Chapter 16: Anesthetics Flashcards Preview

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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

Ketamine can cause ___ as adverse effects?

hallucinations, vivid dreams, psych symptoms! yiiiiikes