Fiser Absite. Ch 08-09. Anesthesia. Fluid And Electrolytes Flashcards Preview

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Flashcards in Fiser Absite. Ch 08-09. Anesthesia. Fluid And Electrolytes Deck (146)
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1

What is MAC?

minimum alveolar concentration = smallest concentration of inhalation agent at which 50% of patients will not move with incision

2

What does a small MAC mean?

more lipid soluble = more potent

3

Speed of induction is inversely proportional to ____

solubility

4

Which inhalation agent is fastest but has high MAC (low potency), also minimal myocardial depression?

Nitrous oxide

5

Which inhalation agent is slow, higest degree of cardiac depression and arrhythmias; least pungent; which is good for children?

Halothane

6

What are the sx of Halothane hepatitis?

fever, eosinophilia, jaundice, increased LFTs

7

Which inhalation agent can cause seizures?

Enflurane

8

Which inhalation agent is good for neurosurgery but has higher cost?

Isoflurane

9

Which inhalation agent has less myocardial depression, fast onset/offset, less laryngospasm; higher cost?

sevoflurane

10

Which induction agent is a fast acting barbituate with side effects of decreased cerebral blood flow and metabolic rate, decreased blood pressure.

sodium thiopental

11

Which induction agent has very rapid distribution and on/off; amnesia; sedative. Not an analgesic. Metabolized in liver by plasma cholinesterases. Do not use in patients with egg allergy.

Propofol

12

What are the side effects of propofol.

hypotension and respiratory depression

13

Which induction agent has dissociation of thalamic/limbic systems; places pt in a cataleptic state (amnesia, analgesia). No respiratory depression.

Ketamine

14

What are the side effects of Ketamine?

hallucinations, catecholamine release (increased carbon monoxide, tachycardia), increased airway secretions, and increased cerebral blood flow

15

When is ketamine contraindicated?

pts with a head injury

16

Which induction agent has fewer hemodynamic changes; fast acting. Continuous infusions can lead to adrenocortical suppression.

Etomidate

17

What is the last muscle to go down and 1st muscle to recover from paralytics?

diaphragm

18

What is the first muscle to go down and the last to recover from paralytics?

neck muscles and face

19

What is the only depolarizing agent?

succinylcholine

20

What is the 1st sign of malignant hyperthermia?

increased end-tidal CO2

21

Tx for malignant hyperthermia?

Dantrolene inhibits Ca release. cooling blankets, bicarb, glucose

22

Do not use succinylchoine in pts with what?

burn pts, neurologic injury, neuromuscular disorders, spinal cord injury, massive trauma, acute renal failure

23

What can happen if pt with open-angle glaucoma gets succinylcholine?

it can become close angle glaucoma

24

Atypical pseudocholinesterases

cause prolonged paralysis with succinylcholine (Asians)

25

How do nondepolarizing paralytic agents work?

inhibit neuromuscular junction by competing with acetylcholine

26

Which paralytic undergoes Hoffman degredation. Can be used in liver and renal failure. Histamine release.

Cis-atracurium

27

Which paralytic is fast, short acting; degradation by plasma cholinesterases. Histamine release.

Mivacurium

28

Which paralytic is fast, intermediate duration; hepatic metabolism.

Rocuronium

29

Which paralytic is slow acting, long-lasting; renal metabolism. Most common side effect is tachycardia.

Pancuronium

30

What two drugs can be given for reversing nondepolarizing agents and what is their MOA?

Neostigmine and Edrophonium, they block acetylcholinesterase, increasing acetylcholine