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23 Cards in this Set
- Front
- Back
What is the MOA of general anesthesia?
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UNKNOWN
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What is anesthesia?
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A reversible state of unconsciousness or oblivion
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What is the key difference between sleep and anesthesia?
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EASE of arousal
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What are the 5 phases of a typical anesthetic?
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1. Induction
2. Maintenance 3. Emergence 4. Recovery 5. Pain Control |
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What type of drugs are typically used for induction?
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Mostly IV drugs (inhalatants no longer used)
Either a barbituate, aromatic alcohol, or steriod |
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What type of drug is usually used for maintenance?
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Inhalation drug (isoflurane, sevoflurane, or desflurane)
Sometimes Nitrous Oxide |
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What do the shape of the pharmacokinetic graphs look like for IV and inhaled drugs?
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IV - peak then decays
Inhalation - builds then stabilizes in horizontal asymtoatal manner (See page 6A-8) |
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What do the following do the pharmakinetics of an inhaled anesthetic?
Low Blood Solubility High Fi (fraction inspired) High Flow Low Cardiac Output |
Pushes curve UP
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What 4 factors push the pharmokinetic curve for inhaled anesthetics down?
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1. High Blood Solubility
2. Low Fi 3. Low Flow 4. High Cardiac Output |
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Emergence relies on what?
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Elimination via VENTILATION, not metabolism
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What is the most vulnerable period in anesthia?
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Recovery
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What is MAC?
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Minimum Alveolar Concentration that prevents a movement response to surgical pain in 50% of population
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Is MAC very useful?
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NO
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What is higher, the amount of anesthesis required to prevent movement in response to pain or to ablate "awareness"?
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2-4x higher to prevent movement in response to pain
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Is the population variance small of large in anesthesia?
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Very small (everyone reacts the same)
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What are the 2 possible genetic reasons for the low variance in anesthesia?
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1. Multiple Contributing Targets
2. Highly conserve target (all biology is affected by them) |
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What is a potential long term, negative effect of inhaled general anesthetics?
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POCD - Post Operative Cognitive Decline
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Children who have >2 operations before the age of 2 are 2x as likely to develope what?
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ADHD
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What part of the cell is it thought that anesthetics interact with?
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The lipid portion
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To what percent of the proteome do anesthetics bind specifically?
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1%
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Where in the brain to anesthetics act?
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EVERYWHERE
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Is there an inhibitor or antagonist for anesthetics?
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NO
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Do patients exhibit tachyphylaxis (adaptation) to anesthetics?
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NO (can give weeks with no change in the amount needed)
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