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26 Cards in this Set

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Inhalant Agents
Nitrous Oxide
Halothane (Flourothane)
Isoflurane (Forane)
Sevoflurane (Ultane)
Desflurane (Suprene)
Intravenous Agents
Midazolam (Versed)
Propofol (Diprivan)
Etomidate (Amidate)
Ketamine (Ketalar)
Opioid Analgesics
Fentanyl (Sublimaze)
Halothane (Fluothane)
1) MAC: 0.75; Blood/gas 2.54
2) Slow induction, rapid awakening
Halothane (Fluothane)

Side effects
1) Uterine Relaxation
2) Respiratory depression
3) Blood Pressure decreases linearly with amount
4) Sensatization to catecholamines, arrythmias
5) Uterine relaxation/ miscarriages
6) reduced renal function/ urine flow
7) Hepatic Necrosis with repeated administration
8) Malignant Hyperthermia with succinylcholine
Enflurane
Contraindicated in patients with seizure disorders.
May cause CNS stimulation and seizures.
Floride production=reversible kidney damage
Isoflurane (Forane)
Rapid induction emergence
Useful in neurosurgery
Low liver kidney Toxicity
Coronary steal
Does not depress myocardium or sensitize it to catecholamines
Sevoflurane (Ultane)
Rapid effect
Least airway irritation
Safest in Cardiovascular disease
Desflurane (Suprane)
Rapid emergence, induction
Good for outpatient surgery
Pungent odor, irritates airway
Not used for induction
Metabolism of Inhaled anesthetics
1) Cl and Br may be removed from Halothane causing immune reaction and hepatitis
2) Evoflurane and Sevoflurane release Floride-kidney toxicity (rare)
Malignant Hyperthermia
Rapid rise in heat production
Caused by use of succinylcholine with inhaled anesthetics.
May be fatal
Treat with Dantrolene
Effects of General Anesthetics
Decrease BP
Decrease Respiratory Drive
Increase Cerebral blood flow
Increase Intracranial pressure
Hypothermia
Effects of General Anesthetics

Emergence
Hypertension
Tachycardia
Myocardial ischemia (CAD patients)
Excitment(Crying, thrashing, moaning)
Shivering
Can Reduce with Opioids
Mechanism of action General Anesthetics
1) GABAa agonist (Barbituates, Benzodiazepines, Propofol)
2) Block NMDA (Ketamine)
3) Opioid Receptor (Opiates)
Nitrous Oxide
Low potency for Anesthesia
Good Analgesia (Dental)
Attenuates Hypotension
Cause Diffusion Hypoxia
No malignant Hyperthermia
Little respiratory depression
Nitrous Oxide

Adverse effects
1) Causes Euphoria-abuse
2) Trapped gas will expand
3) Chronic low level exposure-Peripheral neuropathy
4) Megaloblastic anemia
5) Don't use within three months of eye surgery
Nitrous Oxide

Uses
Speeds induction
With other drugs for "Balanced anesthesia"
Thiopental (pentothal)
Induction for short procedures (onset 30-60sec)
Contraindicated in patients with acute intermittent porphyria- causes demyelination of nerves
Midazolam (Versed)
1) Sedation, Anxiety relief,
Anterograde amnesia
2) Preanesthetic and induction
3)Short procedures it is combined with Fentanyl
4) Reversed by flumanzenil
Propofol (Diprivian)
1) DOC for most procedures
I2) nduction and maintenance
3) Induction equal to thiopental emergence 10 times faster
4) Decrease cerebral blood flow, metabolism and intracranial pressure= good for neurosurg
5) Safe in pregnancy
Propofol (Diprivian)

Adverse effects
1) Severe Respiratory depression
2) Pain at injection site
3) Anaphylactic reactions
4)LESS nausea and vomiting
Etomidate (Amidate)
Increase GABA receptors and displace inhibitors
Rapid onset short duration
No hypotension
Etomidate (Amidate)

Adverse effects
1) Nausea and vomiting
2) Decrease seizure threshold
3) Hiccups
Ketamine (Ketalar)
1) Catatonic state
2) Dissociative anesthesia, profound analgesia
3) Little respiratory depression
4) Used in children
5) Uncommon Nausea and vomiting
Ketamine (Ketalar)

Adverse effects
1) Increase BP and HR
2) Emergence delerium: bizzare dreams hallucination, even psychosis
3) Date rape drug
4) Abused
Fentanyl (Sublimaze) Sufentalnil (Sufenta)
1) IV
2) Rapid onset, Good analgesia
3) Lollipops for kids
4) Midazolam combined for short procedures