IV anesthetics Flashcards

1
Q

Barbiturates:

name 3 short acting barbs

A

thiopental (penthothal)
Mexohexital (brevital)
Thiamylal (surital)

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2
Q

Barbiturates:
they have many CNS actions but, depression on the _____ undoubtablly contributes to the sedative and hypnotic actions of IV agents

A

Reticular Activating System (RAS)

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3
Q

Barbiturates:Thiopental

has what 2 actions

A

anticonvulsant

Amnestic

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4
Q

Barbiturates:Thiopental

what can occur in small doses

A

poor analgesic- may increase the reaction to painful stimuli, may be hyperalgesic

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5
Q

Barbiturates:Thiopental

does what to respiratory system

A

depresses it

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6
Q

Barbiturates:Thiopental

does what to myocardial contractility

A

depresses it.- decreases SV, CO, Arterial BP

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7
Q

Barbiturates:Thiopental

does what to HR

A

Increases it

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8
Q

Barbiturates:Thiopental

does what to cerebral vascular resistance? what does that mean?

A

increases CVR

hence decreases cerebral blood flow and ICP

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9
Q

Barbiturates:Thiopental

contraintidated in what pts?

A

porphoria (a neuro dz caused by inadequate porphyrin metabolism)

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10
Q

Barbiturates:Thiopental

what would u not use with asthmatics

A

histamine release

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11
Q

Barbiturates: methohexital has excitatory effects. what are they

A

hiccups

myoclonus

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12
Q

Propofol:

what is the 1/2 time to elimination

A

0.5-1.5 hrs

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13
Q

Propofol:

which causes a bigger drop in BP prop or thiopental

A

prop

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14
Q

Propofol:

which has bigger respiratory depression prop or thiopental

A

prop

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15
Q

Propofol:

has antiemetic effects b/c it works where

A

Chemorecptor trigger zone (CRTZ)

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16
Q

Propofol:

does it have antipruritic effects?

A

yes

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17
Q

Propofol:

does it produce analgesia

A

no

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18
Q

Propofol:

does it have anticonvulsant effects

A

yes

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19
Q

Propofol:

does what to CBF and CMRo2

A

decreases it

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20
Q

benzodiazepines:

enhance the action of what receptors

A

GABA

21
Q

benzodiazepines:

GABA are what?

A

the brains major inhibitory transmitter

22
Q

benzodiazepines:

name 3 short acting benzos

A

Diazepam (valium)
Lorazepam (ativan)
Midazolam (versed)

23
Q

benzodiazepines:

do they produce analgesia?

A

no

24
Q

benzodiazepines:

name 5 CNS effects

A
Antianxiety
Amnestic
Sedative
Hypnotic
anticonvulsant
25
Q

benzodiazepines:

what CV effects

A

none unless pt is volume depleted then maybe hypotension

26
Q

benzodiazepines:

does what to brain

A

cerebral vasoconstriction- lowers CBF and ICP

27
Q

Ketamine:

produces anmesia and profound analgesia by interacting with what receptor

A

NMDA

28
Q

Ketamine:

Does what to cerebral vasculature

A

Dilates it

so CBF increases and ICP increases

29
Q

Ketamine:

does what to cerebral metabolism

A

increases it

30
Q

Ketamine:

does what to eyes and tone

A

hypertonus and nystagmus

31
Q

Ketamine:

what does it do to CV

A

Stimulates the SNS which promotes CV enhancement- increased HR, CO, and BP

32
Q

Ketamine:

what pts are good canidates

A

trauma

elderly

33
Q

Ketamine:

avoid in what pts

A

CAD
Glaucoma
Increased ICP

34
Q

Ketamine:

emergence can be horrible explain to bad side effects

A

bad dreams
Hallucinations
n/v

35
Q

Opioids:

why is morphine rarely used for anesthesia

A

histamine release

36
Q

Opioids:

do what to respiratory system

A

depress it

37
Q

Opioids:

are they cardiac stable

A

yep

38
Q

Opioids:

can they produce treacle rigidity

A

yep

39
Q

Opioids:

what do they do to cerebral blood flow

A

cerebral vasoconstricor

decreased CBF and ICP

40
Q

Opioids:

why do they cause nausea

A

stimulate CRTZ

41
Q

Opioids:

how do synthetic opioids cause bradycardia

A

stimulate the vagal nerve

42
Q

Opioids:

if it caused sphincter of do spasm what can be given to relax it

A

glucagon 1-2mg

43
Q

Etomidate:

cv effects

A

minimal

44
Q

Etomidate:

how our it’s analgesic and amnestic properties

A

poor

45
Q

Etomidate:

does what to CBF and ICP

A

decreases it

46
Q

Etomidate:

what should you look for on injection

A

pain

47
Q

Etomidate:

what can it cause and how in pts with catecholamine depletion

A

adrenal cortical suppression

directly depresses cortisol output from the adrenal cortex

48
Q

Etomidate:

does what to the immune system

A

depresses it

49
Q

the CNS effects after bolus of an IV anesthestic are terminated primarily how

A

redistribution