Kaplan Section 4 Chapter 1 CNS Pharm - Anesthetics
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| show | Minimal alveolar anesthetic concentration (% of inspired air) at which 50% of pts do not respond to a surgical stimulus. Measures potency of an anesthetic. The lower the MAC value, the stronger the anesthetic.
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| show | In order of decreasing MAC value (increasing potency): NO, Des Sevo, En, Iso, Halo. Nitrous oxide, desflurane, Sevoflurane, Enflurane, Isoflurane, Haloflurane. ISOdora has SEVeral HALOs, so has NO DESire to ENhale that cigarette.
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| Name 6 inhaled anesthetics in blood-gas solubility order | show 🗑
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| show | Rate of onset and recovery of inhaled anesthetics. The more soluble a gasin the blood, the longer that drug takes to exert its effects on the CNS or other body tissues (it wants to stay in ght
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| show | NO - but relatively fast, so often used in combo with other anesthetics
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| show | Minimal
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| Which inhaled anesthetic has the most rapid onset and recovery? Adverse effects? | show 🗑
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| What are the cardiovascular effects of Desflurane? | show 🗑
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| Which inhaled anesthetics cause vasodilation and increased heart rate? | show 🗑
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| show | Sevoflurane, Enflurane, Haloflurane
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| show | Haloflurane
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| Which inhaled anesthetic causes tonic/clonic muscle spasms? | show 🗑
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| Which inhaled anesthetic causes bronchiolar secretions and spasms? | show 🗑
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| show | Haloflurane
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| Which inhaled anesthetic causes malignant hyperthermia? | show 🗑
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| show | Haloflurane
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| show | 1. lowers response to increased PCO2, 2. increase cerebral blood flow, 3. relax uterine smooth muscle
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| show | Thiopental, Midazolam, Propofol, Fentanyl, Ketamine. Rich-as-MIDAs THIO PROPOsed to FEN-yen while on IV special K (ketamine).
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| Which IV anesthetic should be used for induction? Why? | show 🗑
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| Which IV anesthetic should be used for preoperative sedation? Why? | show 🗑
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| Which IV anesthetic should be used for outpatient surgery? Why? | show 🗑
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| Which IV anesthetic is a potent analgesic? | show 🗑
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| show | Ketamine (NMDS receptor antagonist)
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| How is thiopental eliminated from the body? | show 🗑
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| What is the effect of thiopental? | show 🗑
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| show | Depresses respiratory function.
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| How do you reverse the effects of midazolam? | show 🗑
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| Which anesthetic causes dissociative amnesia? | show 🗑
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| Adverse effects of fentanyl | show 🗑
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| What is neurolept anesthesia? | show 🗑
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| show | rapid onset and short-duration, causes amensia, catatonia, and analgesia.
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| show | Occurs with ketmine use - vivid dreams and hallucinations. Can be offset by BZ's.
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| Esters and amides are what kind of anesthetic? How can you tell the difference? | show 🗑
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| show | by plasma and tissue esterases
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| show | liver amidases
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| What is the mechanism of local anesthetics (LA)? | show 🗑
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| show | Increased acidity would protonate the LA's (which are usually weak bases), so they can't cross the lipid bilayer to bind to the inactivated Na channel --> decrease LA activity
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| Which nerve fibers are most sensitive to the actions of local anesthetics? List in order of sensitivity. | show 🗑
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| show | LA absorption into systemic circulation decreases --> prolong LA effects, decreases toxicity.
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| show | Neuro: dizzines, nystagmus, sensory impairment, seizures. CV: CV depression, except for cocaine, which increases HR and BP. Allergies: esters --> PABA --> people are allergic to PABA
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| show | toxin from puffer fish. Binds externally to READY state (M closed, h open) of Na channels in both cardiac and nerve cell membranes --> block Na influx --> no depolarization --> no conduction
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| show | toxin from dinoflagellates in "red tide". Binds externally to READY state (M closed, h open) of Na channels in both cardiac and nerve cell membranes --> block Na influx --> no depolarization --> no conduction
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| show | toxin from exotic fish and Moray eels. Binds in the Na channel in the OPEN state (both M and h are open) --> persistent depolarization --> channel inactivation
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| show | toxin from south American frogs. Binds in the Na channel in the OPEN state (both M and h are open) --> persistent depolarization --> channel inactivation
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