Flashcards in Anesthetics-General Deck (24)
describe the anesthetic ether
relatively safe for user
describe the anesthetic chloroform
relatively dangerous *severe CVD, hepatoxic
describe the anesthetic Nitrous oxide
only partial anesthesia, but excellent analgesia
used in dental clinics, and sometimes in hospitals
describe the anesthetic cyclopropane
most populat 1929-1960
flammable - O.R. explosions
describe the anesthetic halothane
improvement in safety
introduced in 1956
what are the 7 characteristics of the ideal inhalant anesthetic?
chemically stable with out preservatives
compatible with machines
produces unconsciousness while maintaining brainstem function
what is typically used today (chemical backbone of the anesthetic)?
halogenated hydrocarbons, since halogenated aliphatic hydrocarbons or ethers.
the replace them of H- with halogens reduces flammability and enhances stability; more f- more stable.
what are the 3 most comment selected inhalants that are used today?
halothane, isoflurane and sevoflurane.
what are the 4 requirements for optimal anesthesia?
4. muscle relaxation
how is the anesthesia administered?
low [ ] inhalant to render patient unconscious, and use low  of other drugs to inhibit pain or relax the muscles.
1. administer sedative or anioxlytic and analgeesic
2. induce unconsciousness
3. maintain in unconscious state
what is the goal of a premedication?
2. analgesia (intra/post operative pain relief)
3. reduce  of induction agent and anesthetic required.
what are induction agents? (what do they do/ goal)
product general anesthesia
goal: rapidly render patient unconscious
effects wear off rapidly
helps speed up stage 2 to 3 in the stages of anesthesia during induction.
what are the 4 stages or planes of anesthesia during induction?
1. state of analgesia (semi-consciousness)
2. stage of excitement, (struggle, comabitve behaviour)
3. stage or plane of surgical anesthesia (unconsious, ceased movement)
4. **To far process** stage of medullary depression--> death
what are premedications?
variety of injectable drugs used to calm patient, reduce amount of general anesthetics needed to inhibit pain intra- and post op
what are the 3 main types of premedications?
1. sedatives/ anxiolytics (calm patients)
2. hypnotics- to induce sleepiness
3. analgesics (minimiza/abolish intra & post op pain)
what is the major class of sedatives used and name two examples.
1. diazepam, and lorazepam
why is diazepam a useful pre-med?
*trade name is valium
it facilitates the binding of GABA to its receptor
what is a GABAa R?
its a hetero-pentameric lignand-gated chloride channel; when binded to GABA, the alpha unit opens the channel and hyper-polarized the cell, which inhibits the excitation/ AP. the overall effect depends on location of receptors and the regions of the brain that are inhibited.
what are the most common GABAa R subunits?
there are 21, the most common are 2alpha 1, 2beta2, and 1gama 2.
what are endozepines?
they are endogenous, meaning they bind to the same site s benzodiazapines.
what are BZDs a good pre-medication?
relatively safe -> need GABA to be present
BZD have little effect on CV system
Dose-dependent respiratory depression, but little effect at therapeutic dosages
what are the most common adverse effects of BZDs?
drowsiness and confusion
what are some adverse effects/ overdose?
do not combine with alcohol, can be fatal via CNS depression. overdose however can be reversed by the GABA R antagonist Flumazenil