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DIT Recommended Course Order > Video 14 Anesthetics > Flashcards

Video 14 Anesthetics Flashcards

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1
Q

What are the two main characteristics of the inhaled anesthetics?

A

Lipid and blood solubility.

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2
Q

Which are the effects of the inhaled anesthetics?

A

Myocardial and respiratory depressions, nauseas/emesis, increased cerebral blood flow (decreased cerebral metabolic demand).

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3
Q

What is the toxicity effect of the Halothane?

A

Hepatotoxicity.

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4
Q

What is the toxicity effect of the methoxyflurane?

A

Nephrotoxicity.

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5
Q

What is the toxicity effect of the enflurane?

A

Proconvulsant

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6
Q

What is the toxicity effect of the N2O?

A

Expansion of trapped gas in a body cavity.

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7
Q

What is a malignant hyperthermia?

A

Rare, life-threatening hereditary condition in which inhaled anesthetics (except N2O) and Succinylcholine induce fever and sever muscle contractions.

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8
Q

What is the treatment for malignant hyperthermia?

A

Dantrolene

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9
Q

Which group of anesthetics induce unconsciousness but do not provide analgesia?

A

Intravenous anesthetics

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10
Q

Which are the characteristics of Propofol?

A

1) Used in sedation in ICU.
2) Rapid onset: 15 to 20 seconds.
3) Potentiates GABA.
4) High triglyceride content.

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11
Q

What is the mechanism of the Arylcyclohexylamines (Ketamine)?

A

PCP analogs that act as a dissociative anesthetics.

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12
Q

Which are the uses for ketamine?

A

Analgesia, conscious sedation, induction.

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13
Q

Whic are the characteristics of ketamine?

A

1) Dissociative anesthetics.
2) Block NMDA receptors.
3) Cardiovascular stiumlants.
4) Increased cerebral blood flow.

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14
Q

Which are the side effects of the ketamine?

A

At high doses cause disorientation, hallucination, bad dreams.

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15
Q

What is the IV anesthetic that increased duration of GABA receptor Cl- channel stays open?

A

Barbiturates.

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16
Q

Which are the characteristics of the thiopental?

A

High potency, high lipid solubility, rapid entry into brain.

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17
Q

What are the uses of the barbiturates?

A

Used for induction of anesthesia and short surgical procedures.

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18
Q

Which is the main characteristic of the barbiturates?

A

Decreased cerebral blood flow.

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19
Q

Which are the characteristics of the Phenobarbital?

A

1) Liver enzyme induction.

2) Treatment: Crigler-Najjar syndrome type II.

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20
Q

At what group of anesthetic belong diazepam, alprazolam, midazolam?

A

Benzodiazepines.

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21
Q

Which is the anesthetics that increased frequency of GABA receptor CI- channel opening and facilitate inhibitory effect of GABA?

A

Benzodiazepines

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22
Q

Which are the side effects of the benzodiazepines?

A

Conscious sedation, anesthesia, alcohol withdrawal, anxiety, seizures, insomnia and night terrors.

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23
Q

How do you treat the overdose of benzodiazepines?

A

Treat overdose with Flumazenil.

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24
Q

What is the most common drug used for endoscopy?

