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1 Anaesthesia > Intro to Anaesthesia > Flashcards

Intro to Anaesthesia Flashcards

1
Q

Definitions of Anaesthesia

A

Amnesia - LOC

Analgesia - pain relief

Akinesis - M paralysis

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2
Q

what is PONV

A

post operative N/V

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3
Q

common inducers of amnesia

A

porpofol - MJ milk

etomidate

Ketamine

Thiopentone

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4
Q

Tell me about propofol

A

it is an amnesia induction agent

it is commonly used

lipid based

decreased incidence of PONV

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5
Q

unwanted effects of propfol

A

these may include

marked drop in HR and BP

pain on injection

Involuntary movements - how likely

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6
Q

Tell me about Thiopentone

A

it is a Barbiturate (drug that acts on CNS)

faster than propofol hence used in rapid sequence induction

good in that it has antiepileptic properties and protects the brain

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7
Q

unwanted effects of Thiopentone

A

these may include

drops BP but rise in HR

rash / bronchospasm

arterial injection may cause throbosis and gangrene

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8
Q

Tell me about Ketamine

A

dissociative anaesthesia??

slow onset

Rise in HR/BP
Bronchodilator

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9
Q

Unwanted effects of Ketamine

A

N/V

vivid dreams and hallucinations

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10
Q

Tell me about Etomidate

A

rapid onset

Hemodynamic stability?

lowest incidence of hypersensitivity reactions

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11
Q

Unwanted effects of Etomidate

A

Pain on injection

spontaneous movements

adren-cortical suppresion

High incidence PONV

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12
Q

How do you maintain Amnesia

A

through use of inhalation agents

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13
Q

Give me examples of inhalation agents

A

Isoflurane

Sevoflurane

Desflurane

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14
Q

Tell me about Sevoflurane

A

Sweet smelling

Inhalational induction

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15
Q

Tell me about Desflurane

A

Low lipid solubility
Rapid onset and offset
Long operations

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16
Q

Tell me about Isoflurane

A

Least effect on organ blood flow

17
Q

What is Minimum Alveolar concentration (MAC)

A

?

18
Q

What is a vapouriser

A

Device used to deliver accurately measured concentration of volatile anaesthetic agents

19
Q

Short acting Opioids (During operation)

A

Fentanyl (90), Remifentanil (IV infusion) ,Alfentanil (2nd)

20
Q

Long acting Opioids (After operation)

A

Intra-op and post-op analgesia

Morphine, Oxycodone

21
Q

Most common Analgesia drugs?

A 
Most commonly used analgesic
Paracetamol
Most commonly used oral opioid in adults
Codeine
Intravenous NSAIDS
Ketorolac, Parecoxib
22
Q

What other opioid you can give with morphine

A

Tramadol

23
Q

Tell me about Suxamethonium

A

it is an Akinesis agent

Depolarising?

Rapid Sequence Induction (Rapid onset - Rapid offset)

24
Q

Unwanted effects of Suxamethonium

A 
muscle pains, 
fasciculations,
hyperkalemia
malignant hyperthermia, 
rise in ICP,IOP and gastric pressure
25
Q

Provide examples of Non-depolarising Akinsis agents

A

Slow onset and variable duration, less side effects
Compete with Ach for nicotinic receptors

Short acting: Atracurium, mivacurium
Intermediate acting: Vecuronium, rocuronium

Long acting: Pancuronium (60-90minz)
‘Reversal’ with Neostigmine & Glycopyrrolate

26
Q

Vasoactive drugs to treat hypotension

A

Ephedrine
Phenylephrine
Metaraminol

27
Q

Vasoactive drugs to treat severe hypotension in ICU

A

Noradrenaline
Adrenaline
Dobutamine

28
Q

Ephedrine -

A

Rise in HR and contractility leading to rise in BP (direct and indirect action, alpha (α) & β receptors

29
Q

Phenylephrine

A

Rise in BP by vasoconstriction (Direct action, α receptors), drop in HR

30
Q

Metaraminol

A

Rise in BP by vasoconstriction (Direct and indirect action, predominant α receptors)

31
Q

So if you have Low BP, low HR what would you give

A

Ephedrine

32
Q

So if you have Low BP, High HR what would you give

A

Phenylephrine, Metaraminol

33
Q

So if you have a patients needing care in Intensive care, severe sepsis with BP and HR changes

A

Noradrenaline, Adrenaline

34
Q

How to reverse anaesthetics

A

Stop anaesthetic vapours
Give oxygetion
Perform throat suction
Reverse muscle relaxation

35
Q

Drugs for reversal of anaesthetics

A 
Neostigmine:
Anti-cholinesterase
Prevents breakdown of acetylcholine
Muscarinic effects of acetylcholine: 
Bradycardia etc.
Combined with antimuscarinic agent:  			Glycopyrrolate
Side effects : nausea and vomiting

1 Anaesthesia (3 decks)

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