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Flashcards in Anesthesia: Lichtblau Deck (27):
1

What drug is it most common to see malignant hyperthermia with?

Halothane

2

Describe Halothane.

Vapor, Potent, Slower onset than NO because Halothane is more soluble in the blood, Cheap, Doesn't irritate airway.

May see sensitization to catecholamines, High metabolism (undesirable, can lead to "halothane hepatitis" hepatotoxicity)

3

What make something more potent?

More lipid soluble

4

What makes it more rapid?

Less soluble in blood

5

Describe Isofulrane

Vapor, Induction in less than 10 minutes, Potent, no sensitization of myocardium to catecholamines, less renal and hepatotoxicity than Halothane.

Terrible smell. Potential for malignant hyperthermia.

6

Which general anesthetic needs a special vaporizer because its boiling point is near the temp of the OR?

Desflurane

7

Which general anesthetic is considered "almost perfect" and why?

Sevoflurane. It has rapid onset, it is potent, it has low blood solubility to it reaches equilibrium quickly. It is also quickly redistributed so it has rapid recovery time.

8

What is the only gas inhalation anesthetic? Tell me about it.

Nitrous oxide. It has low blood solubility so it has a rapid onset.
There is no chance for malignant hyperthermia and it does not sensitize the heart. It has a potential for diffusion hypoxia if it is rapidly discontinued due to rapid transfer from blood to alveoli (displaces the air).

9

Tell me about propofal.

Rapid induction, anti-emetic, short acting, injection site pain.
most significant respiratory effect is apnea (breathing repeatedly starts and stops)

10

Which drug is extremely lipid soluble, is a Barbiturate, and has an anesthetic dose between 50 and 75 % of the LD50 so it must be used with caution?

Thiopental

11

Describe Midazolam.

(Lichtblau's fav drug)
A benzodiazepine, purely a muscle relaxant, only an induction agent, Less CV and respiratory depression. Actually not an anesthetic.

12

Describe Ketamine.

Dissociative anesthetic. Patient's eyes stay open so they appear awake. Airway reflexes and respiration maintained. Patient unaware of environment, doesn't feel pain. *Ideal for patients with unstable CV function.

NMDA Receptor Antagonist

*One problem: Hallucinations, nightmares, abuse

13

Fentanyl

Analgesic prior to surgery. Maintain respiration artificially, may be depressed post-op.

14

Why are Fentanyl and Sufentanyl good for patients with compromised myocardial function?

Hemodynamic stability

15

What drug class do Fentanyl and Sufentanyl belong to?

Opioids

16

What does the opioid do?

Analgesia

17

BANS?

blunt the autonomic NS

18

Neuromuscular blocker?

Blocks nicotinic receptor at the neuromuscular junction.

19

Benzodiazepine?

Amnesia

20

What is the percent of oxygen needed to survive?

21 %

21

How does Ketamine work?

NMDA receptor antagonist

22

What do the halogenated hydrocarbons do to brain metabolic rate, cerebral blood flow, intracranial pressure and arterial BP?

Decrease brain metabolic rate
increase cerebral blood flow
Increase intracranial pressure
Decrease arterial BP (Decrease myocardial contractility)

23

Halothane vs. Nitrous oxide

Halothane is more soluble: takes longer
NO is less soluble: acts quickly

24

Do inhalation anesthetics bind defined receptors?

NO: alter lipid membranes in all systems by changing membrane fluidity

25

Why are IV anesthetics unsuitable as a drug for many procedures?

No muscle relaxation

26

What class of drug is Thiopental?

Barbituate

27

What is Etomidate used for?

Induction, rapid onset, IV administered.