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General And Local Anthesthetics Flashcards

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1
Q

What is neuraxial anesthesia?

A

Spinal, epidural and spinal-epidural anesthesia

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2
Q

What is a Bier block?

A

Local anesthesia via IV

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3
Q

What is MAC? What does it stand for?

A

Injected anesthesia without volatile liquids

Monitored Anesthetic Care

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4
Q

What is induction?

A

Going from consciousness to stage 3

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5
Q

What is PSA?

A

Procedural sedation w/ analgesia

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6
Q

What are the effects of a pt enters stage 4?

A

Loses vasomotor, cardioregulatory and respiratory center

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7
Q

What occurs after a pt after induction?

A

Maintenance

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8
Q

What is monitored by CRNA when pt is in stage 3?

A

ABC

Airways breathing and circulation

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9
Q

What is PONv stand forever

A

Post operative Nausea and Vomitting

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10
Q

What is balance anesthesia?

A

Low doses of many different anesthesia’s meds

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11
Q

What is desflurane(Suprane)? What effect does it have on the body? How pungent is it?

A

Volatile liquid

Causes bronchodilation
Increases SM tone

Very pungent

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12
Q

What is sevoflurane(Ultane)? What does it cause and how pungent is it?

A

Volatile liquid

Causes bronchodilation and SM tone

Not very pungent

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13
Q

What effects do inhaled anesthetics have on memory and pain?

A

Analgesic and amnesia effect

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14
Q

What do General anesthetics and inhaled anesthetics cause in the body?
Vessels, BP, and respiration

A

Vasodilator

Decrease BP

Respiratory depression

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15
Q

What does PONV stand for?

A

Post operative nausea and vomitting

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16
Q

What is the number 1 inhaled anesthetic?

A

Sevoflurane

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17
Q

What do volatile liquids end in?

A

-flurane

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18
Q

What is the MOA if inhaled anesthetics?

A

Activates GABA-A receptors to increase Cl- permeability

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19
Q

How are inhaled anesthetics administered?

A

Via mask

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20
Q

How are inhaled drugs supplied as and then what happens to them during surgery?

A

Start as liquid then are vaporized to be breathed in

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21
Q

What is the route of elimination for inhaled anesthetics?

A

Respirating

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22
Q

True or false: many volatile anesthetics are ethers?

A

True

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23
Q

A drug that has a high blood:gas partition coefficient is considered? How fast can it get to the brain?

A

More soluble in the blood (more hydrophilic)

Takes longer to get to the brain

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24
Q

A low blood:gas partition coefficient is?

