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Flashcards in pharmacology: anesthesia Deck (25):
1

what are the inhaled anesthetics?

nitrous oxide and halothane

2

which inhaled anesthetic is more potent? why?

halothane - lower MAC value (minimal alveolar anesthetic concentration)

3

which inhaled anesthetic has the lower blood-gas ratio, minimal CV effects, and no metabolism?

Nitrous oxide

4

side effects of halothane

malignant hyperthermia, hepatitis, cardiac arrhythmias

5

what are the IV anesthetics?

thiopental, midazolam, propofol, fentanyl, ketamine

6

thipental - use in anesthesia

barbiturate used for induction of anesthesia - lipid soluble so has rapid onset and short acting

7

midazolam - use in anesthesia

benzo used for preoperative sedation, anterograde amnesia, induction, outpatient surgery

8

propofol - use in anesthesia

used for induction and maintenance and also as an antiemetic

9

which IV anesthestic looks like milk

propofol

10

fentanyl- use in anesthesia

opiate - induction and maintence of anesthesis - depresses respiratory function

11

ketamine - use in anesthesia

NMDA-receptor antagonist
dissociative anesthetic used for induction of anesthesia, causes hallucination and CV stimulation and increased intracranial pressure

12

what are the local anesthetics groups?

esters (procaine, cocaine, benzocaine) and amides (lidocaine, bupivacaine, mepivacaine)

13

problem with esters

slow/fast metabolizers

14

problem with amides

liver function

15

which nerve fibers are most sensitive to local anesthetics?

smaller diameter
type B&C > type A delta > type A beta and gamma > type A alpha

16

what are local anesthetics administered with?

alpha 1 agonists

17

side effects of local anesthetics?

neurotoxicity, CV toxicity, allergies (esters via PABA formation)
why you use the alpha 1 agonists

18

which local anesthetic does not need an alpha 1 agonist?

cocaine - has its own vasconstriction by blocking NE reuptake

19

what are the skeletal muscle relaxants?

nondepolarizing (atracurium and mivacurium)
depolarizing (sccinylcholine)

20

how do the nondepolarizing skeletal muscle relaxants works? (atracurium and mivacurium)

nicotinic antagonists causing progressive paralysis - only effect NM receptors so no cardiac, smooth muscle, CNS effects

21

atracurium uses

safe in hepatic or renal impairment
have spontaneous inactivation to laudanosine which can cause seizures

22

mivacurium uses

very short duration - metabolized by plasma cholinesterases

23

what is the depolarizing skeletal muscle relaxant? mechanism and use?

succinylcholine - nicotinic agonist
depolarization and desensitization
hydrolyzed by pseudocholinesterase so have short duration

24

what are the centrally acting skeletal muscle relaxants?

benzos (GABA A receptors) baclofen (GABA B receptors)
used in spasticity

25

what is used to treat malignant hyperthermia caused by succinylcholine?

dantrolene (blocks Ca release from SR that causes extreme muscle rigidity)