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neuro II > anesthesia > Flashcards

anesthesia Flashcards

1
Q

which inhaled anesthetic produces analgesia? which maintains protective CO2 reflex?

A

nitrous oxide for both

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2
Q

which inhaled anesthetic is not as lipid soluble as the others? what is the result? how is that taken advantage of?

A

nitrous oxide
reaches saturation rapidly
mass effect: coformulated with other agents

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3
Q

which inhaled anesthetic has no effects on CV system? what is the exception to that?

A

nitrous oxide

opioids can block reflexive sympathetic effects and unmask depressive effects

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4
Q

which inhaled anesthetic is most responsible for diffusional hypoxia on termination?

A

nitrous oxide

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5
Q

what does the initial administration of anesthetics show?

A

period of delirium:
exaggerated mechanics of respiration, breath holding
increased muscle tone and BP, mydriasis

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6
Q

why would analgesics be routinely used in anesthesia?

A

loss of memory and perceptive awareness may precede analgesia

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7
Q

which inhaled anesthetic has greatest potency? why?

A

halothane: lowest MAC

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8
Q

why can’t nitrous oxide be used alone?

A

MAC = 105%

incomplete anesthetic: requires supra-atmospheric pressures to work on own

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9
Q

which inhaled drugs work fastest? why?

A

N2O>desflurane>sevoflurane

less lipid soluble->lower blood:gas partition coefficient

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10
Q

besides lower blood:gas partition coefficients, why else do the newer inhaled drugs work faster?

A

lower brain:blood partition coefficients

enter brain faster

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11
Q

irritating odor is adverse effect of which anesthetics?

A

enflurane, isoflurane, desflurane

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12
Q

which inhaled anesthetics produce muscle relaxation?

A

enflurane and isoflurane

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13
Q

which inhaled anesthetic is pro-arrhythmogenic? why?

A

halothane: sensitizes heart to catecholamines

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14
Q

what is a unique toxicity of halothane?

A

halothane hepatitis

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15
Q

which inhaled anesthetic is pro-epileptic in susceptible individuals?

A

enflurane

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16
Q

what are two unique adverse effects of N2O?

A

diffusional hypoxia

increased pressure in gas-containing areas of body

17
Q

which drugs cause malignant hyperthermia? what is the antidote?

A 
volatile anesthetics (not N2O)
dantrolene
18
Q

what is thiopental and what is it used for?

A

barbiturate

IV induction of anesthesia

19
Q

what is propofol and what is it used for? what is worrying about its MOA?

A

IV induction of anesthesia
blocks NMDA glutamate receptors, GABA agonist
at high concentrations, acts in place of GABA

20
Q

what is unique about ketamine? what is its mechanism of action?

A

dissociative anesthetic: dissociates cortex from external environment
NMDA glutamate antagonist

21
Q

what are the longest and shortest acting benzodiazepines used in IV anesthesia?

A

longest: diazepam
shortest: midazolam

22
Q

which opioid used in anesthesia produces ultra-short acting analgesia? long-acting? just short?

A

remifentanil
morphine
fentanyl

23
Q

what is the risk with the formation of lipid-soluble IV anesthetics?

A

surfactants can cause thrombophlebitis

24
Q

which IV anesthetics act on glutamate NMDA receptors?

A

propofol and ketamine

25
Q

etomidate

A

GABA agonist

26
Q

which IV anesthetic’s are most and least stored in fat?

A

most: diazepam, thiopental
least: etomidate

27
Q

what are the effects of thiopental, etomidate, and propofol on CBF, oxygen requirements, and ICP? exception?

A

decrease them all

ketamine: increases CBF and ICP, no effects on O2 requirements

28
Q

which IV anesthetics increase HR? what is their effect on CO and MAP?

A

propofol and thiopental

decrease CO and MAP

29
Q

which IV anesthetic is good for cardiac patients? why?

A

etomidate

no effects on heart of vasculature

30
Q

what drug causes a fatal CV and multi-organ failure of unknown etiology?

A

propofol infusion syndrome

31
Q

what drug inhibits steroidogenesis, potentially fatally?

A

etomidate

32
Q

what IV anesthetic preserves important protective reflexes and is an analgesic?

A

ketamine

33
Q

what drug produces hallucinations when awakening?

A

ketamine

34
Q

what local anesthetic is used in dental procedures with epi? why?

A

articaine

supposed better penetration of bone

35
Q

what topical anesthetics can be applied to mucous membranes? which can’t?

A

benzocaine and dyclonine

dibucaine and pramoxine

36
Q

what drugs might be administered with local anesthetics to increase efficacy?

A

epinephrine or levnordefrin

vasoconstrictors

37
Q

what drug might be administered to speed recovery from local anesthesia? why?

A

phentolamine

alpha-blocker->dilate vasculature

38
Q

methemoglobinemia is primarily seen with which anesthetic? what other drug? how can it be reversed?

A

prilocaine and benzocaine to lesser extent

methylene blue or ascorbic acid

39
Q

what local anesthetics have greatest and least chance of cardiotoxicity and why?

A

greatest: bupivacaine, long-acting
least: ropivacaine, short-acting

neuro II (5 decks)

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