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Systems 2 > Unit 1 Pharmacology Guiding Questions > Flashcards

Unit 1 Pharmacology Guiding Questions Flashcards

1
Q

what is general anesthesia?

A

a reversible state of unconsciousness

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2
Q

An ideal anesthetic agent must be able to produce each of the following conditions:

A

-rapid onset of anesthesia
-skeletal muscle relaxation
-inhibition of sensory and autonomic reflexes
-easy adjustment of the anesthetic dosage during procedure
-a minimum of toxic side effects
-rapid, uneventful recovery after administration is terminated
-amnesia

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3
Q

Two primary routes of administration of anesthetic agents:

A

IV or inhaled

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4
Q

advantage of IV anesthetics

A

rapid onset, allowing patient to pass through first two stages of anesthesia very quickly

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5
Q

disadvantage of IV anesthetics

A

there is a relative lack of control over the level of anesthesia if too much is injected

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6
Q

what is balanced anesthesia?

A

when a combination of IV and inhaled agents are used to provide optimal anesthetic effects with minimal side effects

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7
Q

primary form of inhaled anesthetics

A

halogenated volatile liquids (enflurane, halothane, insoflurane)

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8
Q

uniform distribution of general anesthetics is largely due to

A

their high degree of lipid solubility

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9
Q

why does it take a while for anesthetics to leave a patients system?

A

it may become temporarily stores in adipose tissues

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9
Q

why does it take a while for anesthetics to leave a patients system?

A

it may become temporarily stores in adipose tissues

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10
Q

elimination of anesthetics occurs primarily through

A

excretion from the lungs, biotransformation in the liver, or a combination of both.

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11
Q

adjuvant drugs used to balance the effects of general anesthetic include

A

preoperative medications and neuromuscular blockers

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12
Q

when are preoperative sedatives given to patients

A

1-2 hours before the administration of general anesthesia

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13
Q

how are sedatives normally administered

A

orally or by intramuscular injection

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14
Q

some commonly used preoperative sedatives include

A

barbiturates, opioids, and benzodiazepines

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15
Q

what goals to antihistamines achieve?

A

produce sedation and reduce vomiting during and after surgery

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16
Q

how do neuromuscular blockers work?

A

they block the postsynaptic acetylcholine receptor located at the skeletal neuromuscular junction

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17
Q

possible side effects if neuromuscular blockers include

A

cardiovascular problems, increased histamine release, increased plasma potassium levels, residual muscle pain and weakness, and immunological reactions

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18
Q

local anesthetics can be applied directly to

A

the surface of skin, mucous membranes, cornea, and other regions to produce analgesia

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19
Q

local anesthetics can be applied topically to

A

reduce pain prior to minor surgical procedures

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20
Q

preliminary studies suggest that topical anesthesia can be used to improve

A

motor function in patients with skeletal muscle hypertonicity resulting from a CVA or head trauma

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21
Q

how can transdermal administration of local anesthetics be enhanced?

A

by the use of electrical current or ultrasound

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22
Q

what percentage of lidocaine is used in transdermal patches to treat localized pain in musculoskeletal conditions and neuropathic pain?

A

5%

23
Q

With this method, the drug is injected directly into the selected tissue, allowing it to diffuse to sensory nerve endings within that tissue.

A

infiltration anesthesia

24
Q

the anesthetic is injected close to the nerve trunk so that transmission along the peripheral nerve is interrupted

A

peripheral nerve block

25
Q

polonged administration of local anesthetics within skeletal muscle can produce

A

localized muscle pain and necrosis

26
Q

injection of the drug into the epidural space (the space between the bony vertebral column and the dura mater)

A

epidural nerve blockade

27
Q

what is a caudal block?

A

injecting the local anesthetic into the lumbar epidural space via the sacral hiatus

28
Q

injection within the subarachnoid space (the space between the arachnoid membrane and the pia mater)

A

spinal nerve blockade

29
Q

where are epidural and spinal blocks usually administered?

