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24 Cards in this Set
- Front
- Back
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Why are general anesthetics used?
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For surgery
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Hx of anesthetics
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EtOH, partial asphyxia, cerebral concussion, no anesthetic at all, NO and diethylether, chloroform
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The characteristics of the ideal anesthetic (4)
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1- Loss of consciousness- GA
2- Amnesia- GA 3- Analgesia- opioids 4- Muscle relaxation (Rocuronium) and loss of reflexes |
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T/F The therapeutic index for most general anesthetics is very high
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False, they are very low
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GA act by __ GABAergic activity and __ glutaminergic activity
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Inc; dec
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T/F The higher the lipid solubility the more potent the anesthetic
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True
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T/F MAC (minimal alveolar concentration) measures the efficacy of all anesthetics
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False, it measures the potency of INHALED anesthetics
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T/F The lower the MAC the more potent the anesthetic
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True
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How do you measure solubility of anesthetic in the blood
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By the blood/gas coefficient. Anesthesia occurs when only after the drug reaches the CNS- when blood becomes concentrated it gets released into the CNS.
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T/F The less soluble an anesthetic is in the blood the slower the onset
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False, more soluble=slow onset
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The Halogenated Hydrocarbons (4).
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1- Halothane
2- Isoflurane 3- Desflurane 4- Sevoflurane - All cause dec respiration and can cause malignant hyperthermia=> inc Ca2+ intake by muscles=> (muscle rigidity, inc oxygen consumption, inc body temp) |
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Nitrous Oxide
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- Rapid induction, good analgesic, low potency, no amnesia
- B/g coefficient= 0.5 (very low) - MAC= 100% (low potency) |
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Side effects of NO
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- Low solubility in blood leads to a greater chance of gas released into the peritoneal cavity
- Repeated exposures=> leukopenia, megaloblastic anemia, fetal abnormalities |
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Halothane
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- Not used anymore
- Can cause hepatic necrosis after repeated uses |
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Isoflurane
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b/g =1.4 (slow onset)
MAC = 1.4% (more potent) Excreted by the lungs |
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Desflurane
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b/g = 0.42
MAC = 6% Most rapid induction |
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Sevoflurane
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b/g = 0.68
MAC = 1.8% Less irritating to mucous membranes. Drug of choice. |
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Thiopental
(Barbiturate) |
- High lipid solubility
- Rapid onset and recovery - Poor analgesic - Terminated by redistribution from brain - Hangover effect - Activate GABAergic neurons |
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Propofol
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- Acts on GABAergic pathways
- Rapid onset - Pain upon injection - Anti-nausea effects |
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Ketamine
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- Analog of phencyclidine (Angel dust)/(receptor blocker)
- Dec glutamate effects - "Dissociative" anesthetic - Can cause hallucinations during recovery- less w/ kids though |
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Etomidate
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- Conscious sedative
- Rapid induction - Activates GABA receptors - Can cause muscle spasms |
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The Barbiturates (5)
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1- Thiopental
2- Propofol 3- Ketamine 4- Etomidate 5- Midazolam- a benzodiazepine |
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G.A.s that are no longer used
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Diethylether and chloroform
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NO has a low __ solubility and a high __ solubility.
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Blood; lipid
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