Anesthetics Flashcards
(41 cards)
What was The first local anesthesia- abolition of sensation: leading to need for 1. Unconscious 2. Analgesia 3. muscle relaxation?
Cocaine.
What is the abolition of pain?
Analgesia
This value is the concentration that results in immobility in 50% of patients when exposed to noxious stimuli?
Min. alveolar anesthetic concentration. Higher the MAC= lower potency
What is only anesthetic agent that is inorganic, odorless, tasteless, no burn, never metabolized?
Nitrous oxide. MAC 105% LOW POTENT. Weak ANESTHETIC POWERFUL ANALGESIC
What are the systemic effects of NO?
Low blood solubility- Recovery faster
Min HR, BP, RR, and safe
What is concern of NO with sick pts?
- Myocardial depression.
- Manufacture impurities.
- BEg of case- INC in partial pressures.
- End of case O2 and CO2 blood diluted by this gas. DEC in Partial pressure=HYPOXIA
- Inhibits B12 metabolism
- Inhibits methione synthase-DNA precursor
What has the most significant reduction in systemic vascular resistance?
ISOflurane- MAC 1.30% HIGH POTENT. effect inc coronary steal syndrome, INC ICP, muscle relaxant
What receptors do Isoflurane work on?
*baroecptors. Depress RR and ventilatory response.
Avoid this drug if HF, arrhythmia, and asthma?
Isoflurane
What is a potent inhalant with MAC 7.2%
Desflurane- low solubility in blood, faster recovery. MILD respiratory and cardiac suppression
Which inhalant is ideal for kids and Why?
Sevoflurane- Faster recovery, less RR and CV effects. Masks, pleasant smelling
What are ADE of Sevoflurane?
- More respiratory depression
- Eliminated by lungs
- Excitement during recovery
- **NO p/o analgesia
- Reacts with KOH to create a chemical that cause RENAL damage
Which inhalant needs close monitor of HR and BP, O2 SAT?
Desflurane-
ADE: 1. Cough w/ strong vapors 2. AVoid lyme soda
What IV anesthetic is similar to AZOLES, CNS depressant and GABA agonist?
ETOMIDATE: Works how: dose dependent, DEC cerebral metabolism
ADE; **N/V, myoclonic activity, Cortisol suppression, inj pain,
What IV anesthetic causes dissociative anesthesia via stimulation of SNS?
KETAMINE: Works; maintains laryngeal and tone, similar to PCP, SNS ADE; hallucinatin dreams
What IV anesheic is painful bc not water soluble, lipid soluble-rapid onset, short duration?
PROPOFOL- Works: Myocaridal depression and peripheal vasodialstion. Normal Baroreflex
Which RX produce sedation and amnesia via GABA receptors?
Benzo- azepam Works; pre anesthic, relax b4 surgery, NOT water soluble most
What BENZO is used premeditation and seizure activity?
Diazepam (Valium) Works- mim systemic effects.
ADE- liver metabolized, AVOID narcotics
Which BENZO is an adjunct for anxiolytic and sedative properties?
LORAZEPAM- Works; slower, not for induction
Which BENZO used for drowsiness preop with slow induction, MOST potent?
MIDAZOLAM;
ADE- prolonged recovery via metabolite, Min cardiac effects.
What are some ADE of Opioids of anil/yl that are potent analgesic?
- Bradycardia
- NO Myocardial depression
- peripheral vasodilator and histamine -HYPOTENSION
- Chest wall rigidity
Does inhaled and IV muscle relaxants work?
NO, not good for muscle tone. WORK- block ACH receptor. PK- plasma ACHe, Hepatic or Renal. USE- muscle relax in surgery, 2. intubatin 3. control ventilation
What short acting muscle relaxant is used for intubation and last only 5-10min?
1.Succinylcholine; WORKS- DEPOLARIZING nicotinic receptor
ADE: myalgia day later** Malignant hyperthermia-fever, rhabdo
What are the duration and Elimination of neuromuscular blockers?
SA- succinylcholine, Mivacurium- Plasma ACHe eliminated 5-20min.
IA- ATRA, VE, RO- curonium- 20-35min - HEPATIC and RENAL.
LA- Pancuriium, tubocuraine, metocurine- 60min Renal
