pharm final
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| define general anesthesia | produces unconsciousness and without response to painful stimuli
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| define analgesia | selectively reduces pain without loss of consciousness
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| 3 effects of general anesthesia | loss of pain/all sensations/ consciousness
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| define local anesthesia | does not affect consciousness, only blunts sensation in a limited area
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| 2 major routes of general anesthesia | inhalation; IV
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| what do inhalation anesthetics produce | unconsciousness, analgesia, muscle relaxation, and amnesia
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| mechanisms of aciton of inhalation anesthetics | molecular lipid solubility; depression of transmission at inhibitory synapses
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| MAc | minimum alveolar concentration
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| what is an index of inhalation anesthetic potency | minimum alveolar concentration
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| what represents the minimum concenration of drug in alveolar air that will produce immobility when exposed to painful stimulus | minimum alveolar concentration
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| Low minimum alveolar concentration indicates... | high anesthetic potency
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| effect of uptake with greater concentration of inhalation anesthetic in the air | more rapid uptake
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| What organs are affected first by inhalation anesthetics | vital organs - heart, brain, kidney, liver
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| What organs are affected second by inhalation anesthetics | skin and skeletal muscle
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| inhalation anesthetics are poorly perfused through what tissues | fat, bone, ligaments, and cartilage
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| How are inhalation anesthtics eliminated | almost exclusively by respiratory system; minimal if any liver metabolism
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| duration of inhalation anesthetics depends on | rate of elimination
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| adverse effects of inhalation anesthetics | respiratory/cardiac depression; sensitization of heart to catecholamines; malignant hyperthermia; aspiration; hepatotoxicity
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| goal of balanced anesthesia - combinations | induction smooth and rapid; ensure that muscular relaxation is ideal; analgesia level idea
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| 3 common balanced anesthesia combination types | barbiturates; neuromuscular blocking; opioids and nitrous oxide
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| role of barbiturates in combination anesthesia | effect during induction of the general anesthetic agent
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| role of neuromuscular blocking in combination anesthesia | muscular relaxation
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| role of opioids and nitrous oxide in combination anesthesia | analgesia
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| overall advantage of combination anesthesia | use lower doses and safer
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| value of pre-anesthetic drugs | amnesia; reduce anxiety; reduce pre and post op pain
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| pre-anesthetic drugs are used to... | suppress salivation and bronchial secretions, cough
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| what side effects do pre-anesthetic drugs minimize | bradycardia and vomiting
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| 4 examples of pre-anesthetic drugs | benzodiazepines; opioids; alpha-adrenergic agonists; anticholinergic drugs
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| role of short acting benzodiazepines | reduce anxiety and promote anesthesia
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| role of opioids in preanesthetic drugs | reduces pain; suppress cough; delays awakening; depresses CNS
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| opioids given as preanesthetic drugs | morphine and fentanyl
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| 2 alpha-adrenergic agonists used as preanesthetic drugs | clonidine; dexmedetomidine (Precedex)
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| role of clonidine in preanesthetic drugs | reduce hypertension; pain reduction; reduces anxiety; sedation
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| role of dexmedetomidine (Precedex) in preanesthetic drugs | sedation and analgesia
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| anticholinergic drug given as preanesthetic drug | atropine
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| role of anticholinergic drug in preanesthetic drugs | reduces bronchial secretions; reduces risk of bradycardia; older agent; causes respiratory irritation
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| what kind of drug is succinylocholine | neuromuscular blocking agent
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| action of succinylcholine | prevents skeletal muscle, diaphragm; and other respiratory muscle contraction
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| adverse effects of succinylcholine | produce state of total paralysis and patient can be fully awake
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| 3 postanesthetic drugs categories | analgesics; antiemetics; muscle agonists
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| role of muscle agonists as postanesthetic drug | relieve abdominal distention and urinary retention
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| 2 types of inhalation anesthetics | volatile liquids; gases
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| potency of volatile liquid | low minimal aveolar concentration = high potency
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| analgesic effect of volatile liquids | weak and thus given with potent analgesics
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| muscle relaxation effect of volatile liquids | weak
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| adverse effects of Halothane (Fluothane) | hypotension, decreased CO, respiratory depression, dysrhythmias, malignant hyperthermia, hepatotoxicity; post op n/v
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| elimination of volatile liquids | lungs
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| halothane (Fluothane) | volatile liquid
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| major difference between halothane (Fluothane) and isoflurane (Forane) | isoflurane does not cause myocardial depression
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| isoflurane (Forane) | volatile liquid
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| nitrous oxide | gas
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| potency of nitrous oxide | low; high MAC
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| serious side effects of nitrous oxide | none
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| ether (Ethylene) | gas
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| Why was ether (Ethylene) replaced by better drugs | explosive and no advantages over other medications
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| IV anesthetics used with inhalation drugs to: | support decreased dose of the inhalant needed; get better anesthesia results
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| drug category give before the inhalation gas/liquid | short acting barbiturates (Thiobarbiturates)
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| Why are short acting barbiturates used before inhalation gas/liquid | acts rapidly; produces unconsciousness in 10-20 seconds; short acting = would awaken in 10 minutes if used alone
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| short acting barbiturates are weak... | analgesia and muscle relaxant
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| adverse effects of short acting barbiturates | cardiac and respiratory depression
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| benzodiazepines promote | unconsciousness and amnesia
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| diazepam | benzo
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| lorazepam | benzo
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| midasolam | benzo
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| How long for diazepam (Valium) to produce unconsciousness | 1 minutes
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| benzo used for conscious sedation | midazolam (Versed)
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| how should midazolam (versed)be injected | slowly over 2 minutes to prevent CV and respiratory depression
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| propofol (diprivan) | IV sedation/ hypnotic
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| What type of procedures is propofol used for | non-invasive
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| onset and duration of porpofol (diprivan) | 60 seconds and lasts for 3-5 minutes
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| actions of ketamine (ketalar) | dissociative anesthesia; sedation; immobility; analgesia; amnesia
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| onset of ketamine (ketalar) | rapid onset and lasts for 10-15 minutes
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| adverse effects of ketamine (ketalar) | psychologic reactions
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