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Flashcards in Pharmacology Anasthetics Deck (41):
1

What is the goal of anesthesia

The absence of all perceived sensations. Usually used for major surgeries with minimal harm to patient

2

What was used in the past before anesthesia

Blunt blows to the head to knock them out, strangulation, alcohol, physical restraint

3

When was anesthesia introduced

1846

4

What was the first anesthesia and who discovered it

Ether was the first, but it was rather toxic. It was first used by a dentist

5

What makes the ideal general aesthetic (5)

Want a rapid onset and recovery
Want them unconscious
Want skeletal muscle to relax
Don't want them to recall procedure
Minimal adverse effects

6

What are the stages of anesthesia

1) Analgesia
2) Excitement
3) Surgical anesthesia
4) Medullary Paralysis

7

What is the desired level of anesthesia

Third stage surgical anesthesia. Want to get them here quick but not long enough to enter Medullary paralysis

8

What are the two types of anesthetics

Inhaled and intravenous (IV)

9

What are some inhalation agents for anesthesia

Halogenated liquids
Nitrous Oxide

10

What are some intravenous agents for anesthesia

Barbiturates
Benzodiazepines
Opioids

11

What is the traditional method of using anesthesia

First use intravenous to get them to stage 3 fast and then use inhalation for the remainder of the procedure.

12

What is the mechanism for anesthetics

Increase inhibition or decrease excitement throughout CNS by direct effect on libido bilayer, protein ion channels, or a combination of both

13

How do anesthetics effect the lipid bilayer

Embeds within the bilayer and effects the opening and closing of the bilayer.

14

Neuromuscular Juncture blockers

Used to block the excitability of the skeletal muscles. Can be either de-polarizing or non-depolarizing based on patients needs

15

Drawbacks of NMJ blockers

Some patients don't have the enzymes that are used to digest the drug. If this is the case it could stay in their system until the drug is excreted.

16

Why must you take anesthetics with NMJ blockers

The NMJ blockers alone won't block pain only spasms. The anesthesia is to assure no pain is felt

17

What is dissociative anesthesia

Patient is under anesthesia but it seems like they are conscious. Could even be talking, but will be unaware of what is going on

18

When would you use dissociated anesthesia

If vomiting is an issue
Diagnostic/radiologic readings
Dressing changes
Emergency surgeries

19

When to use general anesthesia

Burn Debridement
Dressing changes
Surgery

20

What are some rehab concerns with general anesthetics

Redistribution where drug is absorbed in fat tissue and released later.
Hallucination effects
Cognition effects that could have a gradual onset lasting months. (personality)

21

What are local anesthetics

Different set of drugs that are administered at the site of the problem

22

Goal of local anesthesia

Interrupt the nerve conduction at the site of application

23

What is the purpose of local anesthesia

To prevent or release pain without the loss of conciousness

24

What are the typical local anesthetics

-caine drugs.
Idocaine, profane, bupivicane

25

What is the mechanism of local anesthetics

It is like a key in a lock. It will lock the doorway of Na
Channels so Na can't get into the membrane. No Na= no action potential

26

Administration methods of anesthetics

Topical
Transdermal
Infiltration
Peripheral Nerve Block

27

What is the infiltration administration method

Inject the anesthesia near the wound and let it filtrate in to decrease pain

28

What is the nerve block method of anesthesia

Injected close to the plexus and it will dull the pain felt from the nerve

29

Compare and contrast spinal and epidural blocks

Epidural is administered outside of the Dura mater.
Spinal is injected into the subarachnoid space. This will have stronger effect
Both are effective at treating pain below the level of the spinal leision/injury

30

Explain the sympathetic block and what it is used for

Injected around sympathetic chain ganglia to decrees the excessive activation of the sympathetic nerve. Common in treating RSD or complex regional pain syndrome

31

What is the intravenous regional or Beir block

Local anesthetic injected and then tourniquet placed proximal to injection site to keep drug localized for about an hour

32

What is the Beir block used for

Complex regional pain syndrome, RSD, overactive empathetic ganglion

33

What is a continuous nerve block

Small catheter is placed near the peripheral nerve and local anesthesia is dripped onto nerve

34

What is the continuous nerve block often used for

Post op pain control

35

What are some precautions with the continuous nerve block

Will not feel the extremity
No pain feedback
Need to be careful with PROM because they have no pain feedback

36

When using a continuous nerve block on a TKR when would we have them weight bear

Needs to be able to actively contract the quads, should wear a brace.

37

What is the differential nerve block

Will not effect all fibers. Effects small fibers first and then the larger fibers

38

What is the order of nerve fibers from smallest to largest

Pain,
Temp,
Touch,
Proprioception,
Motor

39

What is LAST

Local anesthetic systemic toxicity

40

What are the sx of LAST

Tinnitus,
Agitation/Seizures,
Decreased sensation,
Depression

41

What is associated with cardiotoxicity

Change in HR
ECG abnormalities
Depression/dizzyness
Cardiac arrest