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Neuro > Anesthesia > Flashcards

Anesthesia Flashcards

1
Q

What is anesthesia?

A

Elimination of sensation

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2
Q

What is analgesia

A

Elimination of pain

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3
Q

What is sedation?

A

Is a decrease in activity, alertness, arousal and/or vigilance

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4
Q

What is general anesthesia?

A

Drug-induced, reversible depression of the CNS that results in the loss of physiologic response and perception to all external stimuli

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5
Q

What are the general actions of inhalation anesthetic agents?

A 
CV
Resp
Brain
Renal
Hepatic
Malignant hyperthermia
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6
Q

How do inhalation anesthetic agents affect CV?

A

Decreased MAP

Depression of myocardial function

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7
Q

How do inhalation anesthetic agents affect respiratory?

A

Depress mucocilliary function

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8
Q

How do inhalation anesthetic agents affect brain?

A

Decrease metabolic rate of the brain

Increase cerebral blood flow

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9
Q

How do inhalation anesthetic agents affect renal?

A

Decrease renal blood flow and GFR

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10
Q

How do inhalation anesthetic agents affect hepatic?

A

Decrease hepatic blood flow

Rarely causes permanent changes in liver enzymes

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11
Q

What are the drugs that require special ventilation?

A 
NO
Halothan
Isoflurane
Enflurane
Desflurane
Sevoflurane
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12
Q

What is malignant hyperthermia?

A

Autosomal dominant genetic disorder

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13
Q

What are the sx of MH?

A 
Tachy
HTN
Muscle rigidity
Hyperthermia
Hyperkalemia
Acidosis
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14
Q

What is the treatment of MH?

A

Dantrolene

Supportive treatment

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15
Q

What are the IV agents for anesthesia?

A 
Barbiturates
Benzos
Opioids
Propofol
Etomidate
Ketamine
Dexmedetomidine
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16
Q

What are commonly used for IV induction of anesthesia?

A

Barbiturates

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17
Q

What barbiturates are used for anesthesia?

A

Thiopental

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18
Q

Why are benzos not used for anesthesia?

A

Inadequate depth of sedation for surgical anesthesia

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19
Q

Why are benzos used for anesthesia?

A

Premedicate because of the sedative, anxiolytic and amnestic properties

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20
Q

What is the most commonly used opioid for anesthetia?

A

Fentanyl

21
Q

What can the emulsion formulation of propofol cause?

A

Hypertriglyceridemia

22
Q

What do HD of propofol cause?

A

Propofol Infusion Related Syndrome can result in death

23
Q

What is etomidate used for?

A

Induction of anesthesia

24
Q

What are the AEs of etomidate?

A

Injection site pain
Myoclonic activity
Post-op n/v
Decreases plasma cortisol

25
Q

How does ketamine work?

A

Produces dissociative anesthetic state characterized by catatonia, amnesia, and analgesia e/ or e/o loss of consciousness

26
Q

What are the AEs of ketamine?

A

Produces CV stmiulation
Increases cerebral blood flow, oxygen consumption and intracranial pressure
Associated with post-op disorientation, illusions and vivid dreams

27
Q

Where is dexmedetomidine used?

A

ICU

28
Q

What are the indications of NMBAs?

A 
Facilitate short procedures under general anesthesia
Facilitate mechanical ventilation
ARDS
Manage increased ICP
Treat muscle spasms
Decrease oxygen consumption
Surgery
29
Q

What are NMBAs?

A 
Succinylcholine
Pancuronium
Vecuronium
Rocuronium
Atracurium
Cisatracurium
30
Q

How does succinylcholine work?

A

Mimics acetylcholine at the NMJ and prolongs the repolarization phase

31
Q

How is pancuronium eliminated?

A

Renal

32
Q

What are the AEs of pancuronium?

A

Tachy
HTN
Increased CO

33
Q

Which NMBA is the fastest onset?

A

Rocuronium

34
Q

What drugs interact with NMBAs?

A 
Diuretics
Antiarrhythmics
AG
Mg
Li
35
Q

What is the reversal agent for rocuronium and vecuronium?

A

Sugammadex

36
Q

What is the reversal agent for non-depolarizing agents?

A

Neostigmine

Pyridostigmine

37
Q

Where is sugammadex used?

A

In the OR only

38
Q

What is procedural sedation?

A

Creates a decreased level of awareness for a patient while maintaining protective airway reflexes and adequate spontaneous ventilation

39
Q

What medications are used for procedural sedation?

A

Ketamine and benzo
Benzo and analgesic
Propofol or etomidate and analgesic

40
Q

What type of patient can procedural sedation be used in?

A

Healthy

41
Q

How do we monitor sedation in OR?

A

BIS monitor - mini EEG

BIS < 60 = no recall

42
Q

How do we monitor sedation in ICU?

A

RASS
RAMSEY
CAM

43
Q

What are the 7 steps of rapid sequence intubation?

A 
Preparation
Pretreatment
Premedication (induction)
Paralyze after sedation
Protection/positioning
Post-intubation management
44
Q

What drugs are used for pretreatment?

A

Fentanyl IV*
Lidocaine IV
Atropine IV
Esmolol IV

45
Q

What drugs do we use for premedication?

A

Midazolam, etomidate, propofol, ketamine

46
Q

What drug is the gold standard for paralyzation?

A

Succinylcholine

47
Q

What drugs are used to paralyze?

A

Succinylcholine

NMBAS (rocuronium, vecuronium)

48
Q

What is done in protection/placement step?

A

Trach placement

Neuro (13 decks)

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