CNS Flashcards by akshyatah sharma

N2O

MAC -105%
quick, smooth induction 
good analgesia
minimal skeletal muscle relaxation
stimulate sympathetic tone- maintain cvs function

elevate intracranial pressure, pneumothorax, depress bone marrow, neuropathy

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Diethyl ether

inflammable, irritant
giod analgesia
marked skeletal muscle relaxation
prolonged induction
N, V, retching, eye congeetiin, sore tracheq, burns on face
reflex stimulation of respiration
sympathetic tone- maintain cvs function

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halothane

potent (2-4/0.5-1)
relax uterus, intestine somewhat
reduce intracellular Ca, vagal stimulation- cvs functions decreased; no baroreceptor reflex- no reflex stimulation of heart
sensitize heart to Adr - arrhythmia
vasodilation (CO2)- brain; alveoli dilate - v:p mismatch
dilate bronchi - given to ASTHMA ppl

decreased urine
hepatitis
malignant hyperthermia (ryr1 )
29% METABOLISM

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isoflurane

irritant
less potent
quicker action
direct vasodilation (Coronary: steal)
sympathetic stimulation
uterine/sk muscle relaxation
NO pupil dilation, light reflex loss
no seizure - neurosurgery

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desflurane

with N2O and O2
irritant
low solubility- short action
steeper dose response
sympathetic stimulation
direct vasodilation
uterine, skeletal muscle relaxation

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sevoflurane

I>S>D (pk, pd)
3% metabolised

quick induction/recovery
direct vd
no sympathetic stimulation- fall in bp

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enflurane

seizure

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thiopentone sodium iv - common induction

given with atropin, ms relaxant

ultra short acting
high lipid solubility (undissociated form)
alkaline solution - irritant- lrynx spasm
wide distribution
accumulates
redsitribution elimination 3 min, hepatic metabolism 8-12 hours
vasodilation - cvs collapse
reflex changes
vc in brain

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arrhythmogenic

halothane

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sympathetic stimulation

N2O, ether, isoflurane, desflurane

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atropine and thiopentene

react chemically - not in same syringe

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acute intermittent porphyria

thiopentone

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naroanalysis

thiopentone

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methohexitone sod.

more potent, quicker briefer action, EXCITEMENT common during recovery and induction

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propofol i.v

unconsciousness in 15-45 secs, last for 5-10 min

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propofol (with fentanyl) IV + lidocine

no airway irritation - used in asthmatics

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asthmatics - general anesthetics

propofol, sevoflurane, halothane, ketamine

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propofol adr

induction apnea, vasodilation, cvs normal and depression, barorelfex suppression, respiratory

acidosis, lipemia, heart failure

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sympathetic stimulation

manage cvs function

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etomidate

less potent anesthetic, relaxant tc

4 min action

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BZD as general anesthetic

conscious sedation

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diazepam iv

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sedation, amnesia, unconsciousness in 5-10 min

redistribution in 15 mins - amnesia for 2 hours

diazepam running iv drip

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poor analgesic

(poor) central muscle relaxant

BZD anesthesia antagonised by

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flumazenil 2mg i.v

lroazepam

more potent, less irritant than diazepam - SLOW ACTING

midazolam

faster, shorter acting more potent, less irritant use -critical care anesthesia

ketamine

dissociative anesthesia site of action - cortex, subcortex SYMPATHETIC stimulation no respiratory depression

ketamine - action duration

effect within min, recoveryin 15 min and amnesia for 2 hours

ketamine - adr

emergence delirium, hallucination, involuntary movements (increased muscle tone)

ketamine side effects

increase cerebral ((((oxygen consumption)))) and heart work

rape drug

ketamine

fentanyl

``` lipohilic short acting opioid analgesic (pethidine related) anesthetic awareness parasympathetic stimulation - heart rate decrease ```

fentanyl antagonist

naloxone

dexmedetomidine

centrally active alpha 2A agonist - sedation | downregulate sympathetic response

side effect dexmedetomidine and clonidine (alpha agonists)

dry mouth, hypotension ,bradycardia

conscious sedation

diazepam (for 1 hour), midazolam (1 hour before surgery), propofol (iv infusion), N2O, fentanyl

anesthetic and antihypertensives

BP falls

opioids, neuroleptics, MAO I, clonidine

potentiate anesthetics

halothane

sensitises heart to Adr

corticosteroids + anesthetics

cvs collapse, adrenal insuffiency

Diabetic on anesthesia

need more insulin

pre anesthetic medication

antianxiety, amnesiacs, analgesics, anticholinergics, antiemetics, acid deceaser

sedative antianxiety +fentanyl

diazepams, lorazepams, promethazine, pethidine, morphine, chlorpromazine, triflupromazine, haloperidol

amnesiac

midazolam, hyoscine

antihistaminic

promethazine

antiemetic (increase stomach emptying and LES tone)

Metoclopromide, domperidone, promethazine, hyoscine, chlorpromazine, triflupromazine, haloperidol

anticholinergic - reduce secretions, prevent bradycardia, hypotension,

atropine, hyoscine, glycopyrrolate (MAIN- antisecretory), promethazine

analgesia

morphine, pethidine, FENTANYL,

emergence delirium

ketamine, hyoscine,

antimuscarnics

bronchodilation, pupil dilation, relax LES, DRY MOUTH

neuroleptics

chlorpromazine, triflupromazine, haloperidol

PPI/H2 blockers

ranitidine, famotidine, omeprazole

antiemetics - increase stomach emptying and LES tone

metoclopromide - EPS | domperidone (no EPS side effects)

antimetics - serotonin 3 blocker

ondansetron

CNS Flashcards

(54 cards)