Term
|
Definition
1) drug administration
2) drug distribution
3) drug metabolism/excretion |
|
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Term
|
Definition
1) cellular receptors
2) drug concentration & effect |
|
|
Term
What are the 5 most commonly used drug classes for typical anesthetics in balanced anesthesia?
Why are each one used? |
|
Definition
1) benzos (anmesia)
2) opioids (analgesia)
3) induction agents (sedation/unconsciousness)
4) neuromuscular blockers (paralysis)
5) sympathomimetics (hemodynamic control) |
|
|
Term
| What functions of the body may be affected depending on the depth of the sedation? |
|
Definition
|
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Term
| What are the 5 steps that must be completed pre-op? |
|
Definition
1) Hx
2) PE
3) Lab data
4) Summary of physical status
5) Plan: informed consent & monitoring |
|
|
Term
27 y/o female presents for nail removal of right fifth digit. She did not tolerate the procedure in the primary care physician's office.
As an anesthesiologist, what do you need to know? |
|
Definition
1) Hx
-ROS, mood, NOS?
2) PE
-BMI, vital signs, Mallampti class, cardiopulmonary check
3) Lab Data
-What lab tests are appropriate? (none in this case)
4) Summary
-Classification according to ASA (American Society of Anesthesiologists)
5) Plan
-Informed consent, and normal standard of care monitoring needed |
|
|
Term
|
Definition
| Nil Per Os = no food or drink for at least 8 hrs prior to procedure |
|
|
Term
def
mallampati classification |
|
Definition
| Class I-IV, depends on how much tongue/back throat is seen when asked to say "ah." This coorelates with how easy a patient will be to intubate |
|
|
Term
| What are the 6 summary classifications according to ASA? |
|
Definition
I: normal healthy patient
VI: declared brain-dead patient
(E: Emergency procedure) |
|
|
Term
| What is the intraoperative monitored anesthesia care? |
|
Definition
1) Sedation (benzo + analgestic)
2) Local anesthesia (infiltration, digital block, solution, additives) |
|
|
Term
| What benzos can be used in sedation? |
|
Definition
Midazolam
Diazepam
Lorazepam |
|
|
Term
|
Definition
sedation
anxiolysis
amnesia
anticonvulsant |
|
|
Term
|
Definition
| enhancing GABA transmission |
|
|
Term
| Do benzos provide analgesia? |
|
Definition
|
|
Term
|
Definition
| long acting in large doses |
|
|
Term
| How is midazolam administered? |
|
Definition
|
|
Term
|
Definition
| resp. depression, loss of balance, prolonged emergence |
|
|
Term
| Why fors 1-2 mg dose of midazolam last for 20-30 min? |
|
Definition
| redistribution, eliminiation hald life of 3 hrs |
|
|
Term
|
Definition
| mimic endogenous endorphins on mu, kappa, delta receptors in the brain & SC => neurotransmitter inhibition via inhibition of Ach & substance P release |
|
|
Term
|
Definition
| intra-op & post-op pain control |
|
|
Term
| What varies b/w opioids s.a. morphine, fentanyl, and its derivatives? |
|
Definition
| dose, time to peak effect, duration of analgesia |
|
|
Term
|
Definition
resp. depression
sedation
GI slowing
dependence
mood
blunt stress response |
|
|
Term
| What derivative of fentanyl is used for infusion? |
|
Definition
|
|
Term
| What metabolizes remifentanil? |
|
Definition
|
|
Term
| Is fentanyl or morphine more potent? |
|
Definition
| fentanyl is 100x more potent |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| How fast until morphine reaches it's peak concentration? |
|
Definition
|
|
Term
| **What is the toxic dose of lidocaine? |
|
Definition
|
|
Term
| What happens when Epi is added to lidocaine? |
|
Definition
| prolong block (+ allows 7 mg/kg dose) |
|
|
Term
| What happens when you add bicarbonate to lidocaine? |
|
Definition
| speed up the onset of the block |
|
|
Term
| When shouldn't Epi ever be added to lidocaine? |
|
Definition
| fingers, toes, penis, nose, ears |
|
|
Term
|
Definition
| anesthetic technique requiring drug delivery to very precise locations along the body's neural transmission |
|
|
Term
| What are the 2 types of regional anesthesia? |
|
Definition
1) epidural
2) intrathecal (spinal or subdural) |
|
|
Term
Which local anesthetics should be used to provide labor analgesia?
A) Bupivicaine .0625% solution
B) Bupivicaine 2% solution
C) Lidocaine .0625% solution
D) Lidocaine 2% |
|
Definition
|
|
Term
| What does nerve block depend on? |
|
Definition
| size, proximity within neural bundle, myelin presence |
|
|
Term
|
Definition
| bind preferentially to Ns channels in the open/inactivated state => makes membranes unable to generate AP |
|
|
Term
| What is the preferred method for C-section delivery anesthesia? |
|
Definition
|
|
Term
| What agents can be used for GA induction? |
|
Definition
| any IV agent, so drug must be chosen based on SE & matched to patient & case |
|
|
Term
| What is the most common GA induction agent? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| rapid onset, short duration |
|
|
Term
|
Definition
potent resp. & CV depressant
pain on injection |
|
|
Term
|
Definition
GA - induction
antiemetic
antipruritic |
|
|
Term
|
Definition
|
|
Term
|
Definition
| sympathomimetic & analgestic |
|
|
Term
|
Definition
| CV stability & adrenal suppression |
|
|
Term
| What, besides athesthesia maintenance, in managed by the anesthesiologist intraoperatively? |
|
Definition
| Airway management (bag mask ventilation, endotracheal tube) |
|
|
Term
| What are the 2 ways anesthesia can be administed intraoperatively? |
|
Definition
1) IV
2) inhalation
(chosen on patient's comorbidities) |
|
|
Term
| What are the 2 IV GA agents? |
|
Definition
|
|
Term
| What are the 4 inhalation agents? |
|
Definition
isoflurane
sevoflurane
desflurane
NO |
|
|
Term
| What can be added to the GA regimen intraoperatively as needed? |
|
Definition
1) narcostic
2) muscle relaxant
3) sympathomimetics
4) reversal agents |
|
|
Term
| What 4 things need to be done post-op prior to discharge from recovery room to floor or home?? |
|
Definition
1) ensure reversal
2) ensure adequate resp. & extubate
3) provide pain relief
4) awaken |
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