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36 Cards in this Set

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  • Back
List three characteristics that are necessary for adequate general anesthesia
Amnesia
Analgesia
Paralysis
List gases and vapours that were once used as general anesthetics but are now obsolete.
Diethyl ether - very safe but flammable
Chlorofotm - Hepatic toxicity
Trichloroethylene - arrhythmia
Cyclopropane - Explosive
Name a gas that is presently used as a general anesthetic.
Nitrous oxide
Name 5 volatile liquids that are currently used as general anesthetics
Halothane
Iso-Flurane
Sevo -flurane
En - flurane
Des-flurane
What is the Minimum Alveolar Concentration in reference to general anesthetics?
This is the steady state alveolar concentration for a drug that is needed by 50% of the population to not react to surgical stimulus. Would titrate up after this.
Which of the inhaled general anesthetics has the lowest MAC?
Halothane - 0.77%.
Desflurane has the highest - 7%
Two factors that can slow the uptake of inhaled general anesthetics:
Cardiac output - greater cardiac output.
Solubility of the agent - greater solubility has slower uptake.
Agent of choice for inhalation anesthesia in children:
Halothane
One of the major side effects of this general anesthesia is massive hepatic necrosis, mostly in adults:
Halothane
Name three volatile anesthetics that have free F- as one of their metabolic products:
Enflurane
Sevoflurane
Isoflurane
This volatile -flurane has minimal biotransformation in the liver
desflurane
Which volatile anesthetic is contraindicated in patients with pre-existing renal disease?
Enflurane
What effect do volatile anesthetics have on myocardial contractility?
Depress myocardial contractility.
3 volatile anesthetics that increase heart rate
Enflurane
Isoflurane
Desflurane
Which volatile anesthetic has little effect on heart rate?
SEVOFLURANE
This volatile anesthetic slighlty slows down heart rate:
Halothane
Sevoflurane has little effect on heart rate
Enflurane, Isoflurane, Desflurane all increase heart rate.
Two volatile anesthetics that reduce cardiac output:
Halothane
Enflurane

Isoflurane and desflurane have little effect on CO
This volatile anesthetic sensitizes the myocardium to cathecholamines:
Halothane

Enflurane has much less sensitization to catecholamines whereas SEVOFLURANE does not.
All the volatile anesthetics decrease arterial pressure. Which one(s) does this by reduction in systemic vascular resistance?
SEVOFLURANE
Halothane, has very little effect on systemic vascular resistance.
Enflurance and Isoflurane have significant reduction in systemic vascular resistance.
Volatile anesthetics are halogenated hydrocarbons. How does this affect their chemical properties?
Prevents the drugs from being inflammable or explosive.
List respiratory effects of halogenated hydrocarbons used as volatile anesthetics:
Decrease bronchial smooth muscle tone
Decrease pulmonary vascular resistance
Inhibit pulmonary constriction due to hypoxia
Depress mucociliary function
Reduce tidal volume and increase resp. freq.
Decrease resp. to CO2
Block ventilatory response to hypoxia.
Why is N2O not used as general anesthetic by itself?
MAC: 120% not potent, would need a lot of it for effects.
What would be one of the side effects of N2O administered in high concentrations OVER SEVERAL DAYS?
Irreversibly oxidates Vitamin B12. This could lead to bone marrow depression.
Neuropathy
Slight myocardial depression
Increased systemic vascular resistance.
How is N2O metabolized?
It is not, the body gets rid of it via respiration.
Why is N2O contraindicated for use in patient with a pneumothorax?
Pneumothorax = closed air cavity. N2O diffuses faster than other gases and would markedly expand the cavity.
True or False:
All CNS depressants given in high enough dose can act as general anesthetics:
True
Which drugs (3) given IV are clinically used as general anesthetics?
Narcotics
Ketamine
Propofol
How is ketamine metabolized?
Oxidation
Methylation
What is the MOA of ketamine?
Antagonist to M receptors in CNS and agonist to opiate receptors. Also blocks NMDA receptors associated with pain wind-up.
Define "dissociation anesthesis" and name the drug associated with this.
Ketamine
The patient is pain free and unconscious (2 requirements of gen. anestheria) but not paralyzed. The patient may have random movements & nystagmus. The latter is a marker that anesthesia has kicked in.
Which general anesthesia is associated with increase in intracranial pressure, and production of emergent reactions and hallucinations?
Ketamine
A patient on this anesthetic has normal response to carbon dioxide.
Ketamine.
Name the drug:
A nonbarbiturate hypnotic
Causes abnormal adrenocortical suppression after single bolus dose.
Etomidate
Whereas ketamine causes increased BP and HR in a normal person, this diisopropylphenol depresses BP and respiration.
Propofol.
What advantage does propofol have over barbiturates?
Propofol causes less nausea and vomiting than barbiturates.
Which IV general anesthetic is emulsified in soybean-fat and should be discarded 6hrs after opening the vial?
Propofol