A

Hydrophobic. Quicker to get to the brain

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25
Out of desflurane, sevoflurane and halothane, which has the quickest onset or lowest blood:gas partition coefficient?
Desflurane
26
What does MAC stand for? What does it measure?
Minimum alveolar concentration Potency of a drug
27
A low MAC means?
A high potency
28
What is a common ADR of volatile liquids and NMBD?
Malignant hyperthermia
29
How can malignant hyperthermia occur?
Taking volatile liquids or succlynate NMBD
30
What are the 5 common symptoms of malignant hyperthermia?
``` Tachypnea Tachycardia Muscle rigidity Acidosis Increased body temp ```
31
True of false: is malignant hyperthermia life threatening?
True
32
What is the antidote or used to Tx malignant hyperthermia?
Dantrolene(dantrium)
33
What does PSA stand for?
Procedural sedation w/ analgesia
34
What is 4 stages are considered PSA? Which has the greatest CNS depression?
Analgesia Minimal sedation Moderate sedation Deep sedation Deep sedation
35
Which form of anesthesia uses volatile liquids?
General anesthesia
36
What are the indications for PSA?(5)
``` Dislocated joint (reduction) Electrical cardio version Severe laceration Abscess incision Lumbar puncture ```
37
What is propofol(Diprivan)? How is it given? How quick does it onset and last? PONV? Analgesia or amnesia effect? Pain w/ injection?
General anesthetic IV Quick onset and recovery No PONV No analgesic effect, only amnesia Pain with injection
38
What drug is considered the milk of amnesia?
Propofol(diprivan)
39
True or false: propofol has a large therapeutic range?
False, it has a very narrow therapeutic range
40
Why must propofol(diprivan) be given with aseptic technique?
Because it can cause necrosis if bacteria in body are able to use it as good
41
What pieces of equipment is needed if a provider is giving a pt propofol?
Intubation and respiratory assistance equipment
42
What is etomidate(Amidate)? How is it given? What is is MOA? What is it used for? How does it effect BP or cardiac output? PONV? Pain w/ injection? Analgesic and amnesia activity?
General anesthetic Given thru injection Enhances GABA-A Used for PSA and RSI No effect on BP and cardiac output Cause PONV Pain w/ injection Amnesia effect w/ No analgesic activity
43
What is dexmedetomidine(Precedex)? What does it cause? Respiratory depression? Analgesic or amnesia effect? Indications? Why used in ventilator pt?
Alpha 2 agonist Reduces NE release from Pons Causes no respiratory depression Small analgesic activity with amnesia Used for PSA and RSI Used on ventilator pt to not fight ventilator
44
What is ketamine(Ketalar)? Indications? MOA? Analgesic and amnesia effect? Respiratory depression? Route?
General anesthetic General anesthesia and setting broken bones NMDA receptor antagonist (blocks excitation) Good analgesic w/ amnesia Oral or injected
45
What does ketamine have effect on a pt eyes?
Eyes remain open
46
What effect on skeletal muscle does ketamine have?
No effect
47
What is midazolam(Versed)? What is it used for? Analgesic or amnesia effect? What is it used with? route? What age of pt often receive this medication?
Benzodiazepine Minimal sedation (PSA) Amnesia effect with no analgesic effect Oral and rectal Used with kids to calm them down
48
What is another name for nitrous oxide? What must it be given with? PONV? Analgesic effect?
Laughing gas Oxygen Causes PONV Analgesic effect
49
Drugs that are GABA-A receptor enhancers?
``` Barbiturates Benzodiazepines Etomidate Propofol Volatile anesthetics ```
50
Drugs that are NMDA glutamate antagonists?
Ketamine Nitrous oxide Glutamate
51
What is a local anesthetic pH before injection into body? Solution? ECF? Inside cell?
Weak base Acidic Basic Acidic
52
What is the MOA of local anesthetics?
Blocks Na inactivation gate
53
What fibers are effected from local anesthetics?
A-delta fibers C fibers Small nerve fibers Non-myelinated fibers
54
What are the two different types of local anesthetics? How are they broken down? How long are they active?
Esters(broken down by AChase) -short acting Amides(broken down by liver) -long acting
55
What category of local anesthetic is cocaine? Route?
Ester Given as injection
56
What is Benzocaine? What category is it? What can long use cause? What is it used for?
Local anesthetic Ester group Causes allergies Skin abrasions Sunburn Insect bite
57
What is bupivicaine(Marcaine)? How long does it last? What is it used for?
Amide local anesthetic Long acting Used as epidural and nerve block
58
What is lidocaine(Xylocaine)? What is the onset time? How long does it last?
Amide local anesthetic Rapid onset Intermediate lasting
59
What is lidocaine(lidoderm patch)? What is it used for?
Amide local anesthetic Used for postherapetic neuralgia (shingles)
60
What are the difference route of local anesthetics?
OTC EMLA Injection Infiltration analgesia
61
What is intradermal injection with local anesthetic?
Infiltration analgesic
62
What effects does epi w/ lidocaine cause? This helps with what?(2)
Vasoconstriction Increase half life Prevents it going systemic
63
What local anesthetics penetrate the dura mater? Where must they be inserted below?
Spinal injections and taps Below L2
64
What are the ADR if local anesthetic goes systemic?
Cardiovascular collapse Convulsions...leading to coma Spinal headache
65
How can you take away a spinal headache?
Inject blood into leaking area of spinal entry Have pt Lay down
66
What are the two type of skeletal muscle blockers/paralytic/NMBD?
Non-depolarize gets Depolarizing
67
What is succcinylcholine? MOA? Indication? ADR?
Depolarizing NMBD antagonist Binds to N1 receptor causing twitching (agonist) Then alters N1 receptor to not respond to ACh(antagonist) RSI Can cause malignant hyperthermia
68
What are the two drugs that cause malignant hyperthermia?
Volatile liquids Succcinylcholine
69
What do non-depolarizing blockers end in?
-curium or -curonium
70
How long does a blockade for non-depolarizing blockers last? How long is the onset to occur?
20-30min 3-5min wait for onset
71
What is vecuronium bromide(Norcuron)?
Non-depolarizing blocker (paralytic)
72
What is cisatracurium(Nimbex)?
Non-depolarizing blocker (paralytic)
73
What is rocuronium bromide(Zemuron)?
Non-depolarizing blocker (paralytic)
74
What is pancuronium bromide(Pavulon)?
Non-depolarizing blocker (paralytic)
75
Before using NMBD what should a Hx been known on pt?
Hx of response time analgesia Hx of allergies and medications Hx of alcohol and opioids

Pharmacology (27 decks)

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