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14 Cards in this Set
- Front
- Back
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Clinical Stages of Anesthesia
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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 |
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Minimum Alveolar Conc. (MAC)
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conc of anesthetic at 1 atm that produces immobility in 50% in response to painful stimulus
Decreased MAC: hypothermia, hypthyroidism, alcohol intox, age, sedatives |
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Inhaled Anesthetics
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decrease BP (except NO2) b/c decrease periph vasc resistance, increase HR
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Isoflurane
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Mechanism: activate GABA receptor
Clinical Use: not used much |
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Desflurane
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similar to isoflurane
less soluble, so higher inspired conc. required Side effects: irritating to airway, increased BP and HR |
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Sevoflurane
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solubility between isoflurane and desflurane
mild odor, mask inductions |
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Nitrous oxide
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Mechanism: NMDA glutamate inhibitor, high MAC requires other drugs, low solubility
Side Effects: inhibits methionine synthase -> >12-24hrs depress bone marrow and fetal tissue |
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Intravenous Anesthetics
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Mechanism: activate GABA receptor, most are short acting due to redistribution
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Thiopental
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Most commonly used barbiturate
significant cardiac depression at high dose |
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Etomidate
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less cardiac depression, but pain on injection
decreased cortisol and aldosterone |
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Midazolam
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benzodiazepine for anxiolysis and sedation
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Propofol
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Standard induction drug for general anesthesia
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Ketamine
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NMDA receptor blockade
maintains or stimulates respiration |
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Neostigmine
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reverse effect of paralyzing drugs
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