Induction Agents - Quiz 2 Flashcards Preview

Spring 2020 - Pharmacology 1 > Induction Agents - Quiz 2 > Flashcards

Flashcards in Induction Agents - Quiz 2 Deck (90)
Loading flashcards...
1

What helps moves neurotransmitters to the endplate to release itself to the synapse then to the receptor?

Calciuim

2

What is broken down to form GABA

Glutamate

3

What kind of an effect does the GABA Agonist have?

Inhibitory Neurotransmitter

4

How does Glutamate work?

Released by calcium --> binds with NMDA --> Influx of Positively charged ions

Excitatory Effect

5

How can the effects of Glutamate be blocked?

Ketamine - Noncompetitive Antagonist

(also rapid antidepressant)

6

How does the Alpha2 Receptor Negative Feedback Loop Work?

Excess Norepi binds to presynaptic alpha2 receptor and inhibits release of Norepi

7

How does Precedex work?

Binds to presynaptic alpha2 receptors, blocking release of Norepi = sedation

8

Location of Baroreceptors

Aortic Arch, Carotid Body - signals travel to medulla and regulate heart rate, arterial, and venous tone according MAP

9

What nerves do baroreceptor impules travel through?

Vagus, Glossopharyngeal, and Hering's

Action: Inhibits/Stimulates sympathetic/parasympathetic system

10

Central Chemoreceptors

Respond to pH and CO2 changes

(Peripheral Chemoreceptors responds to O2)

11

Advantages of IV Anesthesia

Rapid onset of General Anesthesia (30 sec - 1 min)

Can be used for maintenance of General Anesthesia

Provides sedation for MAC
 

12

How long does it normally take for a patient to wake back up from induction meds?

9 Minutes

13

Disadvantages of IV Anesthesia

There is no ONE med that provides hypnosis, amnesia, analgesia, and immobility.

14

What is Balanced Anesthesia

Use of Multiple drugs

  • Inhalation agents
  • IV induction agents
  • Sedative/Hypnotic
  • Opioids
  • Neuromuscular Blockade

15

Are IV Induction Agents hydrophilic or lipophilic?

All are Lipophilic - for rapid onset in brain and spinal cord

16

Body Mass % of Normal Adult

  • Vessel Rich:  10%
  • Vessel Poor: 20%
  • Fat:                20%
  • Muscle:         50%

17

Blood Flow % of Cardiac Output

  • Vessel Rich:   75%
  • Vessel Poor:  <1%
  • Fat:                  6%
  • Muscle:           19%

18

How is the effect of a Single Dose of IV Induction agent stopped?

Distribution, Not Metabolism

Drug redistributed to less perfused tissues: vessel rich & poor

19

When does metabolism of IV Induction medications come into play?

When multiple doses are given and when there's a buildup of the drug

20

IV Bolus Three Compartment Model

Med goes to general circulation --> distributes to vessel rich organs --> rapid redistribution to vessel poor (shallow) --> slow distribution to peripheral compartments (deep) --> metabolism

21

What are the vessel rich organs?

Brain

Liver

Kidneys

Gut

22

What are the Vessel Poor Organs

Shallow Compartment

Muscles

23

What is part of the Deep Compartment?

Fat

24

In what phase does distrbution last for 2-4 minutes?

Rapid distribution phase to vessel poor group

25

List classes of IV Induction Agents

Barbiturates
Benzos
Propofol
Ketamine
Etomidate
Precedex

26

Barbiturates

1930's - Oldest Class

Sedative, Hypnotic, Anticonvulsant

27

Chemical Structure of Barbiturates

Barbituric Acid - lacks CNS Activity

28

How do hypnotic, sedative, and anticonvulsive effects occur regarding barbituric acid?

Subbing on N1, C2, C5 sites

29

Why do myoclonic jerks occur when bolus dose of induction agent is given?

Body's natural response to bolus of inhibition = Sympathetic outflow

30

Barbiturate MOA

Acts with GABA to enhance profound hyperpolarization