General Anesthetics

Question 1

loss of consciousness, amnesia, immobility

Answer 1

anesthesia

Question 2

loss of pain sensation

Answer 2

analgesia

Question 3

analgesia, amnesia, euphoria

Answer 3

Stage 1: anesthesia

Question 4

Excitement, delirium, combative behavior

Answer 4

Stage 2: excitement

Question 5

unconscious, regular respiration, decreasing eye movement

Answer 5

Stage 3: surgical anesthesia

Question 6

respiratory arrest, cardiac depression/arrest, no eye movement

Answer 6

Stage 4: medullary depression

Question 7

theory that the function of the excitable membrane protein is modified by dissolved anesthetics.

Answer 7

lipid theory

Question 8

Mayerton-overton rule, hyperbaric pressure He can reverse anesthesia.

Answer 8

support lipid theory

Question 9

Enantiomers have differential anesthetic potencies. Some chemical analogues of known anesthetics do not cause anesthesia.

Answer 9

counter lipid theory

Question 10

cuases both significant enhancement of inhibition and inhibition of excitation

Answer 10

inhaled anesthetics

Question 11

Inhibit excitatory NDMA and nicotinic receptors.

Answer 11

cyclopropane and ketamine, volatile NO and Xenon

Question 12

enhancement of GABA transmission. Adrenocortical depression. Pain at injection site. Less CV and resp. depression than thiopental.

Answer 12

etomidate

Question 13

rate of equilibration of inhaled anesthetics depends on what three things?

Answer 13

ventilation rate, plasma solubility, lipophilic character

Question 14

preoperative anxiety and separation anxiety in children

Answer 14

midazolam

Question 15

IV anesthetic. Enhances GABA. Rapid onset, recovery and no cumulative effects.

Answer 15

Propofol

Question 16

most frequently used drug for induction of anesthesia, also used for maintenance in OR and ICU

Answer 16

Propofol

Question 17

produces apnea after and induction dose

Answer 17

Propofol

Question 18

Enhance GABA. Fast onset, slow recovery – hangover. Liver metabolized.

Answer 18

Barbiturates – Thiopental, Methohexital

Question 19

routine induction agent. Tx – ICP and neuronal protection from focal cerebral ischemia. AE – vasoconstriction – gangrene, contraindicated in intermittent porphyria.

Answer 19

Barbiturates – Thiopental, Methohexital

Question 20

perioperative anxiolytics. Anterograde amnesia, sedative hypnotic, antiseizure, anesthesia. Increase of GABA

Answer 20

BZ – diazepam, lorazepam, midazolam

Question 21

OD of BZ give…

Answer 21

Flumazenil

Question 22

IV NMDA inhibitor. Profound analgesia, stimulation of sympathetic NS, bronchodilation and minimal respiratory depression. AE – lacrimation, salivation, raised ICP.

Answer 22

ketamine

Question 23

minimize hallucinations, vivid dreams, euphoria by combining ketamine with…

Answer 23

BZ – diazepam, lorazepam, midazolam

Question 24

alternative to propofol and barbs for rapid IV induction of anesthesia.

Answer 24

Etomidate

Question 25

Alpha-2 agonist. Adjunct to gen anesthesia. Short term sedation of intubated ventilated pts ICU. AE – heart block, bradycardia, asystole.

Answer 25

Dexmedetomidine

Question 26

Inhaled agents currently in use.

Answer 26

halothane, NO, isoflurane, enflurane, desflurane, and sevoflurane.

Question 27

volatile hepatotoxic, and malignant hyperthermia

Answer 27

halothane

Question 28

produce signs of B12 deficiency – megaloblastic anemia. Outpt dental. Adjunct. AE – pneumothorax, post-op nausea.

Answer 28

NO

Question 29

induction of anesthesia in children, maintenance in adults. Volatile. - sensitizes myocardium to catecholamines – arrythmias

Answer 29

Halothane

Question 30

faster onset and recovery than halothane. Mostly maintenance. Isoniazid enhances metabolism. Requires MAC – less if administered with NO or opioids. AE – muscle relaxant, hypotension, seizure

Answer 30

Enflurane

Question 31

similar to enflurane but no proconvulsive properties. Precipitates myocardial ischemia in pts with CAD. Airway irritant

Answer 31

Isoflurane

Question 32

Maintenance. Airway irritant. Faster onset and recovery than isoflurane.

Answer 32

Desflurane

Question 33

No airway irritation – except when reactant with baralyme. Widely used inhaled induction – especially in children.

Answer 33

Sevoflurane

Question 34

allows pt to skip stages 1 and 2 of anesthesia

Answer 34

thiopental with inhaled anesthetic

Question 35

maximize NO benefits while minimizing adverse effects.

Answer 35

NO with Isoflurane