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Stack #152170

pharm ch 11, kilgore lvl1

anesthetics drugs that depress the central nervous system (CNS)
effects of anesthetics -depression of consciousness -loss of responsiveness -muscle relaxation
anesthesia a state of depressed CNS activity
General anesthesia type of anesthetics that affects entire body (puts you to sleep)
Local anesthesia type of anesthetic that only affects the part of body being worked on -general conscience
balanced anesthesia combination of anesthetic drugs
effects of general anesthetics -pain relief -depression of consciousness -skeletal muscle relaxation -reflex reduction
Inhaled anesthetics volatile liquids or gases that are vaporized in O2 and inhaled
inhaled gas nitrous oxide- (laughing gas)
Inhaled volatile liquids -enfulrane (Ethrane) -halothane (Fluothane) -isoflurane (Forane) -methoxyflurane (Penthrane) -others
Injectable anesthetics administered intravenously
effects of injectable anesthetics -induce or maintain general anesthesia -induce amnesia -used as adjunct to inhalation-type anesthetics
Type of injectable anesthetics etomidate (Amidate) ketamine (Ketalar) methohexital (Brevital)* propofol (Ciprivan)* thiamylal (Surital) thiopental (Pentothal)* * may also be used as adjunctive drugs at lower dosages
sedative-hypnotics -used as adjunctive drugs -barbiturates (secobarbital, thiopental) -benxodiazepines (Diazepam, midazolam)
opioids (narcotics) used as adjuctive drugs -morphine, fentanyl, sufentanil
NMBAs (neuromuscular blocking drugs/agents used as adjunctive drug to relax skeletal muscles depolarizing and nondepolarizing drugs
Depolarizing drugs type of NMBAs -succinylcholine
Nondepolarizing drugs type of NMBAs -pancuronium, d-tubocurarine, vecuronium
anticholinergics used as adjunctive drug -atropine, glycopyrrolate, scopolamine
Overton-Meyer theory anesthetics have high lipid soluability and therefore have a high potency
How anesthetics work -orderly and systematic reduction of sensory and motor CNS functions =progressive depression of cerebral and spinal cord functions
Effects of general anesthetics -unconsciousness -skeletal muscular relaxation -visceral smooth muscle relation -rapid onset and quickly metabolized
Adverse effects (AEs) of anesthetics -vary btwn different drugs -esp watch for Malignant hyperthermia- idiopathic
malignant hyperthermia- idiopathic a severe AE of anesthetics that: -occurs during or after general anesthesia -sudden elevation in body temp over 104 F -tachypnea, tachycardia, muscle rigidity -life-threatening emergency
Local anesthetics/regional anesthetics -renders a specific portion of body insensitive to pain -interferes w/ nerve impulse transmission to specific areas of body -do not cause loss of consciousness
Topical anesthetics applied directly to skin or mucous membranes
Parenteral anesthetics injected IV or into the CNS by various spinal injection techniques (Epidural)
Spinal or intraspinal anesthetics type of local anesthesia
Intrathecal anesthetics injected into the spinal cord (spinal tap)
Epidural type of local anesthetic
Nerve block type of local anesthetic injected diretly into the nerve area (Dental work)
Lidocaine (Xylocaine) parenteral anesthetic drug that is a blocker and is injected
steps to paralysis via anesthetics -autonomic activity is lost -pain and other sensory functions are lost -motor activity is lost last wears off in reverse order
surgical, dental, diagnostic procedures, treatment of certain types of chronic pain what local anesthetics are used for
inflitration anesthesia & Nerve block anesthesia types/routes of local anesthetics given
infiltration anesthesia used in/for: -minor surgical and dental proceduress -injection ID, subcut, or submucosally across the path of nerves supplying the target area -may be given in a circular pattern around the operative area
Nerve block anesthesia -can cause problems if too high concentration in body -injected directly into or around the nerve trunks of nerve ganglia that supply the target area
Major AEs of infiltration and Nerve block anesthesia "spinal headache" and epidural blood patch
Uses of NMBAs -to prevent nerve transmission, resulting in paralysis -used with anesthetics during surgery
Special considerations for NMBAs when used during surgery -cause paralysis of respiratory and skeletal muscles -client unable to breathe w/o mechanical respiration -does not cause sedation or pain relief -client may be paralyzed AND conscious
types of NMBAs-nondepolarizing drugs -short acting (mivacurium-Maacacron) -intermediate acting (atracurium-Tracrium, vecuronoim-Norcuron, rocuronium-Zemuron) -long acting (pancuronium-Pavulon, doxacurium-Nuromax, d-Tubocurarine-dTC)
Succinylcholine NMBA- depolarizing drug
function of Succinylcholine -similar to ACh in causing depolarization -slower metabolism than ACH, repolarization cannot occur while present -causes flaccid muscle paralysis
function of nondepolarizing NMBAs -prevent ACh from acting at neuromuscular junctions -muscle fibers are not stimulated bc nerve cell membrane is not depolarized -skeletal muscle contraction does not occur
sequential effects of NMBAs -muscle weakness initially followed by total flaccid paralysis -small, rapidly moving muscles 1st affected -then larger muscles -finally intercostal muscles and diaphragm are affected resulting in cessation of respiration
main uses of NMBAs -maintaining controlled ventilation during surgical procedures -endotracheal intubation (short acting) -reduction of muscle contraction in target area -diagnostic drugs for myasthenia gravis
AEs of NMBAs Serious: -Hypotension (blockade of autonomic ganglia -Tachycardia (Blockade of muscarinic receptors -Hypotension (release of histamine
Overdose of NMBAs symptoms -Cardiovascular collapse -conscious sedation, moderate sedation, procedural sedation, a semi-conscious effect
Moderate sedation (conscious sedation, procedural sedation) used for diagnostic/minor surgical procedures that do not require deep anesthesia -recovery time better than gen. anesthesia -greater safety profile than gen. anesthesia -client may have no memory of experience
vital assessment during pre-, intra- and postoperative phases -vital signs -baseline labwork, ECG -Pulse oximeter (PO2) -ABCs -all body systems
what to watch for during recovery cardiovascular depression, respiratory depression and Major complications of anesthesia
propofol -IV general anesthetic drug -used in ICU and other critical care settings for induction and maintenacne of anesthesia/sedation
succinylcholine -only depolarizing NMBA available -ultra-short-acting, but is more slowly metabolized than ACh -adjunct to general anestehsia for flaccid paralysis of muscle -stimulates motor endplate to ongoing depolarizing, repolarization cannot occur and muscles ca
vecuronium -intermediate-acting NONdepolarizing NMBA -adjunct to gen. anesthesia -most useful in procedures requiring mechanical ventilation
Created by: gfcfnina