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27 Cards in this Set

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  • Back
Stages of anesthesia
stage 1: analgesia
stage 2: disinhibition
stage 3: surgical anesthesia
stage 4: medullary depression
Potency of inhaled anesthetis is roughly proportional to their
lipid solubility
Ketamine MOA
antagonism of action of the excitatory neurotransmitter glutamic acid on the NMDA receptor
inhaled anesthetic with the lowest blood:gas partition coefficient
nitrous oxide
inhaled anesthetic with the highest blood:gas partition coefficient
methoxyflurane
inhaled anesthetic with the highest minium alveolar concentration (MAC %)
nitrous oxide
inhaled anesthetic with the lowest MAC%
methoxyflurane
Ventilation rate and onset of anesthesia
the greater the ventilation, the more rapid the onset of anesthesia (more rapid rise in alveolar and blood partial presssure of agent)
Pulmonary blood flow and onset of anesthesia
high pulmonary blood flow, speed of onset of anesthesia is reduced (gas partial pressure rises at a slower rate)
Rate of recovery from anesthesia iusing agents with ____blood:gas partition coefficeints is faster than that of anesthetics with ____ blood solubility
low; high
MAC definition
alveolar concentration required to eliminate the response to a standardized painful stimulus in 50% of patients
CNS effects: inhaled anesthetics ____ brain metabolic rate; they ____ vascular resistance and thus _____ cerebral blood flow, which could lead to increase in ICP
decrease;reduce;increase
May cause spike-and-wave activity and muscle twitching
enflurane
CV effects: most inhaled anesthetics ______ arterial blood pressure
decrease
Myocardial depressants that decrease CO
enflurane, halothane
Causes peripheral vasodilation
isoflurane
Less likely to lower blood pressure than other inhaled anesthetics
nitrous oxide
Blood flow to the liver and kidney is ___ by most inhaled agents
decreased
May sensitize the myocardium to the arrhythmogenic effects of catecholamines
halothane
Respiratory effects: rate of respiration may be ____ by inhaled anesthetics, but tidal volume and minute ventilation are ______., leading to an _____ in arterial CO2 tension
increased; decreased; increase
Inhaled anesthetics _____ ventilatory response to hypoxia even at subanesthetic concentrations (eg. during recovery)
decrease
Has the smallest effect on respiration
nitrous oxide
Most inhaled anesthetics are bronchodilators, but ____ is a pulmonary irritant and may cause bronchospasm
desflurane
The pungency of ____ causing breath-holding limits its use in anethesia induction
enflurane
Postoperative hepatitis has occurred (rarely) after _____ anesthesia in patients experiencing hypovolemic shock or other severe stress
halothane
Fluoride released by metabolism of _____ may cause renal insufficiency after prolonged anesthesia
methoxyflurane and possible enlurane
Prolonged exposure to _____ decreases methionine synthase activity and may lead to megaloblastic anemia
nitrous oxide