Anesthesia

Front 1

four columns of anesthesia?

Back 1

analgesia
amnesia
hypnosis
immobility

Front 2

properties of an ideal anesthetic drug?

Back 2

-loss of consciousness smoothly and rapidly;
-prompt recovery of cognitive function after administration is discontinued;
-wide margin of safety;
-devoid of adverse effects

Front 3

how were stages of general anesthesia discovered?

Back 3

described by Guedel for induction of diethyl ether anesthesia

Front 4

stages of general anesthesia?

Back 4

1.analgesia
2.excitement
3.surgical anesthesia
4.medullary depression

Front 5

characteristics of stage 1 of general anesthesia?

Back 5

analgesia: conscious but no pain, later amnesia is produced

Front 6

characteristics of stage 2 of general anesthesia?

Back 6

excitement: delirious, may vocalize but is amnesic, respiration irregular in volume and rate, vomiting may occur if stimulated

Front 7

characteristics of stage 3 of general anesthesia?

Back 7

surgical anesthesia: apnea, analgesia, hemodynamic depression

Front 8

characteristics of stage 4 of general anesthesia?

Back 8

medullary depression: severe depression of the vasomotor and respiratory center, death rapidly ensues without support

Front 9

meyer-overton rule?

Back 9

number of anesthetic molecules dissoved at the site of anesthetic action, not the types of molecules present, cause anesthesia

Front 10

unitary theory of narcosis?

Back 10

potency of anesthetics increases with the lipid solubility

Front 11

blood solubility and anesthetic drugs?

Back 11

less blood soluble have quicker induction and recovery

Front 12

lipid solubility and anesthetic drugs?

Back 12

higher lipid solubility have higher potency

Front 13

best measurement of anesthetic potency?

Back 13

minimum alveolar concentration (at 1 atm) of an agent that produces immobility in 50% of subjects exposed to a noxious stimulus

Front 14

factors that determine the uptake of volatile anesthetics depends on?

Back 14

1.lipid solubility
2.cardiac output
3.alveolar-to-venous partial pressure difference

Front 15

general trends for Fa/Fi (alveolar anesthetic concentration/inspired concentration)?

Back 15

approach to Fa/Fi = 1 is most rapid with least soluble anesthetic and slowest with most soluble anesthetic

Front 16

effect of administering N2O with a second gas?

Back 16

reduction in volume from uptake of N2O increases its concentration as well as the concentrations of all 'second' gases

Front 17

cause of increase in cardiac output (if unopposed by a concomitant increase in ventilation)?

Back 17

decrease alveolar anesthetic concentration

Front 18

increase in ventilation?

Back 18

increase alveolar anesthetic concentration

Front 19

influence of age on anesthetic uptake?

Back 19

more rapid increase in Fa/Fi

Front 20

major factors that decrease MAC?

Back 20

decreased with N2O or increased age;
increased in younger

Front 21

importance of diffusion hypoxia?

Back 21

need to increase O2 as decreasing anesthesia as gas coming out will decrease O2 concentrations in alveoli

Front 22

partition coefficient?

Back 22

relative affinity of a compound for two phases and describes the partitioning of it between the two phases at equilibrium

Front 23

volatile anesthetics effects on brain?

Back 23

reduction in metabolic rate but increase in cerebral blood flow

Front 24

toxicity associated with halothane and mechanism?

Back 24

halothane hepatitis: believed to be an immune response directed againste hepatocytes

Front 25

which volatile anesthetic produces highest amounts of CO?

Back 25

desflurane

Front 26

volatile anesthetics?

Back 26

sevoflurane
desflurane
isoflurane
nitrous oxide
halothane

Front 27

intravenous anesthetics?

Back 27

etomidate
fentanyl (opioid)
ketamine
medazolam
propofol
thiopental

Front 28

IV anesthetics used for normal anesthesia?

Back 28

midazolam
propofol

Front 29

IV anesthetics used for trauma or CHF?

Back 29

etomidate
ketamine

Front 30

termination of action of thiopental?

Back 30

redistribution

Front 31

major contraindication for barbiturates?

Back 31

prophyrias

Front 32

benzodiazepine mechansim?

Back 32

GABA-receptor agonists

Front 33

time to recovery after dose or infusion of propofol?

Back 33

fast

Front 34

significance of context-sensitive half-time?

Back 34

rapidity with which drug levels drops is directly related to time of infusion; use drugs with shorter half-times for prolonged infusion

Front 35

which drugs have significantly shorter half-times?

Back 35

etomidate
propofol
ketamine

Front 36

propofol infusion syndrome?

Back 36

associated with infusion at 5 mg/kg/hr or greater for >48 hours;
cardiomyopathy with acute cardiac failure, metabolic acidosis, skeletal myopathy, hyperkalemia, hepatomegaly, lipemia

Front 37

ketamine site of action?

Back 37

NMDA receptor interaction;
does not interact with GABA