25
Which are the 3 receptors of Opioid?
1) Mu. 2) Delta. 3) Kappa.
26
What are the endogenous opioid agonists?
1) Mu receptor: Beta-Endorphin. 2) Delta receptor: Enkephalins. 3) Kappa receptor: Dynorphin.
27
What is the opioid that causes less respiratory depression?
Buorphanol.
28
What is the opioid that causes cough suppressant?
Dextromethorphan
29
What is the opioid that is non-addictive analgesic?
Tramadol
30
What are the opioids that are used as antidiarrheals?
Loperamide and diphenoxykate.
31
Which are the antagonist opioid receptors?
Naloxone and Naltrexone.
32
Which are the 6 non-depolarizing neuromuscular blockers?
1) Tubocurarine. 2) Atracurium. 3) Mivacurium. 4) Vecuronium. 5) Pancuronium. 6) Rocuronium.
33
Which are the two categories for neurmomuscular blockers drugs?
1) Depolarizing. | 2) Nondepolarizing.
34
What is the mechanism of the Nondepolarizing neuromuscular blocking drugs?
Competitive antagonist -compete with ACh for receptors.
35
What is the neostigmine function?
Reversal of blockade.
36
What is the succinylcholine mechanism?
It is an strong ACh receptor agonist; produces sustained depolarization and prevents muscle contraction.
37
What are the reversal of blockade phases in Depolarizing neuromuscular blocking drugs?
1) Phase I (Prolonged depolarization) -No antidote. Block potentiated by cholinesterase inhibitors. 2) Phase II (repolarized but blocked; ACh receptors are available, but desensitized) -Antidote is cholinesterase inhibitors.
38
Which are the complications of the Depolarizing neuromuscular blocking drugs?
Complications include hypercalcemia, hyperkalemia, malignant hyperthermia.
39
What are the characteristics of the phase I block?
1) Normal dose. 2) Rapid onset. 3) Lasts about 10 minutes. 4) Cannot be antagonized.
40
Which are the characteristics for phase II block?
1) Larger dose. 2) Characteristics similar to Nondepolarizing blockers. 3) Can be antagonized by cholinesterase inhibitors (neostigmine). 4) Can last from 20-30 minutes up to a few hours.
41
What are the characteristics of the malignant hyperthermia?
1) Muscle rigidity. 2) Hyperthermia. 3) Caused by giving inhaled anesthetic + succinylcholine to susceptible patient (RYR1 gene mutation).
42
What is the treatment for patients with malignant hyperthermia?
1) Cool patient. 2) Sedation. 3) Dantrolene.
43
What is the mechanism of the Dantrolene?
Prevents the sarcoplasmic reticulum from releasing Ca2+ resulting in muscle relaxation.
44
What is the clinical use of Dantrolene?
1) Malignant hyperthermia. | 2) Neuroleptic malignant syndrome.
45
Which are the local anesthetics?
Lidocaine, procaine and cocaine.
46
What is the mechanism in the local anesthetics?
1) They do not work well in acidic tissue. 2) Order of blockade. ( 1st Small myelinated, 2nd Small unmyelinated and 3rd Large myelinated). 3) They give with a local vasoconstrictor.
47
Which anesthetic, IV, assocIated with Hallucinations and bad dreams?
Ketamine
48
Which anesthetic, IV, most common drug used for conscious sedation?
Midazolam
49
Which anesthetic inhaled, side effect of hepatotoxicity?
Halothane.
50
Which anesthetic,IV, used for rapid anesthesia induction and short duration of action?
Propofol.
51
Which anesthetic, IV, decreased cerebral blood flow (important in brain surgery)?
Barbiturates
52
Which anesthetic, opioid that dose not induce histamine release?
Fentanyl.
53
Which anesthetic, high triglyceride content, increases the risk of pancreatitis with long-term use?
Propofol.
54
What is the mechanism of action of Dantrolene?
Prevents of release of calcium from the sarcoplasmic reticulum of skeletal muscle.
55
What is the mechanism of action of local anesthetics?
Block sodium channels
56
Which nerve fibers are blocked first with local anesthesia?
1) Small myelinated. 2) Small unmyelinated. 3) Large myelinated. 4) Large unmyelinated.
57
What drugs can be reverse neuromuscular blockade?
Cholinesterase inhibitors (neostigmine)
58
What is the mechanism of action of Vecuronium?
Non-Depolarizing neuromuscular blocker that competitively inhibits cholinergic neurotransmission at the neuromuscular junction.
59
Which are the 3 main components of any anesthesia?
1) Amnesia. 2) Analgesia. 3) immobilization.

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