A

L3-4 or L4-5 vertebral interspace

30
Q

the anesthetic is injected into a peripheral vein
located in a selected arm or leg

A

IV regional anesthesia

31
Q

why is a tourniquet applied during IV regional anesthesia?

A

to localize the drug temporarily within the extremity and to prevent the anesthetic from reaching the systemic circulation where it would cause toxic side effects on the heart and CNS

32
Q

the ability of a local anesthetic dose to block specific nerve fiber groups depending on the size (diameter) of the fibers

A

differential nerve block

33
Q

what is local anesthetic systemic toxicity

A

when the anesthetics are absorbed into the general circulation and exert toxic effects on other organs and tissues

34
Q

local anesthetics most important systemic effects involve

A

the CNS and cardiovascular system

35
Q

what happens if local anesthetics reach the systemic circulation?

A

they can inadvertently disrupt the excitability of the CNS and cardiac tissue

36
Q

symptoms such as ___ can occur if sufficient amounts of anesthetics reach the brain

A

somnolence, confusion, agitation, excitation, and seizures

37
Q

The primary cardiovascular effects associated with local anesthetics include

A

decreased cardiac excitation, heart rate, and force of contraction

38
Q

Early symptoms of CNS toxicity typically include

A

ringing/buzzing in the ears (tinnitus), agitation, restlessness, and decreased sensation in the tongue, around the mouth, or other areas of the skin

39
Q

what indicates cardiotoxicity?

A

Changes in heart rate (bradycardia), electrocardiogram (ECG) abnormalities, or clinical signs of cardiac depression (fatigue, dizziness)

40
Q

characterized primarily by an exaggerated muscle stretch reflex. occurs in many patients following injury to the CNS

A

spasticity

41
Q

typically arise from an orthopedic injury to a musculoskeletal structure or peripheral nerve root. often a continuous tonic contraction of specific muscles

A

spasms

42
Q

how does diazepam work?

A

by increasing the central inhibitory effects of gamma-aminobutyric acid. it binds to receptors located at GABAergic synapses and increases the GABA-induced inhibition at that synapse

43
Q

use of Diazepam

A

used to treat spasms associated with musculoskeletal injuries. also to control muscle spasms associated with tetanus toxin

44
Q

primary side effect of diazepam

A

produces sedation and general reduction in psychomotor ability
can also produce tolerance and physical dependence, and sudden withdrawal after prolonged use can cause seizures, anxiety, agitation, tachycardia, and even death.

45
Q

what do centrally acting antispasm drugs do?

A

they may decrease polysynaptic reflex activity in the spinal cord

46
Q

how are centrally acting antispasm drugs used?

A

as adjuncts to rest and physical therapy for short term relief of muscle spasms associated with acute, painful musculoskeletal injuries. given with NSAIDS

47
Q

primary side effects of centrally acting antispasm drugs

A

drowsiness and dizziness
additional: nausea, light-headedness, vertigo, ataxia, and headache

48
Q

how does baclofen work?

A

Preferential binding to GABAB receptors enables baclofen to act as a GABA agonist, inhibiting transmission within the spinal cord at specific synapses.

49
Q

How is baclofen used?

A

administered orally to treat spasticity associated with lesions of the spinal cord, including traumatic injuries resulting in paraplegia or quadriplegia and spinal cord demyelination resulting in MS

50
Q

most common side effect of baclofen?

A

drowsiness
others: fatigue, nausea, dizziness, muscle weakness, and headache

51
Q

how does gabapentin work?

A

by inhibiting calcium entry into presynaptic nerve terminals that release glutamate and other excitatory neurotransmitters

52
Q

what is gabapentin used for?

A

decreasing the spasticity associated with spinal cord injury and multiple sclerosis
also helpful in treating various types of neuropathic pain

53
Q

primary side effects of gabapentin?

A

sedation, fatigue, dizziness, and ataxia

54
Q

what is botulinum toxin used for (clinically)?

A

control localized muscle dystonias, including conditions such as spasmodic torticollis, blepharospasm, laryngeal dystonia, strabismus, and several other types of focal dystonias

Systems 2 (15 decks)

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