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21 Cards in this Set
- Front
- Back
Stages of Anesthesia
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Stage 1 - analgesia
Stage 2 - analgesia, amnesia, loss of consciousness Stage 3 - loss of reflexes, skeletal muscle relaxation -Plane 1 - eyes moist, pupil miotic -Plane 2 - eyes dry, pupils mid-dilate -Plane 3 - loss of corneal reflex -Plane 4 - maximal pupil dilation, apnea Stage 4 - respiratory and cardiac depression |
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Inhalation Anesthetics: Blood and brain levels
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Drug levels in the brain are determined by
1. Partial Pressures 2. Lipid Solubility |
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Nitrous Oxide
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Inhalation anesthetic. Rapid onset and recovery.
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Desflurane
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Inhalation anesthetic. Poor onset and rapid recovery.
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Sevoflurane
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Inhalation anesthetic. Rapid onset and rapid recovery.
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Isoflurane
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Inhalation anesthetic. Medium onset and medium recovery.
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Enflurane
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Inhalation anesthetic. Medium onset and medium recovery.
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Halothane
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Inhalation anesthetic. Medium onset and medium recovery.
AE: hepatotoxicity. |
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Methoxyflurane
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Inhalation anesthetic. Slow onset and slow recovery.
AE: diabetes insipidus. |
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Inhalation Anesthetics: Mechanism of action.
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- Specific and non-specific actions on neuronal activity.
- Direct & indirect effects on various types of ion channels. - Binding sites on ion channel proteins. - Binding sites on cell membrane lipids. |
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Inhalation Anesthetic: Adverse Side Effects
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- Respiratory and cardiac depression.
- Hypotension - Increased skeletal muscle tone. - Diabetes insipidus (methoxyflurane). - Hepatotoxicity (halothane) |
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Intravenous Anesthetics
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Rapid state of unconsciousness.
-Potency correlated with lipid solubility. -Enhances GABA Neurotransmission -Most common: Benzodiazepines and Barbiturates |
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Two most common Intravenous Anesthetics
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1. Benzodiazepines
2. Barbiturates |
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Intravenous Anesthetic: Adverse Side Effects
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1. Respiratory and Cardiac Depression.
-Benzodiazepines: large safety margin -Barbiturates: small safety margin 2. Hypotension 3. Pharmacogenetics (idiosyncratic reactions) |
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Thiopental
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Intravenous Anesthetic, Ultra-Short effect.
Rapid Onset & Recovery. Barbiturate; induction; CV depression |
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Methohexital
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Intravenous Anesthetic
Medium onset, slow recovery. Barbiturate; maintenance of anesthesia. |
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Propofol
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Intravenous Anesthetic.
Rapid onset and recovery. Induction and maintenance; lowers BP, replacing barbiturates. |
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Ketamine
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Intravenous Anesthetic. Also a psychedelic drug.
Medium onset and recovery. NMDA antagonist, Cardiac stimulant. Increase blood flow. |
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Diazepam
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Intravenous Anesthetic
Medium onset, slow recovery. Benzodiazepine, conscious sedation. |
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Midazolam
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Intravenous Anesthetic.
Slow onset and recovery. Benzodiazepine, sedation, marked amnesia. |
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Etomidate
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Intravenous Anesthetic.
Rapid onset, medium recovery. Cardiac stabilizer, skeletal muscle activator. |