Anesthesia

Question 1

5 primary effects of anestheisa

Answer 1

unconsciousness
amnesia
analgesia
inhibition of automatic reflexes
skeletal muscle relaxation

Question 2

Remifentanil is what class of drug

Answer 2

remifentanil

Question 3

thiopental is what class of drug

Answer 3

thiopental

Question 4

stages of anesthesia

Answer 4

induction, maintenance, recovery

Question 5

what is induction

Answer 5

time from initiation of anesthesia until desired concentration is achieved in brain

Question 6

What drug and what route used for induction

Answer 6

propofol IV

Question 7

when are opioids administered during anesthesia (ie what stage)

Answer 7

maintenance

Question 8

which opioid commonly administered during anesthesia

Answer 8

fentanyl

Question 9

what route for maintenance of anesthesia

Answer 9

inhaled and IV

Question 10

Excitatory ion channel targets for general anesthesia

Answer 10

ACh (nic and mus receptors), Glutamate, serotonin

Question 11

what is lipid theory?

Answer 11

correlate anesthetic potency w/ lipid solubility

Question 12

2 factors influencing inhaled anesthetics effiacy

Answer 12

concentration of agent in inspired gas and gas pressure, alveolar ventilation

Question 13

time to onset and time to recovery relationhipo to solubility

Answer 13

inversely related ie lower solubility= faster onset and recovery

Question 14

least soluble inhaled anesthetic

Answer 14

NO

Question 15

Most soluble anesthetic

Answer 15

halothane

Question 16

sevoflurane solubility range

Answer 16

low

Question 17

isoflurane solubility range

Answer 17

mid range

Question 18

alveolar-venous partial pressure pressure effect on anesthesia

Answer 18

larger the difference, the more anesthetic will be taken up by tissues and venous blood will have lower concentration than arterial blood which means that it will take to achieve equilibrium between general circulation and the brain

Question 19

which inhaled anesthetics is metabolized the most by the liver

Answer 19

halothane

Question 20

Minimal alveolar concentration (MAC) measures what?

Answer 20

potency

Question 21

which inhaled anesthetic is more potent

Answer 21

halothane

Question 22

which inhaled anesthetic is least potent

Answer 22

NO

Question 23

rate anesthetics according to potency

Answer 23

Halothane 0.74%
isoflurane

sevoflurane
NO

Question 24

what exactly does MAC measure

Answer 24

minimal alveolar concentration required to prevent responses to surgical incision in 50% of cases

Question 25

Stage 1 of anesthesia

Answer 25

analgesia from conventional to drowsy, count to 10 if you can (propofol is so fast that ususally skip this phase now)

Question 26

Stage 2 of anesthesia

Answer 26

excitement: delirium and possible combative behavior, increased irregular BP and respiration rate. Propofol reduces/eliminates this stage

Question 27

Stage 3

Answer 27

surgical anesthesia: loss of muscular tone and reflexes due to further CNS depression. breathing is regular and skeletal muscles relaxed. Need careful monitoring to ensure CNS is not depressed further

Question 28

Stage 4

Answer 28

death if no support

Question 29

inhaled anesthetics effect on brain

Answer 29

balance b/w decreased metabolic activityand the fact that Volatile anesthetics also cause cerebral vasodilation

Question 30

inhaled anesthetics effect on heart

Answer 30

halogenated= decreased contractility and MAP

Question 31

which anesthetics maintain CO as well as reduce preload and afterload?

Answer 31

isoflurane, desflurane, and sevoflurane

Question 32

inhaled anesthetics effect on lungs

Answer 32

rapid shallow breathing and respiratory depressants

Question 33

inhaled anesthetics effect uterus

Answer 33

halogenated= potent uterine muscle relaxants

Question 34

What are 3 compartments

Answer 34

blood, brain and viscera, and muscle/fat

Question 35

bevocaine and cocaine is what class and subclass

Answer 35

local anesthetic, ester, surface action

Question 36

procaine is what class and subclass

Answer 36

ester, short acting,

Question 37

tetracaine is what class and subclass

Answer 37

ester , long acting

Question 38

lidocaine is what class and subclass

Answer 38

amide, medium acting

Question 39

bupivocaine is what class and subclass

Answer 39

amide , long acting

Question 40

local anesthetics are weak acids/ bases

Answer 40

weak bases

Question 41

increased K levels increase/decrease efficacy of local anesthetics

Answer 41

increase

Question 42

increased Ca levels increase/decrease efficacy of local anesthetics

Answer 42

decrease

Question 43

how are esterLA metabolized

Answer 43

pseudocholinesterases

Question 44

how are amide LA metabolzed

Answer 44

liver, p450

Question 45

procaine half lfie

Answer 45

1-2 mintues

Question 46

lidocain half life

Answer 46

1.5 hours

Question 47

LA mechanism

Answer 47

block voltage dependent Na channels

Question 48

is ionized/ non-ionized form better at interactin w/ receptor

Answer 48

non ionized

Question 49

LA work better on narrower or thickier nerve fibers?

Answer 49

narrower

Question 50

LA work better on heavily myelinated fibers or non/lighlty myelinated

Answer 50

heavily

Question 51

LA work better on rapidly or slow firing nerves

Answer 51

rapid

Question 52

LA work better on peripheral nerves or nerve bundle

Answer 52

peripheral

Question 53

toxicity of LA

Answer 53

- CNS tox can cause convulsion which are treated w/ BZDs or barbs - Cardiovascular depression which are treated w/ lipid rescue therapy

Question 54

Isoflurane mechanism

Answer 54

potentites GABA and opens k channels

Question 55

Isoflurane blood: gas partition coefficient

Answer 55

1.4

Question 56

isoflurane MaC

Answer 56

1.4%

Question 57

sevoflurane blood:gas partition coeffiecit

Answer 57

0.69

Question 58

sevoflurane MAC

Answer 58

2%

Question 59

NO blood:gas partition coefficient

Answer 59

0.47

Question 60

Ketolorac only used less than 5 days because..

Answer 60

GI toxicity

Question 61

propofol mechanism

Answer 61

potentiates GABAa receptor activity

Question 62

major propofol inteteraction

Answer 62

allergies- eggs

Question 63

Etomidate pahrm calss

Answer 63

IV general anesthetic and adjunct to general; hypnotic w/ no analgesic

Question 64

Bupivacaine interactions

Answer 64

MAO-Is, ergot alkaloids w/ epinephrine