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System Screenings I > Anesthesia > Flashcards

Flashcards in Anesthesia Deck (52):
1

As a PT, why should you care about anesthetics?

Pts have used anesthetics, and the effects can last days after surgery; PTs can administer anesthetics (phonophoresis, iontophoresis)

2

Patient is not conscious; Effect is on the whole body; Used for more extensive surgical procedures

General anesthesia

3

Patient is conscious; used in surgery of relatively small, well defined area or surgery where pt needs to remain conscious

Local anesthesia

4

Name 6 requirements that most general anesthetics meet

1. Loss of consciousness and sensation
2. Amnesia
3. Skeletal muscle relaxation
4. Inhibition of sensory and autonomic reflexes
5. Minimum of toxic side effects
6. Rapid onset, easy adjustment of dosage during use, and rapid, uneventful recovery

5

Name the four stages of anesthesia

1. Analgesia
2. Excitement (delirium)
3. Surgical Anesthesia
4. Medullary Paralysis

6

Loss of sensation of pain

Analgesia

7

Using too much anesthesia; results in loss of cardiac HR, decreased breathing, etc.

Medullary paralysis

8

What is the goal of anesthesia

To bring pt to stage III [surgical anesthesia] as quickly as possible

9

What are the administration techniques for anesthesia?

1. Intravenous
2. Inhalation
3. Sequential combo of the two

10

What is an advantage to intravenous administration?

Quick onset

11

What is a problem with intravenous administration?

Lack of control if overdosed; once the drug is in the body, it cannot be removed quickly, so you must wait until the body metabolizes it

12

What is the advantage to inhalation administration?

Easy to adjust dose

13

What is the disadvantage to inhalation administration?

Slow onset

14

What is the currently used for inhaled anesthetics? What older anesthetics were used previously?

Nitrous oxide; Ether [explosive] or chloroform [toxic]

15

What are 5 IV anesthetics used?

1. Barbiturates
2. Benzodiazepines
3. Etomidate
4. Ketamine
5. Propofol

16

General anesthetic that has fast onset; short-acting forms; relatively safe [respiratory and circulatory depressants, decrease intracranial pressure]; however little analgesic or muscle relaxant effect; Hepatic metabolism required for elimination (do not give to people with liver disease)

Barbiturates; Thiopental and methohexital

17

General anesthetic that has a slower onset than barbiturates; longer duration of action; more often used as premedication; prolongs recovery period but produces amnesia; used to get pt to relax before surgery

Benzodiazepines

18

Analgesics; usually not used alone to produce anesthesia but can produce anes. with higher doses; help maintain anes. at low doses; causes respiratory depression, post-op nausea and vomiting; can cause constipation, itching

Opioids

19

General anestesia; patient not fully awake or asleep [analgesia, retrograde amnesia]; short procedures requiring some pt cooperation

Neuroleptanesthesia

-neuroleptic drug AKA dopamine blocker = droperidol
-opioid analgesic = fentanyl

20

Induction of anesthesia (seconds); quick onset, quick recovery; combined with other drugs; adverse effects = no analgesic actions, involuntary movements, pain on injection, nausea and vomiting

Etomidate

21

Dissociative anesthetic [catatonia, amnesia, analgesia]; poor muscle relaxant; mostly for short procedures; increases muscle tone, BP, HR, breathing rate; increase salivary and bronchial secretions; hallucinations or disturbed dreams - reduced by diazepam

Ketamine

22

General anesthesia; Fast onset; antiemetic; lowers BP, ICP; little pain control, lethal metabolic acidosis and skeletal myopathy; dystonia and seizures

Propofol

23

Term meaning "stops vomiting"

Antiemetic

24

Term meaning "involuntary muscle contractions"

Dystonia

25

Drug used to treat dystonia; anticholinergic drug

Benzotropine

26

Prevents involuntary movements and make mechanical ventilation easier; block NMJ fxn

Neuromuscular blockers

27

Competitive antagonists of muscle nicotinic receptor; similar in structure to curare; no muscle movement

Non depolarizing blockers

28

Act like ACh ant NMJ, but not broken down; depolarized muscle is not responsive to further stimulation

Depolarizing blockers

29

What are 5 special concerns of general anesthesia?

