CNS 3 - Anesthetics Flashcards
(125 cards)
0
Q
This is described as having INCREASE tolerance to pain AND DECREASE perception to pain
A
ANALGESIA
1
Q
Give the factors affecting the extent of anesthetic drug effects
A
Specific Drug. Dosage. Clinical situation
2
Q
Described as having no recall of events
A
Amnesia
3
Q
Alcohol effect to the heart.
A
Depression of myocardial contractility
4
Q
Smooth muscle effect of alcohol
A
Vasodilation.
Direct smooth muscle relaxation
5
Q
Thiamine deficiency associated with alcoholism causes what
A
Wernicke-Korsakoff syndrome
6
Q
What organs are affected with acute alcohol consumption?
A
CNS.
Heart.
Smooth muscle
7
Q
What organs are affected during chronic alcohol consumption?
A
Liver and GIT Blood Fetal alcohol syndrome Immune system Increased risk of cancer
8
Q
Binge drinking causes what heart problem?
A
Arrythmias
9
Q
What anemia can be derived from chronic alcoholism?
A
IDA. Anemia from decreased folate synthesis
10
Q
What common infection is associated with chronic alcoholism?
A
Lung infection
11
Q
Gynecomastia is associated with alcoholism. True or false
A
True
12
Q
Alcohol increases estradiol. True or false.
A
True
13
Q
What drug has decreased metabolism due to acute alcohol consumption?
A
TCAs
Sedative-hypnotics
Phenothiazine - alpha 1
14
Q
Activation of CYP2E1 is triggered with acute or chronic alcoholism.
A
Chronic
15
Q
Alcohol has what effect on anti depressants.
A
Additive effect
16
Q
Alcohol does what on OHA and vasodilator effects
A
Potentiates
17
Q
What cancers are commonly associated with alcoholism?
A
Stomach, mouth, pharynx, larynx, esophagus, liver, breast
18
Q
What electrolyte must be monitored during hypoglycemia and ketosis?
A
Phosphate level
K and Magnesium
19
Q
What must be given to all cases of alcoholism?
A
Thiamine
20
Q
What can be used for detoxification on alcohol withdrawal?
A
BDZ
21
Q
What must be prevented in patients having alcohol withdrawal?
A
SAD
Seizure
Arrythmia
Delirium
22
Q
Among anxiolytics used in alcohol withdrawal which can be used in patients who have compromises liver function.
A
Short acting. Lorazepam.
23
Q
Preferred BDZs for alcohol withdrawal.
A
Long acting. Diazepam. Chlordiazepoxide
24
With what kind of drugs can concentration effect can be seen
Low MAC and more soluble
25
The more soluble (mod to high) the drug is in blood there is a significant increase in arterial tension. True or false.
True
26
Low blood coefficient with increase rr will lead to a slight increase in arterial tension
True
27
Opiod administration slows the onset of anesthesia
True
28
Increased pulmonary flow increases arterial tension specially for more soluble drugs.
False. Inversely
29
High AV difference fastens onset
False. Indirectly proportional
30
Anesthetics accumulate in tissue over time but more slowly to where
Muscle and Skin
31
Is AV difference synonymous with increase extraction fraction in tissues thus decrease uptake to the brain
True
32
Frequently abused by dentists
Nitrous oxide
33
Rarely results to hepatitis
Halothane
34
Pungent that leads to coughing and systemic effects
Desflurane
Mabaho si Ate Dess.
35
Reacts with silica or co2 absorbents
Sevoflurane
S - ilica
36
What compound is formed with the combination of silica and sevoflurane. It effect?
Olefinic compound or compound A. Nephrotoxic
37
Is it true that anesthetics shortens labor?
No. Prolonged. Since it relaxes uterine muscles
38
Halothane is also associated with HYPOTENSION. True or false?
True
39
This drug sensitized the myocardium to catecholamines thus leading to arrythmia
Halothane
40
A complication arising from combination of halothane and nm blockin agents such as succinylcholine
Malignant hyperthermia
41
The pathophysiology lies with increase calcium release from RYR1 receptor
Malignant hyperthermia
42
What do u give for OD of depolarizing agent (succi)
Pseudocholinesterase
43
What do u give for nondepolarizing nm blocker OD
AChE inhibitors
44
During anesthesia, wof increasing icp and pco2 sinc patient may have no s/sx
True
45
Which has a faster onset. Inhaled or intravenous
IV, even with rapid inhaled anesth
46
IV agents are commonly used for induction.
True
47
Is propofol adequate as sole anesthetic when combined with nitrous oxide for opd procedures?
True
48
What makes IV drugs good for OPD procedures?
Short / rapid recovery
49
A barbiturate that is mainly used for induction
Thipental
50
Why is thiopental not used for maintenance?
It is short acting and decreases respi and cardiac fxn and has increase context sensitive half time
51
What iv anesth is desired for patients with brain injury
Thiopental
52
Its ok to use thiopental for patients with porphyria
False
53
Methohexital
| Thiamylal
Same effect
| Same structure
54
Preferred over thiopental and for patients udergoing ECT
Methohexital. Even shorter elimination
55
Propofol has rapid recovery same as sevo and desflu
True
56
This are use as preop meds
Bdz
57
Give the flow of redistribution ng thiopental
Blood
Brain and viscera
Lean tissues
Fat
58
Bdz of choice for parenteral adminiatration
Midazolam. Water soluble
59
Are non soluble iv bdz that causes pain and irritation
Diaz and loraz
60
Used in lovectomy
Midaz
61
Which drug has anterograde amnesia
Midazolam
62
Antidote for bdz
Flumazenil
63
Only IV anesth that has both anesthesia and analgesia
Ketamine
64
Manifests catatonia with or without loss of consciousness.
