The Pharmacological Of General Anesthetics

Front 1

List three characteristics that are necessary for adequate general anesthesia

Back 1

Amnesia
Analgesia
Paralysis

Front 2

List gases and vapours that were once used as general anesthetics but are now obsolete.

Back 2

Diethyl ether - very safe but flammable
Chlorofotm - Hepatic toxicity
Trichloroethylene - arrhythmia
Cyclopropane - Explosive

Front 3

Name a gas that is presently used as a general anesthetic.

Back 3

Nitrous oxide

Front 4

Name 5 volatile liquids that are currently used as general anesthetics

Back 4

Halothane
Iso-Flurane
Sevo -flurane
En - flurane
Des-flurane

Front 5

What is the Minimum Alveolar Concentration in reference to general anesthetics?

Back 5

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.

Front 6

Which of the inhaled general anesthetics has the lowest MAC?

Back 6

Halothane - 0.77%.
Desflurane has the highest - 7%

Front 7

Two factors that can slow the uptake of inhaled general anesthetics:

Back 7

Cardiac output - greater cardiac output.
Solubility of the agent - greater solubility has slower uptake.

Front 8

Agent of choice for inhalation anesthesia in children:

Back 8

Halothane

Front 9

One of the major side effects of this general anesthesia is massive hepatic necrosis, mostly in adults:

Back 9

Halothane

Front 10

Name three volatile anesthetics that have free F- as one of their metabolic products:

Back 10

Enflurane
Sevoflurane
Isoflurane

Front 11

This volatile -flurane has minimal biotransformation in the liver

Back 11

desflurane

Front 12

Which volatile anesthetic is contraindicated in patients with pre-existing renal disease?

Back 12

Enflurane

Front 13

What effect do volatile anesthetics have on myocardial contractility?

Back 13

Depress myocardial contractility.

Front 14

3 volatile anesthetics that increase heart rate

Back 14

Enflurane
Isoflurane
Desflurane

Front 15

Which volatile anesthetic has little effect on heart rate?

Back 15

SEVOFLURANE

Front 16

This volatile anesthetic slighlty slows down heart rate:

Back 16

Halothane
Sevoflurane has little effect on heart rate
Enflurane, Isoflurane, Desflurane all increase heart rate.

Front 17

Two volatile anesthetics that reduce cardiac output:

Back 17

Halothane
Enflurane

Isoflurane and desflurane have little effect on CO

Front 18

This volatile anesthetic sensitizes the myocardium to cathecholamines:

Back 18

Halothane

Enflurane has much less sensitization to catecholamines whereas SEVOFLURANE does not.

Front 19

All the volatile anesthetics decrease arterial pressure. Which one(s) does this by reduction in systemic vascular resistance?

Back 19

SEVOFLURANE
Halothane, has very little effect on systemic vascular resistance.
Enflurance and Isoflurane have significant reduction in systemic vascular resistance.

Front 20

Volatile anesthetics are halogenated hydrocarbons. How does this affect their chemical properties?

Back 20

Prevents the drugs from being inflammable or explosive.

Front 21

List respiratory effects of halogenated hydrocarbons used as volatile anesthetics:

Back 21

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.

Front 22

Why is N2O not used as general anesthetic by itself?

Back 22

MAC: 120% not potent, would need a lot of it for effects.

Front 23

What would be one of the side effects of N2O administered in high concentrations OVER SEVERAL DAYS?

Back 23

Irreversibly oxidates Vitamin B12. This could lead to bone marrow depression.
Neuropathy
Slight myocardial depression
Increased systemic vascular resistance.

Front 24

How is N2O metabolized?

Back 24

It is not, the body gets rid of it via respiration.

Front 25

Why is N2O contraindicated for use in patient with a pneumothorax?

Back 25

Pneumothorax = closed air cavity. N2O diffuses faster than other gases and would markedly expand the cavity.

Front 26

True or False:
All CNS depressants given in high enough dose can act as general anesthetics:

Back 26

True

Front 27

Which drugs (3) given IV are clinically used as general anesthetics?

Back 27

Narcotics
Ketamine
Propofol

Front 28

How is ketamine metabolized?

Back 28

Oxidation
Methylation

Front 29

What is the MOA of ketamine?

Back 29

Antagonist to M receptors in CNS and agonist to opiate receptors. Also blocks NMDA receptors associated with pain wind-up.

Front 30

Define "dissociation anesthesis" and name the drug associated with this.

Back 30

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.

Front 31

Which general anesthesia is associated with increase in intracranial pressure, and production of emergent reactions and hallucinations?

Back 31

Ketamine

Front 32

A patient on this anesthetic has normal response to carbon dioxide.

Back 32

Ketamine.

Front 33

Name the drug:
A nonbarbiturate hypnotic
Causes abnormal adrenocortical suppression after single bolus dose.

Back 33

Etomidate

Front 34

Whereas ketamine causes increased BP and HR in a normal person, this diisopropylphenol depresses BP and respiration.

Back 34

Propofol.

Front 35

What advantage does propofol have over barbiturates?

Back 35

Propofol causes less nausea and vomiting than barbiturates.

Front 36

Which IV general anesthetic is emulsified in soybean-fat and should be discarded 6hrs after opening the vial?

Back 36

Propofol