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33 Cards in this Set
- Front
- Back
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halothane |
volatile anesthetic. Blood-gas partition coefficient: 2.4. non irritating to airways, most mycardial depression - more arhythmogenic than others, 20% metabolized (a lot). Halothane hepatitis occurs rarely |
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desflurane (Suprane)
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volatile anesthetic. Blood-gas partition coefficient: 0.42. irritating to the airways. 0.02% metabolism. Myocardial depression is minimal. Produces prompt recovery (really insoluble (0.42)
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isoflurane (Forane)
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volatile anesthetic. Blood-gas partition coefficient: 1.4. irritating to the airways. 0.2% metabolism. Myocardial depression is minimal. |
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enflurane (Ethrane)
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volatile anesthetic. Blood-gas partition coefficient: 1.9. next newer drug after halothane. 2% metabolism.
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sevoflurane (Ultane)
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volatile anesthetic. Blood-gas partition coefficient: 0.68. non irritating to airways. 2%-5% metabolism (turns out not to be a problem). Myocardial depression is minimal. Produces promt recover (insolubility 0.68)
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nitrous oxide
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volatile anesthetic - NOT potent. Blood-gas partition coefficient: 0.46. use: adjuct to potent volatile agents, reducing MAC requirements. Has few side effects |
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dantrolene (Dantrium)
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treats malignant hyperthermia |
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succinylcholine (Anectine)
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causes malignant hyperthermia with volatile anesthetics
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thiopental (Pentothal)
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induction agent. Thiobarbiturate. High lipid solubility; rapid and profound unconsciousness. Marked respiratory depression. Decrease symp. outflow from brain(symp.compensation?) Recovery occurs in 5-8 min due to redistribution. Use: IV induction and ECT
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methohexital (Brevital)
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induction agent. Oxybarbiturate. High lipid solubility; rapid and profound unconsciousness. Marked respiratory depression. Decrease symp. outflow from brain(symp.compensation?) Recovery occurs in 5-8 min due to redistribution. Use: IV induction and ECT
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ketamine
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induction agent. Phencyclidine derivative (high drug abuse risk). Gives sedation, amnesia, and analgesia. No resp or CV depression. No antagonist. NMDA receptor antagonist, instead of GABA facilitator). Dissociative pattern on EEG. Can have emergence delirium. helpful in pts who are opioid tolerant.
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etomidate (Amidate)
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induction agent. Produces resp despression. Does not produce CV depression. Cannot be antagonized. Use: IV induction, good to intubate pts w/hemodynamic instability
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propofol (Diprivan)
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induction agent. Newest induction agent:1991. dissolved in intralipid. Produces CV and resp depression (not good for trauma pts). Can't be antagonized. Can be used for maintenance. Least "hangover effect," so superceding thiopentol
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alfentanil (Alfenta)
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analgesic, potent, fast onset, short acting opioid.
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fentanyl (Duragesic)
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analgesic, profound opiod effect. High lipid solubility, high potency, fast onset, shorter duration of action (redistrubution terminates effects). Use: premedication, reduce MAC of volatile anesthetics. Markes resp depression, not much BP effect. Antagonized by naloxone.
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remifentanil (Ultiva)
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analgesic, opioid. Metabolized by plasma esterase, used as an infusion. Need controlled ventilation?
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sufentanil (Sufenta)
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analgesic, potent, fast onset, short acting opioid.
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flumazenil (Romazicon)
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premedication agent. Antagonist to benzodiazepines.
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midazolam (Versed)
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premedication agent, benzodiazepine. Highly lipid soluble. Produces sedation and amnesia. IV bz's can produce resp depression. Antagnoized by flumazenil.
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volatile anesthetics
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gases at room temp, used for maintenance of anesthesia, can be used for induction in some cases. Produce amnesia, muscle relaxation, suppress hemodynamic response to surgery (sympathetic) and are SAFE
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premedication
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prep for induction - anxiolytic/antianxiety. Usually benzodiazepine (midazolam) or opioid (fentanyl)
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induction
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initiation of unconsciousness for laryngoscopy/intubation. Paralytic induction agent combined with muscle relaxant. Enter brain rapidly, but have short effects as they redistribute
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maintenance
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balanced technique of volatile anesthetic, muscle relaxant, and opioid
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emergence
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anesthetic discontinued, elimination/metabolism occur. RARELY antagonists are administered
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recovery
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stabilize pt. drug elimination/metabolism continues. Side effects of anesthetics diminish/abate
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cocaine
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ester anesthesia metabolized by plasma esterase. Topical anesthetic, vasoconstrictor. Toxicity: MI, arrhythmias, seizures, hypertension
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procaine (Novocaine)
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ester anesthesia metabolized by plasma esterase. 45-60 min after infiltration. pKa 8.9
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tetracaine (Synera)
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ester anesthesia metabolized by plasma esterase. 60-180 min after infiltration. pKa 8.7
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lidocaine (Xylocaine)
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amide anesthesia metabolized by liver. 60-120 min after infiltration. pKa 7.9
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mepivacaine (Carbocaine)
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amide anesthesia metabolized by liver. 90-180 min after infiltration. pKa 7.6
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bupivacaine (Sensorcaine)
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amide anesthesia metabolized by liver. 240-480 min after infiltration. pKa 8.1
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prilocaine (Emla)
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amide anesthesia metabolized by liver. 60-120 min after infiltration. pKa 7.9
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ropivacaine (Naropin)
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amide anesthesia metabolized by liver. S-isomer less toxic with similar potency to bupivacaine
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