronal activity
  • act at voltage gated K channels, GABAa receptor chloride channels resulting in hyperpolarization
A

inhalable anesthetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
  • insufficient potency for surgical anesthesia
  • has analgesic activity
  • can be used as carrier for volatile anesthetics
  • decreases methionine synthetase with chronic exposure and can cause megaloblastic anemia
A

nitrous oxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

halothan, enflurance, desflurane, isoflurane, sevoflurane

A

volatile inhaled anesthetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

anesthetic concentration in the inspired air is proportional to _________, with higher resulting in more rapid achievement of anesthetic concentrations in blood

A

partial pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

blood:gas partition coefficient?

A

Otswald

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

lower Otswald coefficient leads to _______ equilibrium with the rbain

A

faster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

the partial pressure of anesthetics with _______ solubility in blood are more affected by ventilation rate

A

higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

the concentration of anesthetic in the inspired air at equilibrium when there is no response to a skin incision in 50% of patients

A

minimum alveolar concentration (MAC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

higher MAC = ______ potent

A

less

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

inhaled anesthetic that depresses myocardium, has liver toxicity

A

halothane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
  • barbiturates, IV/fixed anesthetics
  • rapid induction
  • no analgesia*, pain on injection
  • decrease in respiration, difficult to control level of anesthesia
  • redistributes, accumulates in adipose
A

thiopental, methohexital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
  • IV/fixed anesthetic
  • acts at GABAa receptors, increase channel open time
  • more rapid recovery than barbiturates, 10X faster hepatic metabolism
  • maintenance and induction anesthesia
  • used for OP procedures
  • significant decrease in BP and blunts baroreceptor reflex, decreases respiration
A

propofol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q
  • used for induction and balanced anesthesia, esp in patients at risk for hypotension
  • minimal CV/resp depression
  • no analgesic activity
  • not recommended for long term infusion
  • high incidence of nausea, vomiting, pain on injection, myoclonus
A

etomidate

18
Q
  • dissociative anesthesia, catatonia, analgesia, amnesia w/o loss of consciousness
  • blocks NMDA glutamate receptor ion channel
  • short duration of action
  • excellent analgesia and amnesia
  • mydriasis, salivation, lacrimation, spontaneous limb movements
  • cardiac stimulation
  • increases cerebral blood flow
  • emergence phenomenon - hallucinations and disorientation, can decrease w/ benzodiazepines
  • use limited mainly to small children, patients at risk for hypotension and bronchospasm
A

ketamine

19
Q
  • shortest acting benzo, least irritating for IV admin
  • used in combo with inhaled agent or IV opioids
  • can be used for maintenance of anesthesia with other agents as part of general or conscious sedation
  • rapid onset and recovery
  • good amnestic effects
  • antagonist flumazenil can accelerate recovery
  • induction too slow to induce anesthesia
A

midazolam

20
Q
  • opioid, can achieve anesthesia with sufficient dose or in combo with benzodiazepines
  • useful in patients with compromised CV function
  • provides excellent post op analgesia
  • can cause truncal rigidity, impair ventilation
A

fentanyl

21
Q
  • minimize anesthetic use
  • good for ortho procedures
  • short acting good for intubations, ECT
  • should never be used as substitute for inadequate anesthesia
A

neuromuscular blocking agents (paralytics)

22
Q
  • d-tobucurarine, mivacarium, rocuronium

- potency altered by pH, increases in histamine release

A

competitive nicotinic antagonists

23
Q
  • depolarizing nicotinic agonist
  • short duration of action
  • desensitization follows with long term exposure
A

succinylcholine

24
Q
  • no effect on motor end plate depolarization
  • no effect on striated muscle
  • small muscles affected first
  • additive w/ d-tobucurarine
  • reversal of block with physostigmine
  • increased potency w/ inhaled anesthetics and antibiotics
A

competitive neuromuscular blockers

25
Q
  • partial persistent depolarization at motor end plate
  • fasciculations of striated muscle
  • skeletal muscle affected first
  • antagonistic effect with d-tobucurarine
  • no antagonism w/ physostigmine
  • no effect with inhaled anesthetics or antibiotics
A

depolarizing neuromuscular blockers

26
Q

-most paralytics cause _______ release leading to hypotension and bronchospasm, most pronounced with d-tobucurarine

A

histamine

27
Q

succinylcholine cause muscle pain due to ________

A

fasciculations

28
Q
  • opioids
  • local anesthetics - increase potency of both competitive and depolarizing agents
  • anticonvulsants
  • CV drugs
  • antibiotics (esp. aminoglycosides, increase potency and duration of competitive antagonists)
  • inhalable anesthetics esp isoflurance increase potency and duration
A

drug interactions with neuromuscular blockers

29
Q
  • block nerve conduction by blocking voltage gated sodium channels, thus preventing depolarization and conduction of the cation potential
  • charged anesthetic molecules gain access to the channel when it is open
  • efficacy is use dependent,
  • also block K channels at higher concentrations
A

local anesthetics

30
Q

local anesthetics order of block?

A

pain –> cold/warm/touch/deep pressure –> muscle tone/proprioception/motor function

31
Q
  • penetrates membranes, vasoconstrictor, medium acting

- ester, used topically for nasal and opthalmic procedures

A

cocaine

32
Q
  • ester, surface use only, very lipophilic

- burns, bites, hemorrhoids, cather, endoscope placement

A

benzocaine

33
Q

-amide, most widely used, medium acting

A

lidocaine

34
Q
  • amide, medium acting

- vasoconstricts, slightly longer lasting

A

mepivicaine

35
Q

long acting amides

A

bupivicaine, ropivicaine

36
Q

potency of local anesthetics affected by ______

A

pH

37
Q

local anesthetics are weak bases, the _______ form is required to penetrate the membrane to gain access to the channel inside the cell membrane
-potency decreased at low pH (infected tissues)

A

unprotonated

38
Q
  • duration of action of local anesthetics proportional to time drug is in contact with the nerve
  • more ________ leads to shorter action, greater systemic absorptin
  • use epi to increase duration
A

vascularization

39
Q
  • CNS: sleepiness, lightheaded, restlessness, nystagmus and myoclonus, tonic clonic seizures with esters, direct neurotoxicity with spinal admin due to pooling in cauda equina
  • CV: depression, hypotension, cocaine can cause HTN, arrythmias, myocardial failure
  • allergic rxns with esters
A

local anesthetic adverse effects

40
Q

______ syndrome tends to occur with continuous spinal anesthesia

A

cauda equina

IC Part II (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions