Exam 1 Flashcards
(211 cards)
1
Q
What is the definition of general anesthesia?
A
Induced loss of consciousness & not arousable, even by painful stimulation.
2
Q
Describe minimal sedation?
A
- Pt is still awake
- Able to respond
- No LOC change
- Self sustained airway
- Stable VS.
3
Q
Describe Moderate sedation?
A
- Easily arousable to verbal or touch
- CV system unimpaired but a bit sleepy
- Able to maintain own airway
4
Q
Describe deep sedation?
A
- Responsive to painful stimuli
- Airway assistance may be required
- CV usually maintained
5
Q
What was the reversal for soporific sponges?
A
Vinegar
6
Q
Why was Diethyl ether used recreational?
A
Due to whiskey tax
7
Q
What did Sir Christopher Wren & Robert Boyle invent?
A
IV access
8
Q
What did Joseph Priestly discover?
A
Oxygen & nitrous oxide, & photosynthesis
9
Q
What did Humphry Davy discover & suggest?
A
- Potassium, sodium, calcium, magnesium
- Suggested nitrous oxide use for pain relief in surgery
10
Q
What is Horace Wells known for?
A
- Noticed no pain recall when using N2O.
- Used N2On@ Mass General for amputation.
11
Q
What is Hewitt known for?
A
Designing first anesthesia machine with nitrous & oxygen
12
Q
What is Crawford Long known for?
A
Used ether for a Pt with 2 vascular neck tumors.
13
Q
What is William Morton known for?
A
- Needed anesthesia for denture fitting
- Used ether
14
Q
Why was the 1st public ether demonstration lucky?
A
Poor inhaler fit, no IV access, prolonged emergence.
15
Q
What is Robinson Squibb known for?
A
Developed process for pure ether
16
Q
What are disadvantages with ether?
A
Has a very slow onset & even slower offset, flammable, odor, high incidence of N/V
17
Q
What is Sir James Simpson known for?
A
Defined pain: “actual or potential tissue damage”
18
Q
What is Dr. John Snow known for?
A
- Full time anesthesiologist for Queen Victoria
- Discovered epidemiology
19
Q
What is Guthrie known for?
A
Delayed chloroform hepatotoxicity in children
20
Q
What is Dr. Koller known for?
A
Cocaine as an anesthetic for eye surgery.
21
Q
What is Dr. Halsted known for?
A
1st regional (mandibular) nerve block using cocaine.
22
Q
What is Dr. August Bier known for?
A
- 1st spinal using cocaine
- Developed Bier block
23
Q
Who was the first nurse anesthetist?
A
Sister Mary Bernard
24
Q
What is Agatha Hodgins known for?
A
- Developed nitrous/oxygen techniques
- Founded AANA
- Opened one of the 1st CRNA schools
25
Why is cyclopropane not used anymore?
Violently explosive
26
Why is halothane not used anymore?
Slow onset & can cause Hepatitis
27
What is Isoflurane not used for & why?
Outpatient Sx due to slow offset
28
What is the most rapid onset & offset gas?
Desflurane
29
What is Edmund Egar known for?
- Establishing MAC
- Did lots of experiments & published info about desflurane (Suprane)
30
What is the best volatile gas for asthmatics & why?
Sevoflurane because it does not cause airway irritation.
31
What is the “triad” of anesthesia & what was added later?
Amnesia, analgesia, muscle relaxation & Homeostasis was added later
32
Why was analgesia not favorable initially?
It had a high death rate
33
What is Dr. Liston known for?
3 deaths from 1 operation
34
What is Dr. George Crile known for?
- Local infiltration of procaine prior to Sx
- Light use of nitrous/oxygen for anesthesia
35
What is Harvey Cushing known for?
- Regional blocks
- Anesthetic records
- BP/HR measurements
- Used ether
36
What was the issue with neurolept anesthesia?
High incidence of awareness, dysphoria, extrapyramidal movements.
37
When is stage 1 of anesthesia?
Beginning of induction of general anesthesia to loss of consciousness.
38
What are the 3 planes of stage 1 of anesthesia?
1= no amnesia or analgesia
2= amnestic but only partially analgesic
3= complete analgesia & amnesia
39
When is stage 2 of anesthesia?
Loss of consciousness to onset of automatic breathing.
40
What signs (can/could) be observed in stage 2 of anesthesia?
- Eyelash reflex disappears
- Coughing
- Vomiting
- Struggling may occur
- Irregular respirations
41
When is stage 3 of anesthesia?
Onset of automatic breathing to respiratory paralysis
42
When is stage 4 of anesthesia?
Stoppage of respiration till death
43
What are the 4 planes of Stage 3 anesthesia?
1= automatic respiration to cessation of eye movement.
2= cessation of eye movement to beginning of intercostal muscle paralysis; secretion of tears increases.
3= beginning to completion of intercostal muscle paralysis, mydriasis, desired plane prior to muscle relaxants.
4= complete intercostal paralysis to diaphragmatic paralysis.
44
Competitive antagonism will do what to the dose response curve?
Shifts it to the right
45
Describe inverse agonism?
Competes for the same site as the agonist but produces the opposite effect
46
Continued albuterol treatment in asthma patients does what over time?
Downregulates receptors
47
Pheochromocytomas can cause?
Decreased beta receptors in response to release of catecholamines
48
What are examples (3) of drugs using intracellular proteins?
Insulin, steroids, milrinone
49
What drug class (covered in class) uses circulating proteins?
Anticoagulants
50
What are examples of drugs using lipid bilayer receptors?
Opioids, beta-blockers, catecholamines, NMB, benzos.
51
Acidic drugs primarily bind to___ & alkalotic drugs primarily bind to___?
Albumin & Alpha-1 glycoprotein
52
What determines concentration of a drug available to receptors?
Only free drug
53
What are examples of decreased plasma proteins?
Age, hepatic disease, renal failure, pregnancy
54
Poor protein binding & lipophilic leads to?
Big volume of distribution
55
Give some examples of drugs with active metabolites?
- Midazolam
- Diazepam
- Propranolol
- Morphine
- Prodrugs
56
What is Phase 1 metabolism & examples?
Increase polarity & prepare for Phase 2 reactions. Oxidation, reduction, hydrolysis.
57
What is Phase 2 metabolism?
Covalently link with higher polarity molecule to become water soluble. Conjugation
58
What is the most common Phase 1 enzyme & examples it metabolizes?
CYP3A4. Opioids, benzos, antihistamines, immunosuppressants, LA
59
Chronic EtOH use results in___ anesthetic use & acute EtOH results in___anesthetic use?
Normal & less
60
Inhibition___ enzyme activity & induction___ enzyme activity?
Decreases & increases
61
What are examples that cause enzyme inhibition & induction?
- Inhibition= grapefruit juice
- Induction= phenobarbital
62
When does passive tubular reabsorption increase?
If drug is lipid soluble
63
What is elimination ½ time?
Time it takes to eliminate 50% of drug from plasma.
64
What drugs are weak acids?
Barbiturates
65
What drugs are weak bases?
Opioids, local anesthetics
66
Which drug molecule will cause a pharmacologic effect, ionized or non-ionized?
Non-ionized
67
Non-ionized drugs are___ soluble, & ionized drugs are___ soluble?
Lipid & water
68
Which drug form is hepatic metabolized?
Non-ionized
69
A barbiturate with a PK of 6.8 is put in a solution with pH of 7, is it ionized or not?
- Barbiturates are acids (Pk after pH)
- pH - pK
- 7 - 6.8= 0.2 = ionized
70
An opioid with a PK of 7.9 is put in a solution with a pH of 7.3, is it ionized or not?
7.9 – 7.3= + 0.6= ionized
71
What is Ion trapping?
Drug crosses the lipid bilayer back cannot escape
72
What is pharmacodynamics?
What the drug does to the body
73
About what percentage of current drugs are racemic?
33%
74
R-Bupivicaine is ___ cardiac toxic than L-Bupivicaine?
More
75
Why is Cisatracurium, the isomer of atracurium, better?
Lacks histamine effects
76
Histamine causes vasodilation, and especially in someone that?
Is dehydrated or has inflammation
77
What percent of receptors must be bound for Vecuronium to have its greatest effect?
70%
78
Compare sedatives vs hypnotics?
Sedatives induce calm or sleep & hypnotics induce hypnosis or sleep.
79
Sedatives & hypnotics both inhibit?
Thalamic & mid-brain RAS
80
What is altered by anesthesia, seen on EEG’s?
- Cerebral blood flow (CBF)
- Cerebral metabolic rate of oxygen (CMRO2)
81
The lower the BIS level/number means?
The lower= less movement
82
What is a desired BIS level during anesthesia & why?
40-60 & it’s enough to have no recall or movement.
83
The BIS monitor works best with narcotics, hypnotics, or ketamine?
With hypnotics
84
A BIS monitor suppression ration of 55 means what?
The patient is almost brain dead. The higher the number the worse the Pt is.
85
What are the 5 effects of benzodiazepines?
- Anxiolytic
- sedation
- anterograde amnesia
- anticonvulsant
- spinal-cord mediated skeletal muscle relaxation.
86
What would cause retrograde amnesia?
ECT (electroconvulsive therapy)
87
Why have benzos replaced barbiturates for pre-op sedation?
- Less tolerance
- less abuse potential
- fewer & less serious side effects
- do not induce CYP450 (CYP2A) enzymes.
88
Which drug is most attractive for post-op sedation & why?
Midazolam & it has less ½ time than diazepam & lorazepam
89
What is the MOA of benzos?
Attach to nearby receptor increasing affinity for GABA receptor leading to chloride hyperpolarization of the postsynaptic membrane
90
The bzd receptor is located where on GABA receptor?
Between the alpha-1 & gamma-2 subunits
91
What effects does a bzd binding the alpha-1 subunit of a GABA receptor have?
Sedation, amnesia, anticonvulsant
92
What effects does a bzd binding to the gamma-2 subunit of a GABA receptor have?
- Anxiolytic
- Skeletal muscle relaxation
93
The alpha-1 subunit of a GABA receptor affects which parts of the brain?
- (C)erebral cortex
- (C)erebellar cortex
- (T)halamus
94
The Gamma-2 subunit of a GABA receptor affects which parts of the brain?
Hippocampus, amygdala
95
Besides benzos, what other drugs bind to GABA receptors?
- Barbiturates,
- Etomidate
- Propofol
- EtOH
96
What are the general effects of benzos?
- Decreased alpha activity
- Antegrade amnesia
97
Benzos have synergistic effects with these?
- EtOH
- Injected anesthetics
- Opioids
- Alpha-2 agonists
- Inhaled anesthetics
98
How do benzos affect platelets?
They inhibit plt aggregation by inhibiting conformational change
99
What stabilizes & allows rapid metabolism of midazolam?
The Imidazole ring
100
What lasts longer with versed, sedation or amnesia?
Amnesia
101
When is versed water soluble & when is it lipid soluble?
- Water soluble & pronated @ a pH <3.5
- Lipid soluble & unprotonated @ a pH >4.0
102
What are the pharmacokinetics of versed?
- Onset 1-2mins,
- highly plasma protein bound,
- peak effect 5mins, does not stay on receptor very long,
- rapid redistribution, Vd is 1-1.5L/kg (large)
- E ½ time is 2hrs (double in elderly),
- stays longer in obese & elderly.
103
How is & into what is midazolam metabolized?
- Hepatic & intestinal CYP3A4 into active & inactive metabolites.
- Active metabolites cleared by kidneys
- ½ inactive is 1-hydroxymidazolam.
104
What drugs cause inhibition of P-450 enzymes?
- (A)ntifungal
- (F)entanyl
- (E)rythromycin
- (C)imetidine
- (C)CB’s
105
What are the CNS effects of midazolam?
- Decreased CMRO2 & CBF,
- No isoelectric,
- Potent anticonvulsant,
- Preserve vasomotor response,
- No change in ICP (Good for neuro Pt’s)
106
What are the pulmonary effects of midazolam?
- Decreased hypoxic drive
- Depressed swallow reflex
- Decreased upper airway activity
- Depression with COPD
- Transient apnea (esp w/ opioids)
107
What are the CV effects of midazolam?
- Dose dependent increased HR & lowered BP
- Decreased SVR
- No Cardiac output change
- Enhanced hypotension w/ hypovolemia
- Does not inhibit BP/HR response to intubation
108
What is the midazolam pre-op dose for children & peak effect?
0.25-0.5mg/kg PO & peak effect in 20-30mins
109
What is the midazolam pre-op dose for adults & peak?
1-5mg IV & peak @ 5mins
110
What is the induction dose for midazolam & its preceding medication & dose?
- Give 50 - 100mcg fentanyl
- Wait 1 - 3 mins
- Versed dose: 0.1-0.2mg/kg IV over 30-60sec
111
What are the N/V occurrences with midazolam?
Rare
112
What is the post-op dosing for midazolam?
1-7mg/hr
113
What are the IV infusion guidelines for midazolam?
2-3 days due to T-cell effect --> harder time fighting infection
114
What is the preparation of diazepam?
Insoluble in water & mixed w/ propylene glycol, which can burn on injection
115
What are the pharmacokinetics of diazepam?
- Onset 1-5mins
- E ½ time: 20-40hrs
- Extensively protein bound
- High Vd
- Shorter duration of action than lorazepam but longer E ½ time.
116
What is the metabolism of diazepam?
- CYP3A pathway
- Return of drowsiness in 6-8hrs
117
What are the 2 active metabolites of diazepam?
Desmethyldiazepam (48-96hrs) & oxazepam
118
What are the CNS effects of diazepam?
- CAN produce isoelectric EEG
- anticonvulsant
- abolishes DT’s
119
What is the diazepam dose for convulsions?
0.1mg/kg IV
120
What are the pulmonary effects of diazepam?
- Minimal decrease in Vt.
- Reversed w/ surgical stimulation
121
What are the CV effects of diazepam?
- Minimal BP, CO & SVR decrease.
- Decreased BP w/ opioids
122
What happens when mixing diazepam & nitrous?
No BP change but prevents recall
123
What are the neuromuscular effects of diazepam?
- Decreased tonic effect on spinal neurons & muscle tone.
- No action at NMJ
124
What is the induction dose of diazepam & when is it decreased?
- 0.5-1.0 mg/kg IV
- decreased w/ elderly, hepatic disease & presence of opioids
125
What is the difference between lorazepam & oxazepam?
Lorazepam has an extra chloride atom
126
Compared to midazolam & diazepam, lorazepam is more potent in what?
Sedation & amnesia
127
What is the preparation of lorazepam?
Requires polyethylene glycol d/t water insolubility
128
What are the pharmacokinetics of lorazepam?
- 1 - 4mg IV,
- peak effect in 20-30mins,
- E ½ is 14hrs (glucuronidation),
- Less affected by blood flow
- Less affected by hepatic function, age, drugs
129
What is the metabolism of Romazicon?
Hepatic enzymes to inactive metabolites
130
What is the consciousness dosing for Romazicon (IVP & infusion)?
- Repeat 0.1 mg q1min to 1mg total
- 0.2 mg IV & titrated to consciousness.
131
What is the reversal (sedation & therapeutic dose) dosing for Romazicon?
- 0.3 – 0.6 mg to reverse sedation
- 0.5 – 1.0 mg to abolish therapeutic dose
132
What is the duration of action of Romazicon?
30 – 60mins
133
What is the infusion dose of Romazicon?
0.1 – 0.4 mg/hr
134
What does using Romazicon as reversal not affect?
- No acute anxiety
- No HTN or tachycardia
- No change in MAC of volatiles
- No neuroendocrine evidence
135
When is Romazicon contraindicated?
- It reverses anticonvulsive effects &
- Precipitates acute withdrawal seizures
136
Which drugs (4) pre-op drugs induce histamine release & what kind (2)?
- Morphine, mivacurium, protamine, atracurium
- Basophils & mast cells
137
Released histamines from pre-op drugs induce what unwanted effects?
- Contraction of airway smooth muscles
- Stomach acid secretion
- Neurotransmitter release (ACh, NE, 5HT-3)
138
Histamines binding to H1 receptor leads to what negative effects?
- Hyperalgesia & inflammatory pain
- allergic rhino-conjunctivitis symptoms
139
Histamine on H2 receptor leads to?
- Elevated CAMP (Beta-1)
- increases acid/volume production
140
Histamine receptor activation through an agonist causes what?
- Hypotension (nitric oxide release)
- Flushing
- Prostacyclin release
- Tachycardia
- Increased capillary permeability
141
What is the E ½ time for diphenhydramine & what is the IV dose?
7 – 12hrs & 25 – 50 mg
142
Diphenhydramine may inhibit___ & stimulates___?
- Afferent arc of oculo-emetic reflex (this reflex causes N/V)
- ventilation
143
How does Benadryl stimulate ventilation?
Augments relationship of hypoxic & hypercarbic drives if given solo
144
What is the E ½ time , dose & onset for Phenergan?
- E 1/2: 9 – 16hrs
- Dose: 12.5 – 25 mg IV
- Onset 5mins
145
What is the dose for cimetidine (Tagament)?
- 150 – 300 mg
- ½ dose in renal impaired Pt’s
146
What are the adverse effects of cimetidine (Tagamet)?
- Bradycardia, hypotension (cardiac H2 receptors),
- increased prolactin plasma levels
- inhibits dihydrotestosterone binding to androgen receptors
147
What does cimetidine (Tagamet) strongly inhibit & what is affected?
CYP450 & affects drug metabolism of warfarin, phenytoin, lidocaine, propranolol, nifedipine, meperidine, diazepam, tricyclics
148
Where is cimetidine (Tagamet) metabolized & cleared?
CYP450 & cleared in urine
149
What is the dose & administration for ranitidine (Zantac)?
- 50 mg diluted to 20cc
- Infused over 2mins
- 1/2 dose for renal impaired
150
Which H2 antagonist does not interfere with CYP450 & is the most potent, what is its E 1/2?
- Famotidine (Pepcid)
- E ½: 2.5 – 4hrs
151
What is the dose for Pepcid (famotidine)?
20 mg IV & ½ dose for renal impaired
152
What does famotidine (Pepcid) interfere with?
Phosphate absorption --> hypophosphatemia
153
How do PPI’s work?
Irreversibly bind & inhibit proton movement across gastric parietal cells
154
What are PPI’s most useful for?
- Controlling gastric acidity
- Decreasing gastric volume
155
What are PPI’s more effective in, compared to H2 antagonists?
- Healing esophagitis & ulcers
- Relieving GERD
- Treatment of Zollinger-Ellison syndrome
156
What is Zollinger-Ellison syndrome?
Digestive disorder resulting in too much gastric acid
157
What possible side effects do PPI’s have?
- Bone fractures
- SLE
- Acute interstitial nephritis
- C-diff
- Vit B-12 & magnesium deficiency
158
Which two important drugs do PPI’s affect & how?
Blocks warfarin metabolism & blocks Plavix activation enzyme
159
What is the dose for pantoprazole (protonix)?
40 mg in 100mL over 2-15mins
160
What can long term use of antacids lead to?
Increased stomach pH --> inhibit food breakdown by acid & acid rebound can occur
161
What are long term side effects of magnesium-based antacids use?
- Osmotic diarrhea
- Neurologic & neuromuscular impairment
162
What are side effects of long term use of calcium-based antacids?
Hypercalcemia
163
What are side effects of long term use of sodium-based antacids?
Increased sodium load (hypertensive Pt’s)
164
Activating H1 receptors can lead to activation of what other receptors?
Muscarinic, cholinergic, 5-HT3, alpha-adrenergic
165
Activating H2 receptors can lead to activation of what other receptors?
5-HT3 & Beta-1
166
What is Benadryl mostly used for?
Antipruritic (allergies, anaphylaxis)
167
Histamine antagonists are technically what?
Inverse agonists, they don’t prevent histamine release but responses
168
What are H1 antagonists effective for?
- Motion sickness
- Bronchospasms
- Cardiac stability
- Anaphylaxis
169
What are the side effects of H1 antagonists?
Blurred vision, urinary retention, dry mouth, drowsiness (1st gen).
170
H2 receptor antagonists work by?
- Decreasing CAMP, hypersecretion of gastric protons & gastric volume
- increasing pH
171
What are the side effects of H2 antagonists?
- Diarrhea
- HA
- skeletal muscle pain
- weakened gastric mucosa
- bradycardia
- increased creatinine by 15%
172
What is the dose for omeprazole (Prilosec)?
40 mg in 100cc NS over 30mins or PO >3hrs prior
173
How does omeprazole work?
- Protonates parietal cells to active form,
- only inhibits present pumps up 66% inhibition
174
What are Omeprazole’s side effects?
- Crosses BBB --> HA, agitation, confusion,
- abd pain, N/V, flatulence, bowel bacterial growth
175
Aspirating which antacids is worse?
Particulate (aluminum or magnesium based ones)
176
Which antacids should be given for a trauma surgery?
Non-particulate, they neutralize stomach acid making it more alkalotic
177
What is the dose & half-life of Sodium citrate (Bicitra)?
15 – 30mL PO & works immediately for 30 – 60mins
178
What do dopamine blockers do?
- Increase lower esophageal sphincter tone
- Stimulate peristalsis
- Increase gastric emptying
179
What are side effects of dopamine blockers?
- Orthostatic hypotension
- Extrapyramidal reactions (crosses BBB)
- Dopamine inhibition/depletion
180
What is the dose for Reglan & when is it given?
- 10 – 20mg over 3 – 5mins
- Given 15 – 30mins prior to induction
181
What are side effects of Reglan?
- (D)ecreased plasma cholinesterase levels
- (A)bd cramping
- (M)uscle spasms
- (N)euroleptic malignant syndrome (temp, rigidity, tachycardia, confusion)
- (H)ypotension
- (I)ncreased prolactin
- (S)edation
182
What is the dose for Droperidol?
