Anesthetics

Front 1

Inhaled Anesthetics- General Principals

1)Drugs must be ____ soluble to cross the _____

2)Drugs with decreased solubility in blood = ____ induction and ____ recovery time

3)Drugs with increased Lipid Solubility = ____ potency

Back 1

1) Lipid, Blood-Brain Barrier

2)Rapid, rapid -- the drug doesn't need to be saturated in the blood before reaching the Brain, and it is easily excreted from lungs

3)Increased

Front 2

Inhaled Anesthetics- Halothane, Enflurane, Isoflurane, Nitrous Oxide

1)MOA
2)Use
3)Toxicity

Back 2

1) Unknown --> low solubility in blood allows for faster induction

2) Myocardial depression, respiratory depression, nausea, emesis, increased cerebral blood flow

3) Hepatotoxic (halothane), Nephrotoxic (methoxyflurane), Convulsions (enflurane)

Malignant Hyperthermia

Front 3

Thiopental (Barbituate IV anesthetic)
1)MOA
2)Use
3)Toxicity

Back 3

1) High Potency with High Lipid Solubility to cross BBB quickly and open GABA Cl- channels

2)Rapid induction of anesthesia, and for short procedures

3) Decreased Cerebral Blood Flow

Front 4

Midazolam (Benzodiazepines IV anesthetic)

1)MOA
2)Use
3)Toxicity

Back 4

1)Open GABA channel more frequently

2)Used in endoscopy and in conjunction with inhaled anesthetics

3)Post op resp depression, AMNESIA, and low BP

Front 5

Ketamine
1)MOA
2)Use
3)Toxicity

Back 5

1) PCP analog which acts as a dissociative anesthetic

2) rarely used for Anesthesia

3) Disorientation, hallucination, bad dreams, and increased ceebral blood flow

Front 6

Opiates

Back 6

Fentanyl and Morphine are given with anesthesia

Front 7

Propofol

Back 7

Used for rapid anesthesia induction because it has little post op nausea than Thiopental

Front 8

Local Anesthetics
1)esters
2)Amides (have 2 i's in the name)

Back 8

1)Procaine, Cocaine, tetracaine
2)lidocaine, mepivacaine,bupivicaine

Front 9

Local Anesthetics
1)MOA
2)Principles

Back 9

1) Block Na+ channels
Amides enter cell as uncharged form, then bind receptor as a charged form

2) In the affected acidic tissue, the anesthetic becomes charged and can't cross the membranes -->need to inject more

-Order of Blockade
Small diameter > Large Diameter and Unmyelinated > Myelinated

-Order of blockade (First on, Last off)
Pain>Temperature>Touch>Pressure

-Given with Epi to vasoconstrict to enhance localized action, and decrease bleeding

Front 10

Local Anesthetics
1)Use
2)Toxicity

Back 10

1) Minor Surgical Procedures, Spinal Anesthesia

2) If allergic to esters, use amides
CNS excitation, cardiotoxicity (bupivicaine), BP changes, Arrhythmias

Front 11

Succinylcholine (Neuromuscular blockade)
1)MOA
2)Use
3) Reversal

Back 11

1) Binds to ACh receptors in neuromuscular junction and it is much slower to release, so it causes less stimulation by ACh leading to paralysis (some initial fasiculation due to initial binding)

2)To keep a patient paralyzed during surgery

3)The patient can wake up with paralysis from the constant minor tone kept by Succinylcholine --> Treated with Cholinesterase Inhibitors (Neostigmine)

Front 12

Nondepolzrizing Neuromuscular Block
All end in -ium (atraconium, mivacurium, etc)
1)MOA
2)Reversal

Back 12

1)Competitive blockade of ACh receptors

2) reversed by cholinesterase inhibitors

Front 13

Dantrolene
1)MOA
2)Use

Back 13

1)Prevents Ca+ release from SR of skeletal muscle

2) Malignant Hyperthermia (inhaled anesthetics + succinylcholine), Neuroleptic Malignancy Syndrome (Antipsychotic side effect)