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14 Cards in this Set

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Clinical Stages of Anesthesia
Stage 1: Interfered synaptic transmission in spinothalamic tract -> analgesia
Stage 2: blockade of inhibitory pathways -> excitement, disinhibition, irregular respiration, vomiting
Stage 3: Depression of ascending pathways in reticular activating system -> unconsciousness, muscle relaxation
Stage 4: depression of medullary vital centers
Minimum Alveolar Conc. (MAC)
conc of anesthetic at 1 atm that produces immobility in 50% in response to painful stimulus
Decreased MAC: hypothermia, hypthyroidism, alcohol intox, age, sedatives
Inhaled Anesthetics
decrease BP (except NO2) b/c decrease periph vasc resistance, increase HR
Isoflurane
Mechanism: activate GABA receptor

Clinical Use: not used much
Desflurane
similar to isoflurane
less soluble, so higher inspired conc. required

Side effects: irritating to airway, increased BP and HR
Sevoflurane
solubility between isoflurane and desflurane
mild odor, mask inductions
Nitrous oxide
Mechanism: NMDA glutamate inhibitor, high MAC requires other drugs, low solubility

Side Effects: inhibits methionine synthase -> >12-24hrs depress bone marrow and fetal tissue
Intravenous Anesthetics
Mechanism: activate GABA receptor, most are short acting due to redistribution
Thiopental
Most commonly used barbiturate
significant cardiac depression at high dose
Etomidate
less cardiac depression, but pain on injection
decreased cortisol and aldosterone
Midazolam
benzodiazepine for anxiolysis and sedation
Propofol
Standard induction drug for general anesthesia
Ketamine
NMDA receptor blockade
maintains or stimulates respiration
Neostigmine
reverse effect of paralyzing drugs