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Flashcards in Anesthesia Drugs Deck (40):
0

What are the inhaled anesthetics?

Halothane
Enflurane
Isoflurane
Sevoflurane
Methoxyflurane
Nitrous oxide

1

What are the effects of inhaled anesthetics?

Myocardial depression
Respiratory depression
Nausea/emetics
Increased cerebral flow

2

What is the toxicity of halothane?

Hepatotoxicity

3

What is the toxicity of methoxyflurane?

Nephrotoxicity

4

What is the toxicity of enflurane?

Proconvulsant

5

What is the toxicity of inhaled anesthetics in general except for nitrous oxide?

Malignant hyperthermia

6

What is the danger of nitrous oxide?

Expansion of trapped gas in the body

7

What is seen in the liver with halothane toxicity?

Massive hepatic necrosis
Sx: increased LFTs, liver tenderness, hepatomegaly
Light microscopy shows widespread centrilobular hepatic necrosis

8

What are the IV anesthetics?

Thiopental
BZD
Arylcyclohexylamines (ketamine)
Opioids
Propofol

9

What is the action of thiopental?

It is a barbiturate - so it facilitates GABA action by increasing the duration of chloride channel opening thus decreasing neuron firing

10

What is unique about thiopental?

It has high potency and high lipid solubility so it has rapid entry into the brain then it redistributes into the skeletal muscle and fat.

11

What is thiopental used for?

Induction of anesthesia

12

What is the MOA of midolazam?

It is a BZD so it facilitates GABA action - increases the frequency of chloride channel opening

13

What is midolazam used for?

Endoscopy
Adjunctively with gaseous anesthetics and narcotics

14

What are the side effects of midolozam?

Post op respiratory depression
Decreased BP
Amnesia

15

What is the MOA of the arylcyclohexylamines?

PCP analogs that act as dissociative anesthetics
They block NMDA receptors --> increase CV and cerebral blood flow

16

What are the side effects of arylcyclohexylamines?

Disorientation
Hallucination
Bad dreams

17

What are the opioids used in anesthesia?

Morphine
Fentanyl

18

What is propofol used for?

Sedation in ICU
Rapid anesthesia induction
Short procedures

19

What is the MOA of propofol?

Potentiates GABA

20

What is the advantage to propofol?

Less nausea than thiopental

21

What are local anesthetics?

Esters = -caines = procainamide, cocaine, tetracaine
Amides = 2 I's in their names = lidocaine, mepivacaine, bupivacaine

22

What is the MOA of local anesthetics?

Block sodium channels by binding to specific receptors on inner portion of channel
They preferentially bind to inactivated sodium channels, so most effective in rapidly firing neurons.
Note: tertiary amines penetrate the bb barrier as uncharged form then bind ion channels in charged form

23

Why would you give vasoconstrictors with a local anesthetic?

To enhance the local action and increase anesthesia of the area by decreasing the systemic concentration

24

Why must more anesthetic be given when dealing with infected tissue?

Alkaline nature of amine anesthetics can't penetrate because the acidic environment of the infection

25

What is the order of nerve blockade?

Small myelinated> small unmyelinated > large myelinated > large unmyelinated

26

What is the order of sensory loss?

Pain > temperature > touch > pressure

27

What are local anesthetics used for?

Minor surgery
Spinal anesthesia

28

What is the toxicity of local anesthetics?

CNS excitation
Severe CV toxicity (bupivacaine)
HTN
Hypotension
Arrhythmias (cocaine)

29

What are the drugs used for muscle paralysis during surgery.

NMJ blocking drugs : succinylcholine, tubocurarine, -curiums, -curoniums

30

What is succinylcholine?

A de polarizing Ach receptor agonist

31

What is the action of succinylcholine?

Produces sustained depolarization and prevents muscle contraction

32

What are the complications of using succinylcholine?

Hyperkalemia, hypercalcemia, malignant hyperthermia

33

What is phase I of reversal of succinylcholine blockade?

Prolonged depolarization
No antidote - prolonged by cholinesterase inhibitors

34

What is phase II of succinylcholine reversal blockade?

Repolarized but blocked - Ach receptors are available but desensitized - use cholinesterase inhibitors (stigmines)

35

What are the nondepolarizing NMJ blockers?

-curiums, tubocurarine, -curoniums

36

What is the MOA of nondepolarizing NMJ blockers?

Compete with Ach for receptors

37

How do you reverse blockade with nondepolarizing NMJ drugs?

Cholinesterase inhibitors

38

What is the MOA of dantrolene?

Prevents release of calcium from sarcoplasmic reticulum in skeletal muscle

39

What is dantrolene used for?

To tx malignant hyperthermia
Neuroleptic malignant syndrome