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General Anesthetics
n/a
32
Medical
Graduate
10/16/2009

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Term
IV Anesthetics
Definition
Induction; Benzodiazepines, barbituates, ketamine, propofol, etomidate
Term
Inhaled Anesthetics
Definition
NO, halothane, isoflurane, desflurane, sevoflurane
Term
Muscle relaxants
Definition
Used for tracheal intubation and maximizing surgical conditions
Term
Opiod analgesics
Definition
fentanyl, remifantanal; control autonomic response to noxious stimuli
Term
CV drugs
Definition
Control autonomic response to noxious stimuli and maintain blood pressure/blood flow to essential organs
Term
Stage 1 - Analgesia
Definition
Patient feels no pain but has memory of the events
Term
Stage 2 - Excitement
Definition
Autonomic dysfunction because GABAergic neurons are inhibited before excitatory ones; laryngospasm, vomitting, incontinence, excited/delirious mental state, irregular respiration, patient is amnestic
Term
Stage 3 - Surgical Anesthesia
Definition
Plane 1 - Eyeballs rolling, then fixed, Plane 2 - Loss of corneal and laryngeal reflexes, Plane 3 - Pupils dilate, loss of pupillary reflex, Plane 4 - Intercostal paralysis and shallow abdominal respiration
Term
Stage 4 - Medullary
Definition
Patient requires circulatory and respiratory support - BAD - OVERDOSE
Term
Relationship between partial pressure and solubility in tissue
Definition
INVERSE - higher partial pressure = less soluble
Term
Preferential solubility of halothane
Definition
Blood > CNS
Term
Minumum Alveolar Concentration / ED50
Definition
Alveolar concentration at which 50% of exposed patients are immobilized (lower MAC = higher potency and less crowding of respired gases)
Term
CV adverse effects of volatile anesthetics - BLOOD PRESSURE
Definition
Isoflurane, sevoflurane and desflurane decrease SVR / Halothane and enflurane decrease CO --> HYPOTENSION
Term
CV adverse effects of volatile anesthetics - HEART RATE
Definition
Halothane stimulates vagus nerve --> decreases HR; Isoflurane and desflurane stimulate sympathetics --> increase HR
Term
Pulmonary adverse effects of volatile anesthetics
Definition
Patients breathe shallower and faster (increased apneic threshold, increased respiratory rate, decreasd tidal volume, decreased hypoxic response)
Term
CNS adverse effects of volatile anesthetics
Definition
Decreased sympathetic tone (hypotension), increased apneic threshold, cerebral vasodilation and increased ICP
Term
Toxicity of methoxyflurane
Definition
Renal failure due to fluoride ions
Term
Halothane toxicity
Definition
Induces p450, produces trifluoroacetic acid in 20% of patients --> halothane hepatitis
Term
Sevoflurane toxicity
Definition
Induces p450, makes compound A in 5%
Term
Desflurane toxicity
Definition
Can produce CO
Term
NO
Definition
Inhibits methionine synthetase and is contraindicated in pregnancy
Term
Malignant hyperthermia treatment
Definition
5% still die, give dantrolene sodium (muscle relaxant)
Term
Sequelae of malignant hyperthermia
Definition
Tachycardia, rhabdomyolysis, hypercarbia and metabolic acidosis
Term
Decreased respiration with...
Definition
Barbituates, opiods, propofol
Term
Myocardial depression
Definition
Barbituates, propofol
Term
Vasodilation with...
Definition
Barbituates, propofol
Term
Analgesia with...
Definition
opions, ketamine
Term
Amnesia with...
Definition
Benzodiazepines, ketamine
Term
Adverse effects of opiods
Definition
Post-op nausea, vomiting, muscle rigidity, bradycardia, urinary retention, constipation
Term
Quirk of desflurane metabolism
Definition
Minimal in humans
Term
Hx of nausea/vomitting with anesthesia
Definition
Give pre-op propofol for it's anti-emetic properties
Term
Considerations for traumatic injury requiring surgery
Definition
Need to keep CO and BP up - etomidate is best, along with epi and NE
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