Exam #01g - General Anesthetics

Question 1

Name the (8) desirable properties of general anesthesia?

Answer 1

1. analgesia
2. loss of consciousness (not always needed)
3. retrograde amnesia
4. skeletal muscle relaxation (esp during surgery)
5. smooth, rapid induction
6. controllable concentration
7. rapid termination
8. wide margin of safety

Question 2

What are the (2) types of general anesthetics?

Answer 2

1. Inhaled

2. IV

Question 3

Name the (2) subtypes of inhaled GA and give one example for each?

Answer 3

1. gases - nitrous oxide

2. volatile liquids - halothane

Question 4

Name the (4) subtypes of IV GA and give one example for each?

Answer 4

1. Barbiturates - thiopental (phenobarbital)
2. Benzodiazepines - midazolam (Versed), diazepam (valium)
3. Dissociative - ketamine
4. Miscellaneous - etomidate propofol

Question 5

Name the (5) drugs that positively allosterically modulate GABAa receptor? What happens when these agents modulate GABA receptor?

Answer 5

1. barbiturates
2. benzodiazepines
3. nitrous oxide
4. propofol
5. etomidate

enhances Cl- influx and DECREASES neuronal activity (hyperpolarizes cell)

Question 6

True or False - there is a positive correlation between lipid solubility and inhaled GA activity?

Answer 6

True

Question 7

Name (4) drugs that negatively allosterically modulate Na+ ionotropic channel? What happens when these agents modulate the Na+ channel?

Answer 7

1. cyclopropane
2. ketamine
3. nitrous oxide
4. xenon

these agents INHIBIT ion influx

Question 8

What effect does glutamate have on a Na+ channel?

Answer 8

glutamate allows influx of Na+ leads to hypopolarization

Question 9

What is the inhaled GA equivalent of an ED50?

Answer 9

MAC (minimum alveolar concentration)

Question 10

List the (5) most widely used GA inhalation agents?

Answer 10

1. desflurane
2. enflurane
3. halothane
4. isoflurane
5. nitrous oxide

Question 11

Which inhalation GA agent has a rapid onset & recovery, but is PUNGENT and cannot give to children?

Answer 11

Desflurane

Question 12

Which inhalation GA agent is a better skeletal muscle relaxant than halothane, but can cause seizures, and can cause hepatic AE after repeated administration?

Answer 12

Enflurane

Question 13

Which inhalation GA agent would be the best choice for children?

Answer 13

halothane

Question 14

Which inhalation GA agent may have a prolonged induction and recovery and shivering is common during recovery?

Answer 14

Halothane

Question 15

Which inhalation GA agent is a better skeletal muscle relaxant than both halothane and enflurane, but produces significant respiratory depression?

Answer 15

isoflurane

Question 16

Which inhalation GA agent is contraindicated in pregnant women, immunosuppressed patients, and patients with pernicious anemia?

Answer 16

Nitrous oxide

Question 17

True or False - all potent inhalation agents can trigger malignant hyperthermia?

Answer 17

True - in response to anesthesia, a sudden, rapid rise in body temp occurs with signs of increased muscle metabolism

Question 18

This term is defined as a state in which patients feel totally dissociated from their surroundings? Give one drug that can cause this?

Answer 18

Dissociative anesthesia

Ketamine - IV; negatively allosterically modulate Na+ channel

Question 19

Which (2) GA IV agents have a slow onset and recovery?

Answer 19

Midazolam (Versed) and fentanyl

Question 20

Which IV GA agent is used in balanced anesthesia and conscious sedation but show signs of marked amnesia?

Answer 20

Midazolam (Versed)

Question 21

Which inhalation GA agent would you want to avoid in porphyrias (inherited disorder of enzymes)?

Answer 21

Thiopental

Question 22

Which inhalation GA agent produces cardiovascular stimulation and increased cerebral blood flow?

Answer 22

ketamine

Question 23

Which inhalation GA agent is used in induction and for maintenance?

Answer 23

Propofol

Question 24

Which inhalation GA agent is a useful antiemetic?

Answer 24

Propofol