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Block 3 Pharm > General and Local Anesthetics > Flashcards

General and Local Anesthetics Flashcards

1
Q

thiopental: what it is, use, positive/negative aspects, side effects, contraindications

A
  • parenterally administered barbiturate general anesthetic
  • induction only
  • has a long half-life so it can produce “hang-over” effects after anesthesia has worn off
  • side effect: causes decreased ICP, venodilation, respiratory depression
  • contraindicated in patients with impaired ability to compensate for venodilation (e.g., hypovolemia, cardiomyopathy)
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2
Q

can cause “hang-over” effects after anesthesia has worn off

A

thiopental

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3
Q

propofol: what it is, use, positive/negative aspects, side effects, contraindications

A

-parenterally administered general anesthetic
-induction and maintenance
-antiemetic
-shorter half-life than thiopental so it is used for outpatient surgery
-side effects: decreased ICP,
more severe decrease in BP than thiopental, more respiratory depression than thiopental
-contraindicated in patients with impaired ability to compensate for venodilation (e.g., hypovolemia, cardiomyopathy)

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4
Q

antiemetic

A

propofol

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5
Q

shorter half-life than thiopental so it is used for outpatient surgery

A

propofol

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6
Q

contraindicated in patients with impaired ability to compensate for venodilation (e.g., hypovolemia, cardiomyopathy)

A

thiopental, propofol

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7
Q

etomidate: what it is, use, positive/negative aspects, side effects

A
  • parenterally administered general anesthetic
  • induction for patients at risk for hypotension
  • little or no decrease in BP, less respiratory depression than thiopental and propofol
  • side effects: significantly more nausea and vomiting than thiopental, increased post-surgical morbidity due to suppression of adrenocortical stress response
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8
Q

suppression of adrenocortical stress response

A

etomidate

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9
Q

used for induction for patients at risk for hypotension

A

etomidate

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10
Q

dissociative anesthesia

A

ketamine

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11
Q

parenterally administered general anesthetic that does not act on GABA receptors

A

ketamine (NMDA receptor antagonist)

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12
Q

emergence delirium

A

ketamine

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13
Q

ketamine: what it is, use, positive/negative aspects, side effects

A
  • parenterally-administered general anesthetic reserved for patients with asthma/bronchospasm
  • NMDA receptor antagonist
  • causes “dissociative anesthesia”
  • causes no respiratory depression and is a bronchodilator
  • side effects: nystagmus, spontaneous limb movements, increased ICP, hypertension, emergence delirium
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14
Q

anesthetic reserved for patients with asthma/bronchospasm

A

ketamine

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15
Q

short-acting benzodiazepine parenterally-administered general anesthetic

A

midazolam

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16
Q

conscious sedation

A

midazolam

17
Q

anxiolytic

A

midazolam

18
Q

midazolam: what it is, duration of action, use, positive/negative aspects, side effects, contraindications

A
  • parenterally-administerd short-acting benzodiazepine general anesthetic
  • induction only
  • used for conscious sedation
  • anxiolytic = good for pre-op
  • side effects: respiratory depression/respiratory arrest, decreased BP
  • contraindicated in patients with neuromuscular disease, Parkinson’s, bipolar disorder
19
Q

how does blood:gas coefficient influence the rate of induction and recovery from anesthesia?

A

the lower the blood:gas partition coefficient, the faster the rate of induction and the shorter the recovery from anesthesia

20
Q

isoflurane: what it is, blood:gas coefficient, use, side effects

A
  • inhalational anesthetic
  • moderate blood:gas coefficient
  • induction and maintenance
  • side effects: airway irritant, decreases BP, increased ICP
21
Q

desflurane: what it is, blood:gas coefficient, use, side effects

A
  • inhalational anesthetic
  • very low blood:gas coefficient (=rapid induction and recovery)
  • maintenance (not used to induce because it can cause bronchospasm)
  • side effects: airway irritant, decreases BP, increased ICP
22
Q

sevoflurane: what it is, blood:gas coefficient, use, side effects

A
  • very low blood:gas coefficient (=rapid induction and recovery)
  • induction and maintenance
  • side effects: NOT a respiratory irritant, decreases BP, increased ICP, less respiratory depression than isoflurane; can be metabolized to fluoride ion in the liver –> renal damage
23
Q

inhalational anesthetic that is NOT a respiratory irritant

A

sevoflurane

24
Q

moderate blood:gas coefficient

A

isoflurane

25
Q

anesthetics used for induction and maintenance

A

SIP: propofol, sevoflurane, isoflurane

26
Q

nitrous oxide

A
  • rapid uptake from the alveolae results in “concentration” of gases that are administered at the same time
  • can dilute oxygen when its use is discontinued, therefore need to place patients on 100% O2 during emergence
27
Q

cocaine: what it is, use

A
  • ester local anesthetic
  • potent vasoconstrictor–>shrinks mucosal membranes and limits bleeding
  • used as topical anesthetic for upper respiratory tract
28
Q

procaine: duration of action, what it is, use

A
  • short-acting synthetic ester local anesthetic

- infiltration anesthesia

29
Q

tetracaine: duration of action, what it is, use

A
  • long-acting ester local anesthetic

- used in spinal anesthesia and in topical and ophthalmic preparations

30
Q

benzocaine: what it is, use

A
  • ester local anesthetic

- applied topically to burns and ulcerated surfaces

31
Q

lidocaine: what it is, duration of action, comparison with procaine, uses

A
  • amide local anesthetic
  • intermediate duration of action
  • faster, more intense, longer lasting anesthesia than procaine
  • wide range of clinical uses
32
Q

bupivacaine: duration of action, what it is, positive aspect, side effects

A
  • long acting amide local anesthetic
  • motor-sparing
  • more cardiotoxic than lidocaine
33
Q

ropivacaine: duration of action, what it is, positive aspects, uses

A
  • long acting amide local anesthetic
  • less cardiotoxic than bupivacaine
  • even more motor-sparing than bupivacaine
  • epidural and regional anesthesia
34
Q

drugs that are long acting amide local anesthetics

A

bupivacaine, ropivacaine

35
Q

least cardiotoxic amide local anesthetic

A

ropivacaine

36
Q

most cardiotoxic amide local anesthetic

A

bupivacaine

37
Q

short-acting synthetic ester local anesthetic

A

procaine

38
Q

long-acting ester local anesthetic used in spinal anesthesia and in topical and ophthalmic preparations

A

tetracaine

39
Q

most motor-sparing amide local anesthetic

A

ropivacaine

Block 3 Pharm (17 decks)

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