Term
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Definition
| Relief of pain without intentional production of altered mental state |
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Term
|
Definition
| decreased apprehension with no change in level of awareness |
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Term
|
Definition
Protective reflexes maintained
Independent maintenance of airway/O2/ventilaltion
Response to physical or verbal stimulation maintained
Dose dependent |
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Term
|
Definition
Sensory, Mental, Reflex and Motor Blockade
Loss of all protective reflexes |
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Term
| What are the Gas Inhalation Anesthetics? |
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Definition
|
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Term
| What are the Liquid Inhalation Anesthetics? |
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Definition
Halothane
Isoflurane
Desflurane |
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Term
| Why is Inhalational and IV dosing preferred for General Anesthetics? |
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Definition
| Immediate control over dose and hence duration of action |
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Term
| Why is maintaining a patent airway often required? |
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Definition
| Loss of Protective reflexes |
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Term
| What period of Anesthesia is absent in IV administration? |
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Definition
| Induction period, because entire dose is given in a bolus. |
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Term
| How does the Myer-Overton Hypothesis link inhalation anesthetics? |
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Definition
| The more Lipid soluble the more potent the anesthetic |
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Term
| If 2 anesthetic agents cause a patient to lose conciousness does that make the mechanism identical? |
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Definition
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Term
| What are the affects of Anesthetics on GABA, Glycine, and NMDA receptors? |
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Definition
Major and Minor Potentiation of GABA and Glycine signaling
Major and Minor Inhibition - NMDA receptors |
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Term
| How do anesthetics control membrane polarity and it's responsiveness in neural signaling? |
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Definition
Affects K+ channels
Potentiates - 2 pore channels
Minor inhibition - Voltage gated K channels |
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Term
| What is the net effect of Anesthetics ionic mechanisms and targets? |
|
Definition
| Decreases CNS activity and Connectivity |
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Term
| How is unconsciousness achieved with anesthetics? |
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Definition
| Loss of Cortical Interations -> Decreases Integration - Feedback is reduced,Occipital response preserved, Parietal Response is attenuate |
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Term
| At what stage of Anesthesia is surgery not performed? |
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Definition
|
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Term
| What designates the start of Stage 2 Anesthesia? |
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Definition
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Term
| What stage is Dental Surgery appropriate at? |
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Definition
|
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Term
| What Surgery is appropriate at each Plane of Stage III? |
|
Definition
1. Dental and Throacic Surgery
2. Abdominal Surgery
3. Deep Abdominal Surgery
4. No Surgery |
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Term
| Which function requires the highest amount of anesthetic to become unresponsive? |
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Definition
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|
Term
| What was added to the structure of inhaled anesthetics to make it less flammable? |
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Definition
|
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Term
| What is the Tension of a gas within a mixuture of gasses? |
|
Definition
| the tension is proportional to its concentration in the overall mixture |
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Term
| What allows for a fast induction of anesthesia? |
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Definition
| Low Blood Solubility -> more rapid equilibrium with the brain |
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|
Term
| How does Lipid solublity affect saturation? |
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Definition
| The more lipid soluble, the higher the capacity the blood has to absorb the anesthetic before the binding sites are saturated |
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Term
| What drug has faster induction, Nitrous Oxide or Halothane? |
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Definition
Nitrous Oxide
(NO is less soluble in the blood than Halothane) |
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Term
| What is the Rate Limiting step that determines the speed of uptake and efflux of the anesthetic? |
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Definition
| Partitioning to the saturability of the binding site for the anesthetic within the blood. |
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Term
| What are 2 ways Induction can be manipulated? |
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Definition
Adjust amount of anesthetic delivered
Adjust ventilation rate |
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Term
| How do inhaled agents effect respiration? |
|
Definition
| Increased Respiration Rate Decreased Tidal Volume (Results in Regular Rhytmic Shallow Breathing) |
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Term
| What Respiratory Reflex response is blocked by all agents except N2O? |
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Definition
|
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Term
| How do Inhaled Agents Directly effect the cardiovascular system? |
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Definition
Decrease Sympathetic Outflow
Peripheral Ganglion Blockade
Decrease Adrenal Catecholamine release
Baroreceptor attenuation
Decrease Ca2+ flux
Vagal Simulation |
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|
Term
| Which inhaled agents have less depressive CO effects? |
|
Definition
Desflurane
Isoflurane
Princess DI will always live in my heart |
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|
Term
| Which inhaled agent has no significant CV effects? |
|
Definition
|
|
Term
| What happens when N2O is used with an opiate (morphine)? |
|
Definition
| Opiate blocks reflex sympathetic effect, unmasks a direct depressive effect on CV system |
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Term
| Which drug has decreased in use due to potential of arrhythmias and Hepatic Toxicity? |
|
Definition
Halothane
"Halothane Hepatitis" |
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Term
| Which inhaled agent provides some pain relief? |
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Definition
|
|
Term
| Which inhaled agents have an irritating odor? |
|
Definition
(DIE)
Desflurane
Isoflurane
Enflurane
(May cause coughing and increase in bronchial secretions) |
|
|
Term
| What inhaled anesthetic provides muscle relaxation? |
|
Definition
|
|
Term
| Which agent does not have loss of reflexes? |
|
Definition
|
|
Term
| Why is it customary to administer neuromuscular blocking agent and an analgesics? |
|
Definition
| Because none, except Nitrous Oxide, produce any pain relief, and to produce the required muscular relaxation |
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|
Term
| What are some potential threats of Nitrous Oxide? |
|
Definition
| Spontaneous Abortion Neurologic deficits in infants Vitamin B12 synthetase inhibitor |
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|
Term
| What are 3 special problems with Nitrous Oxide? |
|
Definition
| Second Gas Effect Diffusional Hypoxia Solubility |
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|
Term
| What's good about Nitrous Oxide? |
|
Definition
| Vapor Sparing Effect Reduced respiratory depression Reduced CV effects Smoothens the anesthetic prodedure Mild Analgesic Properties |
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|
Term
| What are some side effects of Nitrous Oxide? |
|
Definition
| Drowsiness Dizziness/Vertigo Dysphoria Panic Amnesia Inappropriate laughing Paresthesias |
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Term
| How are inhalation anesthetics metabolized? |
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Definition
|
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Term
| What tissues have the highest rate of uptake and decline of inhalation anesthetics? |
|
Definition
Tissues with good blood supply
Lungs > Muscle > fat |
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Term
| What are 5 factors that affect uptake of inhalation anesthetics? |
|
Definition
Concentration (only variable that can be manipulated)
Respiratory Rate
Solubility
Rate of bloodflow to lungs
Tissue distribution |
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|
Term
| Use of what drug in the workplace requires air scavenging? |
|
Definition
Nitrous Oxide
(due to spontaneous abortions with chronic low levels) |
|
|
Term
| What inhalation anesthetic may cause Vitamin B12 deficiency? |
|
Definition
|
|
Term
What inhalation anesthetic may cause malignant hyperthermia?
|
|
Definition
Desflurane
(the newer agent) |
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