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34 Cards in this Set
- Front
- Back
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What is the therapeutic index of all anesthetics?
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2-4
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What is the mechanism of action of the inhaled general anesthetics?
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-Increase GABAneurgic neuronal activity which is the major inhibitory NT in the CNS
-decrease glutamineurgic activity which is the major excitatory NT in the CNS Both of these actions will cause depression of the CNS |
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What two factors will influence the potency of an inhaled anesthetic?
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Lipid solubility - The oil - gas partition coefficient
Minimum alveolar concentration (MAC) |
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What is the oil-gas parition coefficient and how does it affect the potency of inhaled anesthetics?
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It is the lipid solubility of a drug and the higher the oil-gas partition coefficient the more potent the anesthetic
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What is the Minimum alveolar concentration (MAC)?
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The percentage of anesthetic in the alveolar system when 50% of patient are insenstitive
The lower the MAC, the more potent the drug? |
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What is the MAC awake? How does it differ from the regular MAC
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Does use repsonse to pain as a measure but rather a response to a command such as "can you hear me"
It will be lower than the regular MAC |
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How does the speed of recovery relate to the speed of induction?
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They are symmetrical
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What is the speed of induction related to?
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Directly related to the blood-gas coefficient which is a measure of how soluble an agent is in blood relative to the concentration in gas.
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If a drug is very soluble in blood will it take more or less time to work?
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more because it is soluble in the blood then it wants to stay in the blood and it will take longer to get to the brain. The blood must be saturated before drug gets into the brain
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What is the blood-gas coeffcient of Nitrous Oxide?
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.5 (no very soluble in blood) meaning it has a rapid onset of action
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What is the MAC of nitrous oxide?
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greater than 100% meaning it woul not get 50% of the population insensitive to pain. This indictaes it has a very low potency
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What is the MAC awake of nitrous oxide?
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60%
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What are the properties of nitrous oxide?
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rapid, pleasant onset, good analgesia, very low potency, no amnesia
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What are the side effects of nitrous oxide?
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Want to leave the blood so when adminstration stops it may leak into the abdomen and cause discomfort
repeated exposure causes megaloblastic anemia and leukopenia |
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What are the halgenated hydrocarbons?
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halothane, isoflurane, desflurane, sevoflurane
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What are the side effects of the halgenated hydrocarbons?
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Malignant hyperthermia
In genetically predisposed population the muscles will take up Ca2+ and become rigid and muscle metabolism will be enhanced |
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Why are halogenated hydrocarbons used?
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to maintain anesthesia
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What is the
blood-gas coefficient, and MAC of halthane? |
2.3 - has a more rapid onset then nitrous oxide
.75% |
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What are the side effectsof halothane?
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arrythmias and hepatic necrosis
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What is the blood-gas coefficient of isoflurane?
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1.4 therefore it has a more rapid onset than halothane
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What are the side effects of isoflurane compared to halothane
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there are less
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What are the intravenous general anesthetics?
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thiopental, propofol, ketamine, etomidate, midazolam
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What intravenous general anesthetic is a barbituate?
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Thiopental
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What is the mechanism of action of thiopental?
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increases GABA activity
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What is thiopental used for
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rapid induction, but not good analgesic affects
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What intravenous general anesthetic is most commonly used?
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propofol
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Besides anesthetic affects, what does propofol also do?
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anti-emetic affects (anti-nausea)
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What is the mechanism of action of ketamine?
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Glutamate receptor inhibitor
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What are the properties of ketamine
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dissociative anesthesia with very profound amnesia and anesthesia but patient will not be unconcious
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Does ketamine have a short or long duration of action and induction?
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short
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What are the side effects of ketamine
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hallucinations when patients emerge from the anesthesia
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What is the street analog of ketamine?
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angle dust
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What is the drug of choice for starting people in outpatient procedures?
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midazolam (Versed)
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What are the properties of midazolam (Versed)
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amnesia and decreased anxiety
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