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13 Cards in this Set
- Front
- Back
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Epidural Local Anesthesia
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-inject into fat-filled epidural space
-more anesthesia req. |
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Indirect-Acting Cholingergics
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MECH: Inhibit acetylcholinesterase, causing an increase in acetylcholine
---> insecticide effects: nicotonic- muscle fasiculations (twitches), fatigue Muscarinic- increased PNS stimulation |
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Anticholinergics
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MECH: non selective antagonist
EFFECT: -Inhibit parasympathetic inputs to target organs -Induce effects similar sympathetic nervous system activation - |
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Adrenergic Agonist
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*most widely prescribed class of autonomic drug*
MECH: mimics effects of NE/EN on SANS EFFECTS: -Alpha1 = constrict SM (Hg-vssls, uterus) + dilate pupils -Beta1 = increase HR + contraction + renin (potent -vasoC) -Beta2 = inhibit SM (bronchioles, uterus) |
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Alpha-adrenergic antagonist
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MECH: -block alpha1 receptors
*beta 1= cardioselective* EFFECT: -Relax vascular SM (dilation) = decreased BP |
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Beta-adrenergic antagonist
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MECH: block beta2 receptor
EFFECT: -decrease rate + force of contraction -decrease renin decrease BP |
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Epidural Local Anesthesia
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ADMIN
-inject into fat-filled epidural space MECH -inhibited sensory+motor signalling AE: -back pain -infection -inadequate anesthesia -arachnoiditis (chemical inflammation) -spinal headache *more anesthesia req. compared to intra. |
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Intrathecal (spinal) Local Anesthesia
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ADMIN
-inject directly into CSF bwtn L3 and cocyx AE: --back pain -infection -inadequate anesthesia -arachnoiditis (chemical inflammation) -spinal headache *higher efficacy rate and easier to admin than epidural *reqs. less anesthetic compared to epidural |
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Opiods for Regional Anesthesia
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ADMIN:
-epidural/CSF MECH: -bind to presynaptic receptors in substantia gelatinosa and inhibit release of pain signalling NTs in spinal cord -bind to postsynaptic receptors in brain decreasing reaction to pain AE: -pruritis (tx antihistamine) -N/V (if diffuse up) -respiratory depression (rare for regional) |
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General Anesthetics
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ADMIN: IV and/or inhaled
*IV: alone if surg. <15mins MONITOR FOR: n/v, CNS depression, resp, depression, changes in vitals |
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Inhaled General anesthetics
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Used to maintain anesthesia
Prevent flow of sodium ions into neurons in the CNS, reducing neural activity Gaseous inhaled anesthetics (nitrous oxide) Volatile Liquids (isoflurne) |
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Stages of Anesthesia
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1. Analgesia: loss of pain ( loss of gen. sensation, pt awak
2. Disinhibition: excitement and hyperactivity ( possible delirium and resistance, HR and breathing may become irregular, BP can increase) 3. Surgical anesthesia ( skeletal muscle relaxation, delerium, cardiovascular and breathing stabilizes, eye movements slow, pts becomes still) 4. Medullary depression: paralysis of region responsible for controlling respiratory and cardiovascular activity (death can result) |
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Direct-acting cholinergics
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MECH: stimulates smooth muscle conraction via M3 receptors coupled to Gq proteins
EFFECTS: stim. GI system, promotes PS response |