Ketamine
65
What is the diff between ketamine and thiopental in terms of cerebral blood flow
Ketamine increases CBF thus must not be used for px with brain injuy
66
Inhibits reuptake of NE leading to emergence rxns
Ketamine
67
Propofol and BDZs offset ketamine
True
68
Iv anesth that has VERY RAPID onset and recovery
Propofol
Rapid - thio
More rapid - metho
69
Can be used as an induction and maintenance for OPD sx
Propofol
70
Doc for ambulatory surgery
Propofol
71
Ketamine, Etomidate and Propofol all doesnt increase context half time. Why is propofol desired among them?
Ketamine - CV effect
Etomidate - adrenocortical suppression
Propofol - anti emetic pa nga eh pero not for kiddos
72
What drug is usually combined in LARGE DOSES with BDZ
Opiod analgesics
73
Opiods are also good for patients with ciculatory reserve
True
74
Give two drugs used for patients with limited cardiac reserve
Opiod
| Etomidate
75
This opiod is used to minimize ventilatory depression
Remifetanyl
76
What opiod with IV use causes chest wall rigidity?
Fentanyl
77
When you combine fentanyl with droperidol and NO what happens?
Neuroleptanesthesia
78
What mainly cause neurolept rxn
Droperidol
79
It mainly blocks ur NMDA RECEPTOR and Glutamic acid
Ketamine
80
Can cause central excitatory activity
Methohexital
81
Etomidate is not ideal for combination with opiods
False
82
Carboxylated imidazole derivative
Etomidate
83
Aside from being used in px with cardiac reserve, this drug also has minimal cv and respi depression
Etomidate
84
Despite having m cv and respi effect this drug is not used for maintenance because it causes adrenocortical suppression
Etomidate
85
Etomidate causes pain on injection, myoclonus and postop n and v
True
86
This class of anesth effectively and reversibly blocks impulse conduction along NERVE axons
Local anesth
87
For LA to be effective it must be injected in alkaline area
True
88
Ionized form facilitates penetration trough membranes
False. Non ionized
89
Non ionized facilitates the membrane activation
False. Ionize
90
Esters have how many I
ISA LANG
Procaine
Cocaine
Tetracaine
Benzocaine
91
Amides have how many I
DALAWA
Lidocaine
Mepivacaine
Prilocaine
Bupivacaine
92
Among the Amides which is the fastest
PRILOCAINE - mabilis sa PRI (free)
93
MOA is the blockade of voltage gated sodium channel
LA
94
Resting form of channels
Im resting in HEAVEN
| M close H open
95
The larger the nerve fiber the more sensitive it is
False. Smaller sensiive
96
In terms of firin freq, who is most sensitive
High firing
97
Between sensory and motor which has high firing rate?
Sensory - high and long AP (B, C)
Motor - low and short (A - dbga)
98
Some LA have nm blocking property
Lidocaine in low dose. Antiarrythmic
99
All LA are vasodilators except?
Cocaine - VC
100
VC drugs are also effective in longg acting drug such as bupovacaine and ropivacaine
No! Only for short acting
101
Shortest LA
Procaine
102
What causes allergy in La
Paba detivatives of esters
103
LA binds to the internal or external sodium channel. The toxins?
Internal. External
104
From puffer fish
Tetrodotoxin
105
From dinoflagellates
Saxitoxin
106
Both tetro and saxi binds to cardiac and nerve cell? Thus decreasimg conduction
Trie
107
This toxin from eel and frogs keep channels open causing flaccid paralysis
True
Ciguatoxin
Batrachotoxin
108
2 types of non depo
Steroid - onium
| Isoquinolone - urium
109
This non depo is implicates with malignant hyper
Tubo
Halogenated Plus NM
110
Why is tubo called an arrow poison
Releases histamine and blocks depo
111
Pancuronium
Steroid
Increase BP
Log acting
112
Antracurium
Isoquinolone
Intermediate acting
113
Undergoes exhaustive methylation
Hoffman elimination producing luadanosine
114
Shortest of all non depo
Mivacurium
115
NON DEPO - MAP
Histamine
Hoffman
BP
116
Reverses non depo.
Ache in
117
Describe the two phases of nicotinic receptor agonist
Phase 1 - brief stimulation - fasci
Phase 2 - depo - flaccid
NOT REVERSED BU ACHE INH
GIVE PSEUDOCHOLINESTERASES
118
Effect of succinylcholine in low doses and high
Low - decrease
| High - high
119
scc must not be given to pts with?
Burn, glaucoma, hyperkalemia, muscle pain and malignant hyperthermia
120
Doc or malignant hyp
Dantrolene
121
Acts on GABA a receptor
Bdz
122
Acts on gaba a synapse
Diazepam
123
Acts on gaba b receptor
Baclofen
124
Severe spasticity -
Acute and chronic spasticity -
Cord transection
Baclofen -
Bdz -
Diazepam