1. Drowsiness
2. Confusion or delirium
3. Weakness
4. May last several days if a patient has difficulty eliminating the drug
5. Lung concerns

30

Anesthetics decrease ______________ in airways, which increases risk of infection and atelectasis

Mucociliary clearance (move things out from lungs)

31

How can PTs help with residual lung concerns produced by using general anesthesia?

Encourage patients to cough and breath deeply to:
1. Eliminate anesthesia
2. Mobilize secretions
3. Breathing exercises
4. Postural drainage

32

Characterized by a loss of sensation in a specific body part or region

Local anesthesia

33

What two environments would you use local anesthetics?

1. Surgery; no post op effects of general anes.; doesn't interfere with CV, resp. or renal fxn
2. Non-surgical; short- or long-term pain relief; block sympathetic pathways; iontophoresis or phonophoresis

34

Name 3 local anesthetics

1. Benzocaine (Américaine)
2. Lidocaine (Xylocaine)
3. Procaine (Novocain)

35

What is local anesthetics often administered with? Why?

A vasoconstricting agent such as epinephrine; slows down removal of the drug and to reduce entering the bloodstream

36

How are anesthetics metabolized?

Hydrolysis by liver or enzymes in plasma

37

How are anesthetics excreted?

Metabolite secreted by kidneys

38

Local anesthetic applied directly to skin, mucous membranes, cornea, etc.; drug is for the thing its being applied to

Topical administration

39

Local anes. applied to skin, absorbed into underlying structures; iontophoresis, phonophoresis, transdermal patch

Transdermal administration

40

Local anes. injected into a region and saturates it; diffuses to sensory nerve endings; used in dental procedures

Infiltration anesthesia

41

Local anes. injected into a nerve trunk so that transmission in peripheral nerve is blocked; prolonged administration into skeletal m. can produce localized m. pain and necrosis

Peripheral nerve block

42

Local anes. injected into spaces surrounding the spinal cord; too high of dosage has a risk for neurotoxicity, resulting in nerve damage; used whenever anesthesia is needed for large region

Central neural blockade

43

Central neural blockade injected in space between vertebra and dura mater; safer and easier of the 2 blockades

Epidural nerve blockade

44

Central neural blockade injected in subarachnoid space (intrathecal anesthesia); faster and more effective, but higher risk for neurotoxicity

Spinal nerve blockade

45

Can occur during peripheral and central nerve blocks; can be used for specific treatment - CRPS; tend to work better in beginning of disorder rather than later

Sympathetic block

46

What is Complex Regional Pain Syndrome (CRPS)? How is a block used to treat this?

Affects a region of the body, thought to be due to dysfunction of symp. NS; injections into the region surrounding the sympathetic ganglion

47

Injected into peripheral vein; drug diffuses into body region; tourniquet restrict blood flow so anesthetic stays in the region

IV regional anesthesia

48

Inhibit of sodium ion channels [blocks action potential]; blockage at one point blocks all forward progression of action potential; smaller diameter axons affected the most

MOA (mechanism of action, inhibitor)

49

Drugs meant to have a local effect; if absorbed into general circulation, can affect nervous and CV systems; happens when a blood vessel is hit instead of a nerve

Systemic effects

50

What are anesthetic systemic effects of the CNS?

Initially stimulates the brane [somnolence, confusion, agitation, excitation, seizures]; followed by CNS depression [respiratory depression, cardiac depression]

51

What are anesthetic systemic effects of the cardiac system?

Decreased excitation, HR, force

52

What causes systemic actions due to anesthesia?

1. Long-acting and excessive dose
2. Increased absorption rate
3. Injected into systemic circulation