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21 Cards in this Set

  • Front
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Stages of Anesthesia
Stage 1 - analgesia
Stage 2 - analgesia, amnesia, loss of consciousness
Stage 3 - loss of reflexes, skeletal muscle relaxation
-Plane 1 - eyes moist, pupil miotic
-Plane 2 - eyes dry, pupils mid-dilate
-Plane 3 - loss of corneal reflex
-Plane 4 - maximal pupil dilation, apnea
Stage 4 - respiratory and cardiac depression
Inhalation Anesthetics: Blood and brain levels
Drug levels in the brain are determined by
1. Partial Pressures
2. Lipid Solubility
Nitrous Oxide
Inhalation anesthetic. Rapid onset and recovery.
Desflurane
Inhalation anesthetic. Poor onset and rapid recovery.
Sevoflurane
Inhalation anesthetic. Rapid onset and rapid recovery.
Isoflurane
Inhalation anesthetic. Medium onset and medium recovery.
Enflurane
Inhalation anesthetic. Medium onset and medium recovery.
Halothane
Inhalation anesthetic. Medium onset and medium recovery.

AE: hepatotoxicity.
Methoxyflurane
Inhalation anesthetic. Slow onset and slow recovery.

AE: diabetes insipidus.
Inhalation Anesthetics: Mechanism of action.
- Specific and non-specific actions on neuronal activity.
- Direct & indirect effects on various types of ion channels.
- Binding sites on ion channel proteins.
- Binding sites on cell membrane lipids.
Inhalation Anesthetic: Adverse Side Effects
- Respiratory and cardiac depression.
- Hypotension
- Increased skeletal muscle tone.
- Diabetes insipidus (methoxyflurane).
- Hepatotoxicity (halothane)
Intravenous Anesthetics
Rapid state of unconsciousness.
-Potency correlated with lipid solubility.
-Enhances GABA Neurotransmission
-Most common: Benzodiazepines and Barbiturates
Two most common Intravenous Anesthetics
1. Benzodiazepines
2. Barbiturates
Intravenous Anesthetic: Adverse Side Effects
1. Respiratory and Cardiac Depression.
-Benzodiazepines: large safety margin
-Barbiturates: small safety margin
2. Hypotension
3. Pharmacogenetics (idiosyncratic reactions)
Thiopental
Intravenous Anesthetic, Ultra-Short effect.

Rapid Onset & Recovery.

Barbiturate; induction; CV depression
Methohexital
Intravenous Anesthetic

Medium onset, slow recovery.

Barbiturate; maintenance of anesthesia.
Propofol
Intravenous Anesthetic.

Rapid onset and recovery.

Induction and maintenance; lowers BP, replacing barbiturates.
Ketamine
Intravenous Anesthetic. Also a psychedelic drug.

Medium onset and recovery.

NMDA antagonist, Cardiac stimulant. Increase blood flow.
Diazepam
Intravenous Anesthetic

Medium onset, slow recovery.

Benzodiazepine, conscious sedation.
Midazolam
Intravenous Anesthetic.

Slow onset and recovery.

Benzodiazepine, sedation, marked amnesia.
Etomidate
Intravenous Anesthetic.

Rapid onset, medium recovery.

Cardiac stabilizer, skeletal muscle activator.