Flashcards in Pharmacology VI Deck (25)
What is the mechanism of action of inhaled anesthetics?
Unknown mechanism (p.453)
Name four effects of inhaled anesthetics.
Myocardial depression, respiratory depression, nausea/emesis, increased cerebral blood flow (decreased cerebral metabolic demand) (p.453)
What toxicities are associated with Halothane use?
What toxicities are associated with methoxyflurane use?
What toxicities are associated with enflurane use?
It is a proconvulsant (p.453)
What toxicity is associated with inhaled anesthetic use?
Malignant hyperthermia in all but nitrous oxide (rare, lifethreatening, inherited susceptability) (p.453)
What toxicity is associated with use of nitrous oxide?
Expansion of trapped gas in the body cavity (p.453)
What five types of anesthetic drugs are administered intravenously?
Barbiturates, benzodiazepines, arylcyclohexylamines (ketamine), opioids, propofol (p.454)
Describe the anesthetic properties of thiopental.
High potency, high lipid solubility, rapid entry to the brain; decreases cerebral blood flow (p.454)
What is thiopental used for?
Induction of anesthesia and short surgical procedures (p.454)
How is thiopental's effect terminated?
By rapid redistribution of the drug into tissues (i.e. skeletal muscle) and fat (p.454)
What benzodiazepine is most commonly used for endoscopy?
Midazolam; used adjunctively with gaseous anesthetics and narcotics (p.454)
What toxicities are associated with benzodiazepine use as an IV anesthetic?
Severe postoperative respiratory depression, decreased blood pressure, amnesia; treat with flumazenil (p.454)
What are arylcyclohexylamines?
PCP analogues used as dissociative anesthetics (ketamine); cardiovascular stimulants; increase cerebral blood flow (p.454)
What is the mechanism of action of arylcyclohexylamines?
Block NMDA receptors (p.454)
Name the most frequently used arylcyclohexylamine.
What toxicities are associated with arylcyclohexylamines?
Disorientation, hallucination, bad dreams (p.454)
Describe the role of opioids in general anesthesia.
Used with other CNS depressants during general anesthesia (p.454)
What two opioids are most commonly used in general anesthesia?
Fentanyl, morphine (p.454)
What is propofol used for?
Sedation in the ICU, rapid anesthesia induction, short procedures (p.454)
What is the mechanism of action of propofol?
Potentiates GABA(a) (p.454)
What is the advantage of using propofol over thiopental for anesthesia induction?
Less postoperative nausea (p.454)
What are the two classes of local anesthetics?
Esters, amides (amides have 2 I's) (p.454)
Name three ester anesthetics.
Procaine, cocaine, tetracaine (p.454)