0.625 – 1.25mg IV
183
What are the side effects of Droperidol & what other class of meds should be avoided?
- Extrapyramidal symptoms (involuntary movements)
- Neuroleptic malignant syndrome
- Prolonged QT
- Avoid CNS depressants
- Volatile anesthetics
184
How does serotonin cause vomiting?
Chromaffin cells of small intestine release serotonin, which stimulates vagal afferents thru 5HT-3 --> vomiting
185
What are 5HT-3 antagonists not effective for?
Motion sickness/vestibular stimulation
186
What are the side effects of ondansetron?
- HA
- Diarrhea
- Slight QT prolongation
187
What is the plasma ½ life of ondansetron?
4hrs
188
What is the onset & half life of Decadron?
Onset is 2hrs & 24hrs half life
189
What is the dose for Decadron?
4mg, 8mg, or higher if airway issues/trauma while intubating
190
What are the side effects of Decadron?
- Perineal burning/itching (if rapid IV),
- Slight perioperative hyperglycemia for DM Pt’s
191
How does a scopolamine patch work?
- Priming dose of 140mcg
- 1.5mg released over next 48 - 72hrs
192
What are the side effects of scopolamine?
Mydriasis, photophobia, sedation
193
What is the onset & peak concentration for a scopolamine patch?
Apply 4hrs pre-op & peak in 24hrs
194
What is the MOA of a scopolamine patch?
Muscarinic antagonist, competitive antagonist of ACh
195
Where should a scopolamine patch be placed?
On thin skin areas like postauricular
196
What are the actions of bronchodilators?
Reduce inflammatory cell activation & directly reax smooth muscle
197
Compare SABA delivery via inhalation & ET tube?
- Inhalation delivers 12% of drug
- ETT delivers 50 – 70%
198
What are the side effects of bronchodilators?
- Tremors
- Tachycardia
- Hyperglycemia
- Transient decrease in O2 sats
199
Name all people relating to Nitrous Oxide
- Joseph Priestly (discovered N, O, photosynthesis)
- Humphry Davy (discovered electrolytes, suggested N2O use)
- Horace Wells (dentist, N2O= no recall)
- Andrews (surgeon)
- Hewitt (1st anesthesia machine)
- George Crile (Light N2O/O2 & LA w/Procaine)
200
Name all people relating to cocaine
- Koller (Eye anesthetic)
- Halsted (Head/Mandibular block)
- Bier (spinal block/Bier block)
201
Name all people related to Ether
- Crawford Long (vascular neck tumors)
- William Morton (Dental fittings)
- Morton/Warren (Public demonstration in London "Letheon")
- Robinson Squibb (Purified ether)
- Valerius Cordus (Tested diethyl ether on chickens)
- Harvey Cushing (Regional block after ether; Anesthesia records, BP, HR; Cushing's Triad)
202
Name all people related to chloroform
- Sir James Simpson (Defined pain)
- John Snow (1st full time anesthetist for Queen, Father of Epidemiology)
- Hyderbad Commission (safe practices, chloroform is not)
- Guthrie (delayed chloroform hepatotoxicity in children)
- Levy (light chloroform + Epi= V-fib)
203
Compare onset, offset, side effects of inhaled volatile anesthetics.
- Halothane: super slow onset & offset; Hepatitis.
- Isoflurane: Slow onset & offset; Less N/V.
- Desflurane: Rapid onset & offset, large quantities needed.
- Sevoflurane: Intermediate onset & offset, toxic degradation concerns.
204
What is neuropathic pain?
Pain caused by lesion or disease of somatosensory nervous system.
205
What is neuralgia?
Pain in the distribution of a nerve or group of nerves.
206
The dose required to produce a therapeutic response is called?
Potency
207
Central volume refers to?
Intravascular
208
What are the examples for H1 receptor antagonists?
- Diphenhydramine (Benadryl)
- Promethazine (Phenergan)
- Cetrizine (Zyrtec)
- Loratidine (Claritin)
209
What are the drug examples for H2 receptor antagonists?
- Cimetidine (Tagament)
- Ranitidine (Zantac)
- Famotidine (Pepcid)
210
What are the drug examples for dopamine blockers?
- Metoclopramide (Reglan)
- Domperidone
- Droperidol (Inapsine)
211
What are the drug examples for anti-emetics?
- Ondansetron (Zofran)
- Granisetron (Kytril)
- Dolasetron (Anzemet)
