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91 Cards in this Set

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What stage of anesthesia can be described by delirium, violent behavior, increased blood pressure, and increased respiratory rate
State II (excitement)
What stage of anesthesia can be described by depression of vasomotor center, depression of respiratory center, and death may occur
Stage IV (medullary depression)
What stage of anesthesia can be described by eye movements cease, fixed pupils, regular respiration, and relaxation of skeletal muscles
Stage III (surgical anesthesia)
What stage of anesthesia can be described by loss of pain sensation, and patient is conscious
Stage I (analgesia)
With regard to inhaled anesthetics, what does MAC stand for
Minimum alveolar concentration
What is MAC
The concentration of inhaled anesthetic required to stop movement in 50% of patients given a standardized skin incision; a measure of potency for inhaled anesthetics
For potent inhaled anesthetics, is the MAC small or large
Small (inverse of the MAC is used as an index of potency for inhaled anesthetics)
Which inhaled anesthetic has the largest MAC
Nitrous oxide
Which inhaled anesthetic has the smallest MAC
Halothane
The more lipid soluble an inhaled anesthetic is, the concentration of anesthetic needed to produce anesthesia is lower or higher
Lower
What is the blood/gas partition coefficient
Ratio of the total amount of gas in the blood relative to the gas equilibrium phase; refers to an inhaled anesthetic’s solubility in the blood
If an inhaled anesthetic has a high blood/gas partition coefficient, will times of induction and recovery be increased or decreased
Increased (time to increase arterial tension is longer)
Give two examples of inhaled anesthetics with low blood/gas partition coefficients (low blood solubility)
Nitrous oxide (0.5)
Desflurane (0.4)
None
Give two examples of inhaled anesthetics with high blood/gas partition coefficients (high blood solubility)
Halothane (2.3)
Enflurane (1.9)
None
Which inhaled anesthetic, halothane or nitrous oxide, will take longer to change the depth of anesthesia when the concentration of drug has been changed
Halothane
Are MAC values additive
Yes
Are MAC valued higher or lower in elderly patients
Lower
Are MAC values higher or lower when opioid analgesics and/or sedative hypnotics are used concomitantly
Lower
None
What is another name for nitrous oxide
Laughing gas
Do inhaled anesthetics increase or decrease the response to PCO2 levels
Decrease
Do inhaled anesthetics increase or decrease cerebral vascular flow
Increase
Do inhaled anesthetics increase or decrease intracranial pressure
Increase
Do inhaled anesthetics relax or strengthen uterine smooth muscle contractions
Relax (except methoxyflurane when briefly inhaled, therefore, can be used during childbirth)
Give examples of inhaled anesthetics
Sevoflurane
Halothane
Isoflurane
Nitrous oxide
Enflurane
Methoxyflurane
Desflurane

*SHINE MD
None
Which inhaled anesthetic is not a halogenated hydrocarbon
Nitrous oxide
Which inhaled anesthetic is associated with malignant hyperthermia
Halothane
What characterizes malignant hyperthermia
Hyperthermia
Muscle rigidity
Acidosis
Hypertension
Hyperkalemia
None
Should a patient with a family history positive for malignant hyperthermia be concerned
Yes (genetic defect may be inherited)
What drug is given to treat malignant hyperthermia
Dantrolene
Which inhaled anesthetic is associated with increased bronchial secretions
Isoflurane
Which inhaled anesthetic is associated with muscle spasms
Enflurane
Which inhaled anesthetic is associated with hepatitis
Halothane
Which inhaled anesthetic is associated with increased bronchial spasms
Isoflurane
None
Which inhaled anesthetic is associated with cardiac arrhythmias
Halothane
Which inhaled anesthetics increase heart rate (via reflex secondary to vasodilation)
Isoflurane
Desflurane
None
Which inhaled anesthetics (3) decrease heart rate
Sevoflurane
Halothane
Enflurane
None
Halothane is not hepatotoxic in what patient population
Pediatric patients
Which inhaled anesthetic is contraindicated in patients with renal failure
Enflurane
Which inhaled anesthetic significantly sensitizes the heart to catecholamine
Halothane
Which inhaled anesthetic does not sensitize the heart to catecholamines
Isoflurane
An iatrogenic pneumothorax has been associated with which inhaled anesthetic
Nitrous oxide (low blood/gas partition coefficient, therefore, accumulates rapidly and increases volume and pressure in closed compartments)
Which inhaled anesthetic is the least hepatotoxic
Nitrous oxide
None
Are the inhaled halogenated hydrocarbon anesthetics volatile or nonvolatile gases
Volatile gases
None
Which inhaled anesthetic must be used with other anesthetics for surgical anesthesia
Nitrous oxide (potent analgesic properties with weak anesthetic properties)
Which inhaled anesthetic decreases renal and hepatic blood flow
Halothane
Which inhaled anesthetic relaxes bronchial smooth muscle
Halothane
Give examples of IV anesthetics
Thiopental
Etomidate
Midazolam
Propofol
Fentanyl
Ketamine

