General Anesthetics

Question 1

what are 3 effects of preanesthetic medication

Answer 1

decrease respiratory secretions
antiemetic effect
decrease gastric juice acidity and volume in case of aspiration

Question 2

what are 2 mechanisms of action of general anesthetics

Answer 2

enhance inhibitory activity (GABA)
diminish excitatory activity

Question 3

to achieve effective concentration in CNS, inhaled anesthetics require transfer from __ –>__–>__

Answer 3

alveoli–>blood–>brain

Question 4

are general anesthetics with low blood:gas partition coefficient more or less soluble in blood

Answer 4

less

Question 5

do general anesthetics with low blood:gas partition coefficient have slow or rapid induction and recovery

Answer 5

low= less soluble in blood= rapid induction and recovery

Question 6

high blood:gas partition coefficient
=___ soluble (more or less)
=__ induction and recovery (faster or slowe)

Answer 6

high coefficient= more soluble= slower

Question 7

the higher the lipid solubility, the more or less potent the general anesthetic

Answer 7

higher solubility= more potent

Question 8

at low pulmonary flow rates, is general anesthesia onset faster or slower

Answer 8

faster

Question 9

what is the form of elimination of most general anesthetics

Answer 9

through lungs

Question 10

what general anesthesia undergoes partial metabolism in the liver, leading to hepatotoxicity

Answer 10

Halothane

Question 11

what is the MAC value

Answer 11

median alveolar concentration that results in immobility in 50% of patients when exposed to pain

Question 12

do highly lipid soluble anesthetics have higher or lower MAC

Answer 12

lower

Question 13

does a lower MAC mean more or less potent

Answer 13

more

Question 14

nitric oxide is a good __ but weak __

anesthetic or analgesic

Answer 14

good analgesic
weak anesthetic

Question 15

what 2 effects are seen during recovery with NO

Answer 15

second gas effect
diffusional hypoxia

Question 16

NO use is cautioned in those with __

Answer 16

pneumothorax

Question 17

Halothane is a good __ but weak__

anesthetic or analgesic

Answer 17

good anesthetic
weak analgesic and muscle relaxant

Question 18

what inhaled analgesic is commonly used in children

Answer 18

Halothane

Question 19

what are 3 adverse effects of Halothane

Answer 19

hepatic necrosis
malignant hypertension
can induce arrhythmias

Question 20

what commonly used anesthetic maintains coronary circulation and does not provoke seizures

Answer 20

Isoflurane

Question 21

what is an adverse effect of Sevoflurane

Answer 21

nephrotoxicity

Question 22

what mode of general anesthetics have rapid induction and are used for maintenance of anesthesia when inhalational general anesthetics are contraindicated

Answer 22

IV

Question 23

recovery from intravenous general anesthetics is mainly by __

Answer 23

redistribution

Question 24

what characteristic of the IV anesthetic Thiopental provides a limitation

Answer 24

consciousness is regained in 10-20 minutes

Question 25

what is the main use of Thiopental

Answer 25

induction of anesthesia in neurosurgery

Question 26

what property of Thiopental allows it to be used in head injury

Answer 26

decreased cerebral blood flow so there is no increase in ICP

Question 27

Thiopental is contradicted in patients with __

Answer 27

porphyria

Question 28

what is the most commonly used IV anesthetic

Answer 28

Propofol

Question 29

why is Propofol the most commonly used IV anesthetic

Answer 29

produces a euphoric effect less postanesthetic nausea and vomiting short half life

Question 30

what is the mechanism of action of the IV general anesthetic Propofol

Answer 30

increases binding and affinity of GABA for GABA-A receptor

Question 31

what are 2 adverse effects of the IV general anesthetic Propofol

Answer 31

decreases BP respiratory depression

Question 32

what is Propofol infusion syndrome (PRIS)

Answer 32

acute refractory bradycardia leading to asystole

Question 33

what is the mechanism of action of the IV general anesthetic Etomidate

Answer 33

GABA like effects with potentiation of GABA-A mediated chloride channels

Question 34

what is the effect of repeated administration of IV Etomidate

Answer 34

suppresses steroid production

Question 35

what IV general anesthetic induces dissociative anesthesia in which the patient is conscious without feeling pain

Answer 35

Ketamine

Question 36

what is the mechanism of action of Ketamine

Answer 36

blocks NMDA receptors

Question 37

what is the effect of Ketamine on cerebral blood flow

Answer 37

increases cerebral blood flow and ICP

Question 38

what general anesthetic produces hallucinations during the postoperative/recovery stage

Answer 38

Ketamine

Question 39

one of the main uses of ketamine as an anesthetic agent is for what

Answer 39

burn dressing and trauma surgery

Question 40

what anesthetic can be used to manage acute severe asthma in children

Answer 40

Ketamine