Flashcards in Chapter 16: Anesthetics Deck (29)
1
What is the most widely used anesthetic? How is it administered?
Isoflurane
Inhaled
2
What inhaled anesthetic would be optimal for pediatric use? Why?
Halothane, bc its smell is nonirritating
"Halo for an angelic child"
3
Why is diethyl ether not in common use in the US?
Bc it is highly flammable
"You will DIEthyl from the flames"
4
Which anesthetics have malignant hyperthermia as an adverse effect?
Isoflurane *main one
Enflurane
Halothana
Diethyl ether
Nitrous oxide
Desflurane
Sevoflurane
5
With which anesthetic are seizures and epilepsy both contraindications and potential adverse effects?
Enflurane
E for epilepsy
6
How do you treat malignant hyperthermia?
Dantrolene
7
What does the following mean:
high (oil/gas)
high (blood/gas)
high potency
slow induction & recovery
8
What dos the following mean:
high (oil/gas)
low (blood/gas)
What agents have this property?
high potency
rapid induction & recovery
desflurane
sevoflurane
9
Which anesthetic with a high potency but slow induction and slow recovery can cause serious hepatoxicity?
halothane
10
Which anesthetic is commonly used with other agents and must be administered with oxygen, but for no more than 24 hours continuously?
nitrous oxide
11
Why does desflurane irritate the airway?
bc it can cause laryngeal spasm
12
Which anesthetics are ventilation limited?
isoflurane
enflurane
diethyl ether
halothane
13
Which anesthetics are perfusion limited?
Nitrous oxide
desoflurane
sevoflurane
14
What is the major adverse effect of nitrous oxide?
It can cause expansion of air cavities...EEEEK!
EX) pneumothorax, middle ear obstruction, bowel obstruction, intracranial air...
15
Which has a greater risk of causing renal toxicity, isoflurane or enflurane?
enflurane
why? i don't know.
16
Rate the following from MOST potent to least
diethyl ether, halothane, isoflurane, enflurane
Halothane --> isoflurane/enflurane --> diethyl ether
17
How do changes in cardiac output affect induction time?
An increase in cardiac output SLOWS INDUCTION
18
Metabolism is not typically a significant route of removal except for with what anesthetic?
Halothane (~20%)
19
What effect does hyperventilation have on perfusion limited vs ventilation limited anesthetics?
Hyperventilation --> will decrease cerebral blood flow
Vent lim: faster delivery to alveoli = FASTER induction
Perf lim: decreased cerebral blood flow = SLOWER induction
20
What is the IV anesthetic of choice for short day surgery procedures because of its rapid elimination?
propofol
21
Which is the only IV anesthetic that can be used for both induction AND maintenance of anesthesia?
Propofol
22
How is propofol often administered?
With an intralipid preparation
23
What is the ultra short acting barbituate that can induce surgical anesthesia within seconds?
thiopental
24
Thiopental can be used for treating ___?
Inducing anesthesia
Narcoanalysis
Elevated ICP
Seizures
25
Which IV anesthetic would you use to induce anesthesia in a hemodynamically unstable pt? Why?
etomidate
Does not effect sympathetic nervous system and thus causes minimal cardiopulm depression
** when you're on a DATE you can become hemodynamically unstable
26
What is a potential adverse effect of etomidate?
myoclonus
**when you're on a DATE and nervous your hands may shake like myoclonus
27
Which drug binds to the interface between the a and b subunit of GABA receptor?
etomidate
**when you're on a DATE you have trouble choosing between dress A and dress B
28
What is the sole anesthetic for procedures that do NOT require skeletal mm relaxation? What is its MOA?
ketamine
NMDA receptor antagonist
29