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26 Cards in this Set
- Front
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Phase 1 of general anesthesia
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Premedication with a sedative/hypnotic (VERSED):A narcotic analgesic (meperidine,morophine,fentanyl):and a parasympathetic inhibitor (atropine)
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Phase 2 of general anesthesia
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Induction with an ultra-short acting barbituate anesthetic (DIPRIVAN) The PT is preoxygenated with a high flow of O2 with mask.
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PHASE 3 OF GENERAL ANASTHESIA
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Endotracheal intubation is performed after giving neuromuscular blockin agent (ROCURONIUM). Deep skeletal relaxation also occurs now. PT is positioned and preped for surgery.
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PHASE 4 of general anasthesia
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Maintenance of general anesthesia is with an anesthetic gas (DESFLURANE) possibly in conjunction with an I.V. barbituate or narcotic analgesic (fentanyl or sufentanil)
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Phase 5 of general anesthesia
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Emergence Phase (reversal) occurs as the agents are stopped and neuromuscular blocker needs to be reversed with (NEOSTIGMINE and RUBINOL). Some patients, especialluy pediatric and young patients may experience "excitement stage". Observe and maintain adequate airway and PT safety.
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Phase 6 of general anesthesia
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Recovery Phase: Pt monitored closely in the PACU to ensure adequate ventillation, V/S stability, and pain management.
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Adjuvant meds to treat bradycardia heart rate perioperatively
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RUBINOL or ATROPINE for bradycardia
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Adjuvant meds to treat BP
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EPHEDRINE for hypotension
LABATELOL fot hypertension |
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Anti-emetics to prevent nausea
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PHENEGRAN, ZOFRAN - to treat nausea
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Bicitra
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Acid Neutralizer
S/E diarrhea, nausea, vomiting, stomach pain, fluid retention (water gain), convulsions, unusual weakness Precautions: kidney or heart disease, liver disease, Addison's disease, high blood pressure, sodium |
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Versed (Midazolam)
Benzodiazapine |
Sedative/Amnesic
S/E: Resp depresion, apnea, delayed emergence from anesthesia |
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Fentanyl (Sublimaze)
Opioid Narcotic |
Analgesic: 1-2 hrs
S/E - Resp depression, depresision, bradycardia, hypotension, N & V, muscle ridgidity |
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Sufentanyl (Sufenta)
Opioid Narcotic |
Analgesic: 30-60 min
S/E - Resp depression, bradycardia, hypotension, N & V |
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Diprivan (Propofol)
IV hypnotic (NO ANALGESIA) |
Hypnotic: very short (Minutes)
S/E: Apnea, pain on injection, hypotension, twitching |
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Sevoflurane
General anesthetic |
used for fast induction and maintenance of general anesthesia
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Desflurane (Suprane)
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Inhalation Anesthesic: Very short action
Myocardial depression, hypotension, coughing, N&V, can cause MH (malignant hyperthermia) |
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Succinylcholine (Anectine)
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DEPOLARIZING Neuromuscular Blocker: 5-10 mon
Muscle pain, hyperkalemia (pts with burns, upper motor neuron lesions, muscular dystrophies, major muscular injuries, spinal cord injuries), MH (malignant hyperthermia) |
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Rocuronium (Zemuron)
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NON-depolarizin intramuscular blocker
N&V, Bronchospasms, hiccups, hyper/hypotension, wheezing |
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Neostigmine (Prostigmin)
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REVERSAL for Non-depolarizing neuromuscular blocking agents
S/E: Sinus bradycardia, N&V, salivation, diaphoresis, bronchospasm |
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Robinul (glycopyrrolate)
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Anticholinergic: up to 7 hrs
s/e:Dizziness, drowsiness, sinus tachycardia, increases intraocular pressure |
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Atropine
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Anticholinergic: 2 hrs
S/E: Inhibits salivary and respiratory secretions, causes bronchodilation, counteracts bradycardia and other dysrythmias, increases intra-ocular pressure |
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Romazicon (Flumazenil)
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benzodiazepine antagonist, used as an antidote in the treatment of benzodiazepine overdose: 1-2 minutes
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Narcan (Naloxone)
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Opoid antagonist:1-4 hrs
N&V, withdrawal symtopms in narcotic addicts |
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Lidocaine (Xylocaine)
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Local anesthetic
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Marcaine (bupivicaine)
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local anaesthesia including infiltration, nerve block, epidural, and intrathecal anaesthesia. Bupivacaine often is administered by epidural injection before total hip arthroplasty.
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Balanced anesthesia
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A technique of general anesthesia based on the concept that administration of a mixture of small amounts of several neuronal depressants summates the advantages but not the disadvantages of the individual components of the mixture.
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