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AB 4th Year Acute Care + Anaesthetics > Anaesthetics > Flashcards

Anaesthetics Flashcards

(60 cards)

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1
Q

when is an RSI done?

A

high aspiration risk

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2
Q

what are the three aspects of an anesthetic?

A

analgesia
hypnosis
muscle relaxant

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3
Q

what happens in an RSI?

A

5 mins of preoxygenation
pressure on cricoid cartilage (prevent aspiration)
induction + muscle relaxant
intubated

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4
Q

what are the components of an RSI?

A

analgesia - fentanyl
anaesthetic/induction - propofol
muscle relaxant - suxamethonium

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5
Q

in a GA, what is given to make sure patient can ventilate themselves?

A

volatile agents

e.g NO

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6
Q

where does the spinal cord run to?

A

L1 (adults)

L3 (kids)

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7
Q

what level is the iliac crest?

A

L4/5

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8
Q

where does epidural go?

A

to epidural space (between dura and spinal cord)

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9
Q

where does spinal go?

A

subarachnoid space (CSF flows out)

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10
Q

what does an epidural pass through?

A 
skin
subcut tissue
supraspinous lig
inerspinous lig 
lig flavum 
epidural space
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11
Q

who should be intubated?

A 
GCS <8
obese
pregnant
reflux
non fasted
length 
DM
trauma
laparoscopic surgery 
acutely unwell
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12
Q

what are the short vs long acting locals?

A 
short = lidocaine
long = bupivacaine
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13
Q

who and where should adrenaline not be given?

A

fingers/ears/toes

those on MAOis/TCAs

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14
Q

who is at higher risk of local anaesthetic toxicity? what does it cause?

A

liver problems/low protein

CNS overactivity/depression/arrythmias

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15
Q

what does propofol work on?

A

works on GABA

anaesthetic

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16
Q

side effects of propfol?

A

hurts to inject
stops upper airway reflex
myocardial depression

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17
Q

what is atracurium? do you get fasciculations?

A

long acting muscle relaxant

NO

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18
Q

what is suxamethonium? do you get fasciculations?

A

short acting muscle relaxant (depolarising agent)

YES

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19
Q

how long should warfarin be withheld for pre op?

A

5 days (check INR)

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20
Q

what is the INR aim for surgery?

A

≤1.5

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21
Q

what is the warfarin reversal agent?

A

vit K

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22
Q

when can warfarin be given post op?

A

same day

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23
Q

when should heparin be stopped pre op?

A

6 hours unfrac

24 hours LMWH

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24
Q

who should not have anticoagulants stopped?

A

VTE <3mnths
mechanical valves
AF/valve disease with Hx thrombosis

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25
when should clopidogrel be stopped pre op?
7 days
26
what cardiac drugs should be withheld on the day of surgery? why?
ACE AKI and hypotension risk
27
how should T1DM be managed pre op?
fasted and first on list take long acting but not short give post op once eaten
28
how should T2DM be managed pre op?
fasted and first on list withold oral hypo on day give metformin after once renal function is checked
29
difference between HDU and ICU?
``` HDU = single organ failing ICU = multiple ```
30
difference between CPAP and BIPAP?
CPAP - pressure doesn't change BIPAP - less pressure when breathing out/more breathing in
31
where are CVC usually inserted?
IJV subclavian femoral
32
what do inotropes do vs chronotrope?
inotropic - increase contractility | chronotrope - rate
33
examples of inotropic drugs?
adrenaline | dobutamine
34
how does adrenaline work?
attaches to B1 receptors | increases force and rate of contraction
35
examples of vasopressors? what do these do?
NA adrenaline make blood vessels contract to try increase BP
36
what is classified as chronic pain?
>3 months
37
pain ladder?
non opiod + adjuvant opiod + non + adjuvant opiod + non + adjuvant
38
what are the mid vs stronger opiods?
mid = codeine, tramadol, oxy strong = morphine, oxy, methadone, fentanyl
39
what can be used as pain adjuvants? what drug class are these?
amitryptilline (TCA) duloxetine (SNRI) anticonvulsants
40
what is the pain rating scale?
``` 0 = no pain at rest or movement 1 = no pain at rest, slight on movement 2 = intermittent at rest, moderate on movement 3 = continuous at rest, severe on movement ```
41
what is a normal paracetamol dose?
1g 6 hourly
42
what is a fast onset opiod?
oxycodone
43
what is a less addictive opiod?
tramadol
44
what is a normal PCA dose?
morphine 1mg with 5 min lockout (12mg per hour)
45
e.g of a depolarising and non depolarising muscle relaxant?
depolarising - suxamethonium non depol - rocuronium
46
how do histamine antagonists work?
block H1 receptors in the CNS cause sedation e.g cyclizine
47
how do dopamine antagonists work?
binds to D2 receptors and relaxes the gut (promotility)
48
how do 5HT3 antagonists work?
antagonise 5HT3 receptors in the CNS/GI tract
49
what type of drug is hyoscine bromide?
anti muscarinic (anti emetic)
50
how long should the COCP be stopped before surgery?
2 weeks
51
if on warfarin pre op, what can this be changed to?
heparin
52
if on insulin, what should be done with this pre op?
stop on day | give a glucose, K, and insulin infusion
53
what anaesthetics are more likely to make people sick?
opiods NOS ketamine
54
how to check if patient is intubated and not in oesophagus?
chest air entry chest movement capnography (flat - no CO2 detected) no steam on mask
55
what happens in local anaesthetic toxicity?
``` peri oral tingling numb anxiety lightheaded collapse ```
56
what layers does an epidural pass through?
``` skin subcut tissue supraspinous interspinous ligamentum flavum epidural space ```
57
what layers does a spinal pass through?
``` skin subcut tissue supraspinous interspinous ligamentum flavum dura into subarachnoid space ```
58
layers of the spinal cord?
dura arachnoid pia
59
``` e.g of a dopamine antagonist 5HT3 antagonist H1 antagonist anti muscarinic ? ```
dopamine = metaclopramide 5HT3 = ondansetrone H1 = cyclizine anti muscarinic = hyoscine bromide
60
e.g of drowsy and non drowsy anti histamines?
drowsy = chlorampenicol | non drowsy = cetirizine

AB 4th Year Acute Care + Anaesthetics (8 decks)

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