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70 Cards in this Set

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