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70 Cards in this Set
- Front
- Back
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stage 1 of anesthesia
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Analgesia, Amnesia, Stupor, but NOT loss of consciousness
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stage 2 of anesthesia
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Excitement or delirium
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stage 3 of anesthesia
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Surgical anesthesia:
-unconsciousness -block of somatic & autonomic response to a painful stimulus -high voltage slow wave (HVSW) EEG |
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stage 4 of anesthesia
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Medullary depression:
-respiratory/CV depression -flat EEG (burst suppression) |
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During a surgical procedure, which stage does the anesthesiologist try to achieve?
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stage 3
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volatile agent: non-irritant--but long term ==> n/v
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Nitrous oxide
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volatile agent: can achieve only stages 1 or 2 of anesthesia (not stage 3)
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nitrous oxide
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volatile agent that may increase bp
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nitrous oxide
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volatile agent used as a frame of reference for stages of anesthesia
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ether
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volatile agent: peroxides formed by this drug can evaporate ==> explosion
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ether
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volatile agent: NO cardiac effects--circulatory stability
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ether
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volatile agent: irriating ==> (+) n/v
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ether
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volatile agent: most irritating drug
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desflurane
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volatile agent has the most rapid onset and recovery time
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desflurane
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volatile agent: least P450 (small metabolic degradation, 0.2%)
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desflurane
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volatile agent: needs special vaporizer system
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desflurane
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volatile agent: (+) uterine contractions
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isoflurane
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volatile agent: causes malignant hyperthermia
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isoflurane
sevoflurane |
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volatile agent: chemically unstable in presence of absorbants
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sevoflurane
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what are drugs w/ low solubility limited by?
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cardiac output (CO)
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onset of action for low solubility
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rapid onset
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onset of action for high solubility
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slow
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drugs that have high solubility are limited by?
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ventilation
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what is overpressure? what is it used for?
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overpressure = incresaing mac values. used to increase equilibration time for high solubility drugs
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Which (high or low solubility) requires less time to equilibrate?
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low
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opiates/bdz/NMJ blockers--why use those?
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opiates--analgesia
bdz--amnesia (anterograde) nmj blockers--muscle relaxation |
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what drives gas movement?
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partial pressure
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low mac values mean ___ potency
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high potency
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low PC_blood/gas means ___ solubility & ____ onset of action
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low solubility
rapid onset of action |
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increase open time of gaba
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thiopental
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injectable GA: causes hyperalgesia
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thiopental
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injectable GA: causes bronchospasms
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thiopental
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injectable GA: c/i in porphyrias (increase heme precursor)
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thiopental
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injectable GA: high lipid solubilty (accumulates in fat in long procedures)
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thiopental
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injectable GA: increases P450s
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thoipental
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injectable GA: short-acting b/c brain redistributes drug to other tissues (NOT b/c of slow hepatic metabolism)
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thiopental
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injectable GA: causes bacteremia
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propofol
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injectable GA: causes initial apnea & decrease BP
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propofol
etomidate |
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True or false:
like Thiopental, propofol accumulates in fat |
False!
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injectable GA: is in fat emulsion
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propofol
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causes adrenal cortisol insufficiency
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etomidate
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injectable GA: causes PONV (post-operative n/v)
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etomidate
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injectable GA: NO respiratory depression
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etomidate
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injectable GA: CV & respiratory depression
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thiopental
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injectable GA: used in diagnostic procedures--endoscopy
"conscious sedation" |
BDZ--midazolam & diazepam
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injectable GA:
true or false: BDZ are used as anesthetics? |
False. As pre-anesthetics or induce and supplement anesthesia
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injectable GA: cause vascular irritation
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BDZ--except midazolam
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injectable GA: X by flumazenil
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BDZ
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injectable GA: used in anesthesia for mac sparing effect
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opiates--fentanyl & sufentanil
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injectable GA:
AE = constipation, miosis, sedation, bradycardia, & chest wall rigidity at high doses |
opiates--fentanyl & sufentanil
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injectable GA: causes emergent psychosis
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ketamine
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injectable GA: increases bp
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ketamine
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injectable GA: anesthetic that causes amnesia
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ketamine
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injectable GA: dissociative anesthetics
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ketamine
pcp |
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injectable GA: C/I in schizo & HTN
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ketamine
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injectable GA: is a pressor
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ketamine
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onset of action & duration for succinylcholine
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rapid onset of action
ultrashort duration of action |
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metabolized by plasma cholinesterases--BuchEi
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succinylcholine
mivacurium |
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result of administration of AchEi (e.g. neostigmine) to:
a)succinylcholine b) competitive agents |
a) worsens block
b) relieves block |
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causes hyperkalemia & malignant hyperthermia
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succinylcholine (a depol agent)
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drugs that cause malignant hyperthermia
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isoflurane & sevoflurane & succinylcholine
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what is dantrolene for?
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malignant hyperthermia
neuroleptic malignant syndrome (NMS) |
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C/I of succinylcholine
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burns, rhabdomyolysis
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hoffman elimination
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atracurium
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metabolized by plasma esterases
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atracurium
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competitive agent w/ short duration
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mivacurium
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competitive agent w/ long duration
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d-tubocurarine
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competitive agent w/ most rapid onset of action
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rocuronium
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name the competitive agents in the benzo-isoquinolius group?
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atracurium
mivacurium |
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name the competitive agents in the ammonia steroids group?
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rocuroNIUM
vecuroNIUM |
