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23 Cards in this Set

  • Front
  • Back
What is the MOA of general anesthesia?
UNKNOWN
What is anesthesia?
A reversible state of unconsciousness or oblivion
What is the key difference between sleep and anesthesia?
EASE of arousal
What are the 5 phases of a typical anesthetic?
1. Induction

2. Maintenance

3. Emergence

4. Recovery

5. Pain Control
What type of drugs are typically used for induction?
Mostly IV drugs (inhalatants no longer used)

Either a barbituate, aromatic alcohol, or steriod
What type of drug is usually used for maintenance?
Inhalation drug (isoflurane, sevoflurane, or desflurane)

Sometimes Nitrous Oxide
What do the shape of the pharmacokinetic graphs look like for IV and inhaled drugs?
IV - peak then decays

Inhalation - builds then stabilizes in horizontal asymtoatal manner

(See page 6A-8)
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
What 4 factors push the pharmokinetic curve for inhaled anesthetics down?
1. High Blood Solubility
2. Low Fi
3. Low Flow
4. High Cardiac Output
Emergence relies on what?
Elimination via VENTILATION, not metabolism
What is the most vulnerable period in anesthia?
Recovery
What is MAC?
Minimum Alveolar Concentration that prevents a movement response to surgical pain in 50% of population
Is MAC very useful?
NO
What is higher, the amount of anesthesis required to prevent movement in response to pain or to ablate "awareness"?
2-4x higher to prevent movement in response to pain
Is the population variance small of large in anesthesia?
Very small (everyone reacts the same)
What are the 2 possible genetic reasons for the low variance in anesthesia?
1. Multiple Contributing Targets

2. Highly conserve target (all biology is affected by them)
What is a potential long term, negative effect of inhaled general anesthetics?
POCD - Post Operative Cognitive Decline
Children who have >2 operations before the age of 2 are 2x as likely to develope what?
ADHD
What part of the cell is it thought that anesthetics interact with?
The lipid portion
To what percent of the proteome do anesthetics bind specifically?
1%
Where in the brain to anesthetics act?
EVERYWHERE
Is there an inhibitor or antagonist for anesthetics?
NO
Do patients exhibit tachyphylaxis (adaptation) to anesthetics?
NO (can give weeks with no change in the amount needed)