Quiz 6 Reverse Flashcards Preview

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Flashcards in Quiz 6 Reverse Deck (41):
1

1. Analgesia2. Amnesia3. Akinesia4. Attenuation of automatic response

4 A's of anesthesia

2

1. Analgesia2. Excitement3. Surgical anesthesia4. Imminent death

What are the 4 stages of anesthesia?

3

Minimal Alveolar Concentration-conc. of the agent in the lungs that prevents mvmt in 50% of Pts**Use 1.3x the MAC

What is the MAC?

4

Inhaled anestheticSedation, analgesia & amnesiaAdjunct to inhalation & IV anesthesia

Use of nitrous oxide

5

Inhaled anestheticInduction & maintenance of general anesthesia

Use of Sevoflurane

6

1. Biotransformation2. TransQ loss3. Exhalation 1/2 lives are compartment specific so the times vary

How does anesthesia leave the body?

7

1. Venous/arterial air embolism2. Pneumothorax3. Acute intestinal obstruction w/ bowel distension4. Intracranial air5. Pulmonary air cysts6. Intraocular air bubbles7. Tympanic membrane graftiingAlso dec. MAC of volatile liquid anesthetics

Who should you be cautious with using Nitrous oxide?

8

1. Emergence agitation &/or delirium2. Perioperative hyperkalemia3. QT prolongation4. Potential to trigger malignant hyperthermia

ADRs Sevoflurane

9

Sevofluraneflammable & forms formeldahyde

Which anesthetic do you need to have fresh dessicant?

10

1. Nitrous oxide2 Sevoflurane

What are the inhaled anesthetics?

11

1. Propofol 2. Etomidate3. Ketamine4. Methohexital

What are the IV anesthetics?

12

Affects GABA channels to shut down nerve function1. Induction of anesthesia in Pts >3 y/o2. Maintenance of anesthsia in Pts >2 mo. 3. Adults - for monitored care sedation during procedures4. Sedation in intubated mech. vent. ICU Pts

How does Propofol work & what is it used for?

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NO - has egg, lecithin & soy

Can you reuse Propofol?

14

Propofol Kinetics not affected by obesity, cirrhosis or kidney failure

Which drug might turn your urine or hair green?

15

1. HOTN 2. Resp. depressant 3. Dec. cerebral blood flow & ICP

ADRs Propofol

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1. Antipruritic2. Antiemetic3. Antiseizure

What are the 'good' side effects of Propofol?

17

Occurs ~48h of propofol infusion1. Bradycardia leading to asystole2. HF cardiogenic shock3. Rhabdo4. Hyperlipidemia5. Fatty liver FFA released into bloodstream causing acidosis

What is Propofol Infusion Syndrome?

18

Induction & maintenance of general anesthesiaDon't use <10 y/o

What is Etomidate used for?

19

O - 30-60 sec Great lipid solubilityP - 1 minD - 3-5 minsStop infusion & recover immediately

Onset, Peak & duration of Etomidate?

20

1. Myoclonus 2. Dec. peripheral vascular resistance3. Resp.4. N/V5. "Cortisol" effect

ADRs Etomidate

21

Induction & maintenance of general anesthesia 1. IV2. IM3. Oral4. Nasal5. Rectal6. SubQ7. Epidural

What is Ketamine used for & routes of administration?

22

O - 30 secD - 5-10 min

Onset& duration of Ketamine?

23

1. Coronary heart disease2. Uncontrolled HTN3. HF4. Arterial aneurysms

Who should you be cautious with giving Ketamine?

24

1. Inc. arterial BP2. Inc. HR3. Inc. CO*Emergence phenomenon - disturbing dreams & delirium

ADRs Ketamine

25

1. Induction of anesthesia2. Procedural sedationBarbiturate

Uses of Methohexital & what class of drug is it?

26

O - 30 secD - 20 min

Onset & duration of Methohexital

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1. Dec. BP from peripheral vasodilation2. Inc. HR3. Dec. vent. response4. Dec. renal blood flow & dec. GFR5. Dec. hepatic blood flow

ADRs Methohexital

28

1. Relief of pain, preop meds, adjunct to gen. anesthesia2. Block stress response from catecholamines, cortisol, ADH3. Reduction of dose of other anesthetics like inhaled, propofol, neuromuscular blockers4. Postop analgesia

Uses of Fentanyl citrate

29

1. Bradycardia2. Venodilation3. Dec. sympathetic reflexes4. Depressed cardiac contractility5. Hypoxic drive dec.6. Chest wall rigidity 7. Dec. ICP

ADRs Fentanyl citrate

30

Meperidine

What should you give a shivering Pt postop?

31

1. Midazolam2. Diazepam3. Lorazepam

What are the Benzos for anesthesia?

32

aka Versed1. Induction & maintenance of gen anesthesia2. Preop sedation3. Moderate sedation prior to diagnostic or radiographic procedures4. ICU sedation

Uses for Midazolam

33

1. Sedation prior to &/or during surgical procedures of nonintubated Pts2. Procedural sedation prior to &/or during awake fiberoptic intubation3. Sedation of initially-intubated & mechanically-ventilated Pts during Tx in an intensive care setting

Uses for Dexmedetomidine

34

Depolarizing neuromuscular blockerTo facilitate RSI & routine endotracheal intubation & to relax skeletal muscles during surgery

Uses for Succinylcholine

35

1. Arrhythmias, BP changes, tachycardia2. Hyperkalemia3. Jaw rigidity, muscle fasciculation, postop muscle weakness4. Malignant hyperthermia

ADRs Succinylcholine

36

Thumb goes in - adductor pollicis

How can you tell if non-polarizing neuromusclar blockers are wearing off?

37

non-depolarizing neuromuscular blockerNeostigmine - acetylcholinesterase inhibitor

How do you reverse Rocuronium?

38

1. To facilitate RSI & routine endotracheal intubation & to relax skeletal muscles during surgery 2. Facilitate mechanical ventilation in ICU Pts

Uses for Rocuronium

39

Inherited metabolic disorder of skeletal muscle -Abnormal Ca hemostasis Rapid onset of extremely high fever w/ muscle rigidity

What is malignant hyperthermia?

40

1. Discontinuing precipitant2. Manage metabolic acidosis3. Institute cooling4. Monitor electrolytes5. Watch urinary output

Tx malignant hyperthermia

41

1. Mgmt malignant hyperthermia2. Prevention of malignant hyperthermia in susceptible Pts3. Tx of spasticity assoc. w/ UMN disorders

Uses of Dantrolene