Flashcards in Original General and Local Anesthetics Deck (17)
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1
sodium thiopental
-barbiturate
-GABA activator
-induction only
-long half-life = hang-over
-can be administered to pediatric patients rectally
-side effects: reduced cerebral blood flow and ICP, venodilation, respiratory depression
-not contraindicated in patients with coronary artery disease, no arrhythmogenic effects
2
propofol
-GABA activator
-induction and maintenance
-antiemetic
-short half-life = good for outpatient surgery
-side effects: pain on injection, more severe blood pressure decrease than thiopental, blunts baroreceptor reflexes, more respiratory depression than thiopental
3
etomidate
-only for patients at risk for hypotension
-induction only
-side effects: does not decrease BP, less respiratory depression than thiopental, but more nausea and vomiting and suppression of adrenocortical stress response
4
ketamine
-"dissociative anesthesia" = profound analgesia, unresponsiveness to commands even though eyes open, amnesia, spontaneous respiration
-NMDA antagonist
-very little respiratory depression, bronchodilator
-side effects: nystagmus, lacrimation, salivation, increased ICP, emergence delirium, hypertension
-reserved for patients with bronchospasm or children undergoing short, painful procedures
5
midazolam
-short-acting benzodiazepine
-conscious sedation
-anxiolytic
-induction only
-side effects: respiratory depression/arrest
-contraindications: neuromuscular disease, Parkinson's, bipolar disorder
6
isoflurane
-moderate blood:gas partition coefficient
-induction and maintenance
-airway irritant
-decreases BP
-arrhythmias (sensitizes heart to catecholamines)
-increases ICP
7
desflurane
-very low blood:gas partition coefficient
-maintenance only
-not used to induce because of respiratory irritation
-bronchospasm
8
sevoflurane
-very low blood:gas partition coefficient
-5% metabolized to fluoride in liver --> renal damage
-induction and maintenance
-NOT respiratory irritant
-less respiratory depression than isoflurane
9
nitrous oxide
-concentrates gases that are administered with it
-adjunct with other inhalational anesthetics
-may dilute oxygen when discontinued, need to place patients on 100% O2 during emergence
10
mechanism of local anesthetics
bind reversibly to a site within the pore of sodium channels in nerves, thus blocking ion movement
11
cocaine
-ester local anesthetic
-potent vasoconstrictor
-topical for upper respiratory tract (shrinks mucosal membranes and limits bleeding)
12
procaine
-short-acting ester local anesthetic
-infiltration anesthesia
-low potency, slow onset, short duration of action
13
tetracaine
-long-acting ester local anesthetic
-more potent and longer duration of action than procaine
-spinal, topical, opthalmic
-not used for peripheral nerve block
14
benzocaine
-ester local anesthetic
-low solubility in water
-topical for wounds and ulcerated surfaces
15
lidocaine
-amide local anesthetic
-faster, more intense, long-lasting than procaine
-used with vasoconstrictors to decrease toxicity
16
bupivacaine
-long-acting amide local anesthetic
-long duration of action
-motor-sparing
-cardiotoxic
17
