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45 Cards in this Set
- Front
- Back
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what are the five purposes of anesthesia?
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1 amnesia
2 immobility 3 analgesia 4 unconsciousness 5 attenuation of autonomic response |
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Four Stages of Anesthesia?
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1 Analgesia-without amensia 1st and then amnesia
2 Excitement-delurium, irregular respiration 3 Anesthesia- 4 Medullary depression |
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the gas dissolved in a liquid is equal to what two factors?
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solubility and the partial pressure of the gas
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gas will flow from higher pressure to lower or lower pressure to higher pressure?
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gases will flow from a region of higher pressure to lower pressure
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what determines how fast a gas will flow from a high pressure to a low pressure?
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the greater difference in pressure
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what receptors are the anesthetics both IV and inhaled working on?
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GABAa receptor chloride ion channel-do no bind to the GABAa binding site
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the definition of one MAC?
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minimum alveolar concentration that prevents movement in response to surgical stimulation in 50% of patients
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the decrease in mean arterial pressure is directly proportional to what?
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anesthetics alveolar concentration
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how does the anesthetic decrease the mean arterial pressure? 4 ways
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1-vasodilation
2-myocardial depression 3-blunting baroreceptor control 4-decrease in the sympathetic tone |
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what predisposition can lead to malignant hyperthermia while under anethesia?
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skeletal muscle disorder such as duchenne muscular dystrophy
succinylcholine halogenated anesthetics |
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what drugs are used to decrease nausia and vomiting during anesthesia
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ondansetron
metoclopramide try to avoid N.O. |
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is nitrous oxide better for anesthesia or analgesia
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analgesia it is a weak anethetic
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does N.O. have a fast or slow induction and recovery?
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very fast because it has a LOW solubility meaning largers molecules
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what is N.O. generally used for?
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minor surgeries or dental procedures or as an adjust for anesthesia to use a lower concentration of the other anesthetic
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does halothane have a fast or slow rate of induction and why/
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slow rate because it has a patition coeficient of 2.3 which is highly soluble
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why does halothane cause a drop in blood pressure?
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vasodilation
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why is halothane contraindicated in patients with head trauma, brain tumors, or brain edema?
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halothane raised the ICP
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what do all halogenated anethetics do to skeletal muscle?
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relaxation and some uterine smooth muscle relaxation
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what is fulminant halothane assocaiated with, which may be due to toxic metabolites or an immune respose?
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can induce hepatic necrosis (hepatic metabolism of P450)
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which halogenated gas has a high rate of induction and recovery?
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ENFLURANE
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hepatic metabolism of enflurane can cause an accumalation of what anion and lead to what?
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fluride ion
high concentration lead to seizures |
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what is a unique trait of isoflurane and desflurane which is why an antitussive may be used in adjunct?
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pungent odor
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which halogenated anesthetic needs a heated vaorizer?
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desflurane
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what are the two most commonly used IV anesthetics?
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thiopental and propofol
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what are side effects of thiopental?
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hypotension, respiratory depression, drug induces histamine release
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is there any effect of the hepatic renal or endocrine systems with thiopental?
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no
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why is propofol a "better" drug then thiopental?
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is has no hangover effect and can be used in pregnant women
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what is the advantage of etomidate?
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is has cardiovascular stability and commonly used in patients who would be at risk for hypotension
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what benzodiaepine is used most commmonly for surgical procedures now and why?
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midazolam, because it is induced and eliminated from the body relatively quickly
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what is dexmedetomidine (which is an alpha 2 agonist) used for?
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short term sedation in adults and an anesthetic adjunct
the sedation is more like natural sleep |
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what chemcial compotitions do the local anesthetics generally have?
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a lipophilic and hydrophilic element connected by either an ester or amide link
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which local anesthetics have a shorter duration the amide linked or ester linked and why?
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the ester linked because they are more prone to hydrolysis
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where do the local anesthetics act to block conduction?
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they block sodium channels within the neuron or cell (which is where the lipophilic component comes into play)
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which nerve fibers are block more easily with the local anesthetics? large or small?
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small
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why would someone have a hypersensitivity reaction to a local anesthetic?
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because of the preservatives in the drug, and the commonly occur in esters
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what are the ester anesthetics hydrolysed to?
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para-aminobezoic acid PABA which may cause the hypersensitivity reaction
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how are the amide anesthetics broken down and what patients need to be avoided?
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hepatic, patients with liver failure or severe hepatic disease
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what is used with Biers block?
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a turnicate must be used because this is an intravenous regional anesthetic
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does cocaine produce vasoconstriction or vasodilation
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vasoconstriction
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what is procaine metabolised to?
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PABA-hypersensitivity reaction
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what is benzocaine commonly used for? this is also an ester and can be metabolized to PABA
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topical use for sunburns itching and pain, sometimes for mucus membranes in throat sprays
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tetracaine is generally used for what?
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general anesthesia
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signs of CNS toxicity of lidocaine include what?
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euphoria or dysphoria and LOC
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why can prilocaine be used with epinephrine?
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no vasodilation
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which local anesthetic is used as a parenteral and topcial for labor and delivery? (can be used as an epidural)
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bupivacaine
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