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Pharm 2 > Lect 5 > Flashcards

Lect 5 Flashcards

1
Q

Minimal sedation

A

Anxiolysis

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2
Q

Minimal sedation is

A

Responsive to verbal stimulation

Airway, spontaneous ventilation and CV function unaffected

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3
Q

Moderate Sedation

A

Conscious sedation

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4
Q

Moderate sedation is

A

Purposefully responsive to verbal or tactile stimulus

Airway intervention not required-adequate spontaneous ventilation

CV function usually maintenaned and monitored

GDs cannot purposely put people into moderate sedation

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5
Q

Deep Sedation

A

Purposefully responsive after repeated or painful stimulus

Airway intervention may be required

CV function usually maintained

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6
Q

General anesthesia

A

Unarousable even with painful stimulus

Airway intervention often required

CV function may be impaired

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7
Q

GA ideal anesthetic

A

Sedation/Anxiolysis
Amnesia
Muscle relax and reflexes suppressed
Analgesia

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8
Q

Balanced anesthesia

A

No single ideal anesthetic exist

Optimal situation combining:
Preoperative meds, IV + inhaled anesthetics

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9
Q

Stage I

A

Induction
Analgesia

Pupils: Normal size react to light
Normal respiration and HR

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10
Q

Stage II

A

Excitement delirium

Pupils: Dilated disconjugated

RR Rapid irregular

HR tachycardia
Laryngospasm, vomit/retch

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11
Q

Stage III

A

Surgical anesthesia

Pupils constricted
Respiration and HR normal
4 planes

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12
Q

Stage IV

A

Medullary paralysis, death

Pupils fixed dilation
Apnea
Profound bradycardia

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13
Q

Inhalational gases

A 
Halothane
Isoflurane
Sevoflurane
Desflurane
NO

All are halogens except nitrous

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14
Q

Halothane

A

Max .74%

Blood/Gas coefficient 2.4

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15
Q

Isoflurane

A

Pungent odor
Coronary vasodilation but SAFE for lungs and heart

Max 1.2%
BGC 1.4

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16
Q

Sevoflurane

A

Sweet smelling
No airway irritation
Coronary vasodilation
Compound A formation

MAC 2%
BGC .65

17
Q

Desflurane

A

Extremely irritating
Tachycardia
CO formation

MAC 5.8%
BGC .42

18
Q

Nitrous

A

Extremely safe
N/V concern
Decrease tidal volume
Increase RR

MAC 104%
BGC .47

19
Q

NO concerns

A

Nonflammable but supports combustion

DNA synthesis affected
Spontaneous abortion
Abuse potential
Altered hematopoietic

20
Q

NO expands

A

In closed air spaces

21
Q

NO cant be used if

A

Eye surgery in last 6 weeks
Do not use in congested child

Not for previous ear surgery

22
Q

MAC

A

Minimal alveolar concentration

G to prevent 50% people from moving to surgical stimulus

23
Q

MAC potencies

A

Halothane< isoflurane

24
Q

Blood Gas Coefficient

A

Higher coefficient —>higher solubility slower onset

25
Q

BGC lower coefficient

A

Faster onset

Precipitate binds to brain and makes you fall asleep

26
Q

BGC fastest to showers

A

Desflurane< NO2< Sevoflurane

27
Q

IV anesthetics allow for

A

Trifurcation unlike oral sedatives

28
Q

GABAa

A

Ligand gated ion channel binds GABA—> Increase Cl permeability —>difficult to depolarize—>decrease membrane potential- makes it more - inhibiting neuronal excitation

29
Q

Barbiturates

A

Not used much

rapid onset and offset
Causes excitatory phenomenon hiccups

Methohexital

30
Q

Propofol

A

White milk of amnesia

Rapid onset
8 min distribution 1/2 life, pain of injection

Hepatic and extra hepatic metabolism

Profound hypotension and apnea

31
Q

Etomidate

A

Rapid onset severe pain on injection and N/V
CV stability
24h adrenal suppression

32
Q

NMDA

A

Ion channel protein activated by glutamate or glycine—> Ca passage into cells

33
Q

NMDA blocking’s the R prevents

A

Depolarization

Induces dissociated anesthesia

34
Q

Ketamine

A

NMDA

PCP derivation that antagonizes NMDA R

Profound

Binds to Mu

Nystagmus
Emergence delirium

Pharm 2 (6 decks)

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