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