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Anesthetics

USMLE Step 1

DrugMOA & ADRs
Halothane MOA:GABA-A receptor,low MAC,DOC 4 children;ADRs:metabolized 2 tissue toxic hydrocarbons & Br-esp toxic 4 females,vagomimetic cause atropine sensitive brady,not analgesic,hepatotoxic 4 adults,arrhythmias,hypoTN,malignant hyperthermia:antidote Dantrolene
Enflurane MOA:GABA-A receptor,less potent than halothane,rapid induction & recovery,less risk of arrhythmia,less sensitive to catecholamines,increased potentiation of muscle relax;ADRs:contraindicated 4 kidney failure,CNS + @ 2x MAC,low dose hyperventilation
Isoflurane MOA:GABA-A receptor,undergoes little metabolism,not tissue toxic,doesnt induce arrhythmias & doesnt sensitize the heart to catecholamines
Desflurane MOA:GABA-A receptor,preferred agent today,provide shorter emergence times;ADRs:risk of malignant hyperthermia in genetically predisposed individuals
Sevoflurane MOA:GABA-A receptor,preferred agent today,provide shorter emergence times;ADRs:nephrotoxic b/c metabolites Fl & 'cmpd A' are nephrotoxic,risk of malignant hyperthermia in genetically predisposed individuals
N2O aka laughing gas MOA:GABA-A receptor,combo w/ other drugs,not potent anesthetic but potent analgesic,not depress respiration nor muscle relaxation,safe if use 20% O2 given (30% w/ dental procedures),least hepatotoxic & least cardiovascular effects of its class
Thiopental MOA:IV anesthetic,potent,high lipid solubility;ADRs:contraindicated in intermittent porphyria (b/c its a barbiturate),stays in body 4 long time b/c metabolized very slowly,severe hypoTN in hypovol or shock pts & drowsiness upon waking
Propofol MOA: IV anesthetic, potent, extremely high lipid solubility, excellent induction agent, doesnt remain w/in body 4 long periods = good 4 repeat procedures & surgi-ctrs where pts must go home alert & oriented, DOC 4 induction
Ketamine MOA:IV anesthetic,short-acting non-barbiturate,lipophilic,induction agent of choice 4 shock,+ ctral sympathetic outflow=cardiac + = increase BP & cardiac output;ADRs:dissociative anesthesia,not used in HTN or stroke,cause severe hallucinations & nightmare
Balanced anesthesia thiopental (anesthetic) + fentanyl (opioid analgesic-80x more potent than morphine!) + tubocurarine (muscle relaxant) + N2O (analgesic)
Neuroleptic anesthesia droperidol (neuroleptic, used as a tranquilizer) + fentanyl (opioid analgesic) + N2O (analgesic)
Created by: jerrica_08
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