Term
| Relationship between time of onset & potency with inhaled anesthetics |
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Definition
Less lipid bound --> faster onset & lower potency (e.g. N2O)
More lipid bound --> slower onset & higher potency (e.g. halothane) |
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Term
|
Definition
minimal alveolar concentration: concentration at which 50% of the population is anesthetized.
1/MAC = drug potency |
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Term
| Cumulative hepatotoxicity |
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Definition
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Term
|
Definition
Hepatotoxicity (halothane)
Nephrotoxicity (methoxyflurane)
Proconvulsant (enflurane)
Malignant hyperthermia (rare) |
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Term
| Respiratory drive in opioid use |
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Definition
| purely based on peripheral pO2 centers (central pCO2 receptors have mu opioid receptors & don't work) --> don't give O2! |
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Term
| barbiturate used for anesthesia induction |
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Definition
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Term
| inducer of anesthesia that decreases cerebral blood flow |
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Definition
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Term
| Tx midazolam overdose w/? |
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Definition
flumazenil
midazolam may cause severe respiratory depression & decreased BP |
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Term
| used in endoscopy procedures |
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Definition
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Term
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Definition
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Term
| Advantage of ketamine in elderly |
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Definition
No CV depression
Ketamine used in kids w/ painful fractures & old people |
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Term
| opioid used in pacreatitis |
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Definition
| meperidine (avoid w/ serotonin drugs) |
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Term
| These two toxins block Na+ channels |
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Definition
Tetrodotoxin (fugu --> heart stops)
Saxitoxin (shellfish --> flaccid paralysis --> respiratory failure) |
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Term
| Nomenclature rules for local anesthetics |
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Definition
- all end in "-caine"
- Esters & Amides
- Amides have an "i" before the "-caine" (e.g. lidocaine)
- Esters don't (e.g. procaine, cocaine) |
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Term
|
Definition
- blocks Na+ channel (like all anesthetics)
- blocks NE reuptake
(if you give a beta-blocker to someone having a heart attack from a cocaine overdose, they will die from lethal alpha-adrenergic vasoconstriction of coronary vessels) |
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Term
| what drug will help relieve sympathetic rebound in opioid withdrawal |
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Definition
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Term
| What two things need to be in a local anesthetic solution? |
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Definition
- bicarbonate (so the drug can get into cells)
- alpha agonist --> vasoconstrict & minimize systemic effects (usually epinephrine)
The latter thing is not done for cocaine, why? |
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Term
| Name order of nerve desensitization by local anesthetics |
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Definition
small --> large & mylenated --> unmylenated
A-delta -> C -> A-beta, A-gamma -> A-alpha
only A-delta (sharp pain & cold) & C (dull pain, itche, & heat) fibers are really important
A-beta fibers are meissner corpuscles, merkel endings, & pacinian corpuscles used in touch sensation |
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Term
| Order of sensation loss w/ local anesthetics |
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Definition
sharp pain/cold -> dull pain/heat/itch -> touch -> pressure
(A-delta -> C -> A-beta) |
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Term
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Definition
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Term
| Drugs w/ disulfiram-like effect (nothing to do with anesthetics) |
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Definition
metronidazole
cefoperazone
cefotetan
chlorpropamide (OSU)
griseofulvin |
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Term
|
Definition
| diarrhea ("concrete maker"): opioid acting in gut --> increases circular muscle action & relaxes longitudinal muscle --> no peristalsis, but lots of mixing |
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Term
|
Definition
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Term
|
Definition
| dextromethorphan & codeine |
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Term
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Definition
downstream of opioid receptors --> increase cAMP to counteract increased Gi action of mu receptor on presynaptic terminal
(does not have receptor desensitization or downregulation) |
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Term
| why do you get pinpoint pupils in opioid abuse? |
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Definition
| decreased NE release (remember you get NE rebound on detox --> tx with clonidine) |
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Term
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Definition
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Term
| used in acute pulmonary edema |
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Definition
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Term
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Definition
partial mu receptor agonist & full kappa receptors
used for pain; if given to morphine addict --> lots of pain b.c. it precipitates withdrawal
Kappa opioid receptor causes analgesia & DYSphoria |
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Term
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Definition
| weak opioid agonist; also inhibits NE & serotonin reuptake (works on multiple receptors) |
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Term
|
Definition
chronic pain
(weak opioid agonist & SNRI) |
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Term
| decreases seizure threshold |
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Definition
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Term
| Partial opioid agonist & SNRI |
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Definition
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Term
| partial mu agonist & full kappa agonist |
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Definition
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Term
| used in opioid constipation |
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Definition
| Methylnalthexone (stays in gut) |
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Term
|
Definition
| opioid constipation (stays in gut) |
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