*TEMPerature in Farenheit or Kelvins
None
What IV anesthetic is a barbiturate
Thiopental
What IV anesthetic is a benzodiazepine
Midazolam
What IV anesthetic is an opioid
Fentanyl
None
Is thiopental used for induction, maintenance, or both
Induction
Pharmacodynamically, how does recovery occur with the rapid-acting barbiturates
Rapid redistribution from the CNS to peripheral tissues
Does thiopental increase, decrease, or not change cerebral blood flow
No change
Does thiopental increase, decrease, or not change respiratory function
Decreases
Does thiopental increase, decrease, or not change blood pressure
Decreases
Why should caution be taken when administering thiopental to asthmatic patients
May cause laryngospasm
Barbiturates are contraindicated in patients with which disease
Acute intermittent porphyria (barbiturates increase heme synthesis)
Midazolam offers which type of amnesia making it useful for conscious sedation
Anterograde amnesia
What is the antidote for midazolam-induced respiratory depression
Flumazenil
Fentanyl combined with which medication causes neuroleptic analgesia
Droperidol
Fentanyl combined with which two medications causes neuroleptic anesthesia
Droperidol + NO
What adverse drug reaction may be caused by fentanyl when given intravenously
Chest wall rigidity
Does propofol have good analgesic properties
No
What color is propofol and why
White; contains lipids (must consider when calculating lipid concentrations in total parenteral nutrition)
Does propofol increase or decrease blood pressure
Decrease
Does propofol increase or decrease intracranial pressure
Decrease
Is propofol used for induction, maintenance, or both
Both
None
Which IV anesthetic causes dissociative anesthesia
Ketamine
What is dissociative anesthesia
Patient is unconscious and feels no pain yet appears awake (patient is sedated, immobile, and amnestic)
Which anesthetic has antiemetic properties
Propofol
Which IV anesthetic is a cardiovascular stimulant (increases blood pressure and cardiac output)
Ketamine
Which IV anesthetic causes vivid dreams and hallucinations
Ketamine
Does ketamine increase or decrease cerebral blood flow
Increase
Which IV anesthetic is an ultra-short-acting benzylimidazole used for induction of anesthesia and has minimal cardiovascular effects
Etomidate
Are local anesthetics weak acids or weak bases
Weak bases
Give examples of local amide anesthetics
Prilocaine
Lidocaine
Articaine
Mepivacaine
Bupivacaine

All have >1 “i” in their name
None
Give examples of ester local anesthetics
Procaine
Benzocaine
Cocaine

All have 1 “i” in their name
None
Which medication, when used in combination, reduces systemic toxicity and increases the duration of action of local anesthetics
Epinephrine
Epinephrine should not be combined with local anesthetics when injecting near which anatomic sites
Nose
Ears
Digits
Penis
None
Which type of enzymes metabolize amide local anesthetics and where are they located
Amidases located in the liver
Which type of enzymes metabolize ester local anesthetics and where are they located
Esterases located in tissues and blood
What is the mechanism of action of local anesthetics
Inhibition of sodium channels in axonal membranes via binding to the channels in their inactivated state and preventing a structural change to the resting state
Do local anesthetics need to be in the ionized or nonionized form to bind to the sodium channel
Ionized form
Do local anesthetics need to be in the ionized or nonionized form to gain access to the sodium channel, which is located on the inner side of the axonal membrane
Nonionized form (must be able to cross lipophilic axonal membrane)
All local anesthetics cause vasodilation with the exception of which drug
Cocaine (causes vasoconstriction)
Nerve fibers most sensitive to blockade are of smaller or larger diameter
Smaller diameter
Nerve fibers most sensitive to blockade have low or high firing rates
High firing rates
Which nerve fibers are most sensitive to local anesthetics
Type B and C fibers
None
Which nerve fibers are least sensitive to local anesthetics
Type A α fibers
None
What are the adverse effects of local anesthetics
Hypotension (except cocaine)
Nystagmus
Seizures
Dizziness
Allergic reactions
None
Allergic reactions are most associated with ester or amide local anesthetics
Esters (via para-aminobenzoic acid [PABA] formation)